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投稿时间：2022-05-23 网络发布日期：2023-04-20
投稿时间：2022-05-23 网络发布日期：2023-04-20
中文摘要: 目的 探讨在周围性面瘫治疗中，不同浓度罗哌卡因星状神经节阻滞联合腹针疗法的临床疗效。
方法 采取随机数字表法将河北北方学院附属第二医院2019年5月至2021年3月收治的急性期周围性面瘫患者120例分为对照组和观察组,各60例,除去因各种原因中断研究、转院及临床资料缺失者,共111例纳入到最后研究,对照组59例,观察组52例。两组患者均给予相同的药物治疗（阿昔洛韦治疗静脉滴注7d，甲钴胺片口服21d）和腹针疗法治疗（1次/d，7d/疗程，连续3个疗程）；在此基础上，对照组和观察组分别给予0.15%和0.25%浓度罗哌卡因星状神经节阻滞（1次/d，左右交替，7d为1个疗程，休息7d后再进行第2个疗程）。对比两组临床疗效,罗哌卡因作用维持时间,治疗前、治疗7d、治疗21d的面神经功能评分及不良反应。
结果 在星状神经节阻滞2个疗程后评价，与对照组相比,观察组临床疗效较高,罗哌卡因作用维持时间较长,差异有统计学意义（P＜0.05）。与对照组比较,观察组治疗7d后和治疗21d后面神经功能评分较高,差异有统计学意义（P＜0.05）。两组不良反应总发生率比较差异无统计学意义（3.39% vs 5.77%，χ2=0.021，P=0.885）。
结论 0.25%浓度罗哌卡因星状神经节阻滞联合腹针疗法治疗面瘫可有效延长罗哌卡因的作用维持时间,有效促进面瘫症状和面神经功能的改善,且治疗期间无明显不良反应,安全性有保障。
Abstract:Objective To explore the clinical efficacy of different concentrations of ropivacaine in stellate ganglion block combined with abdominal acupuncture in the treatment of facial paralysis.
Methods A total of 120 patients with acute peripheral facial paralysis admitted to the Second Affiliated Hospital of Hebei North University from May 2019 to March 2021 were divided into control group and observation group by random number table,with 60 cases in each group.A total of 111 patients were included in the final study, except for those who were interrupted the study, transferred to other hospital and lacked clinical data due to various reasons. There were 59 cases in the control group and 52 cases in the observation group. Patients in both groups were given the same drug treatment (intravenous infusion of acyclovir for 7 days, oral administration of mecobalamin tablets for 21 days) and abdominal acupuncture therapy (once a day, 7 days per course, for 3 consecutive courses); On this basis, the control group and the observation group were given 0.15% and 0.25% ropivacaine for stellate ganglion block, respectively(both once a day, alternating left and right, 7 days as a course of treatment, and then the second course of treatment after 7 days rest). The clinical efficacy, the duration of ropivacaine effect, the facial nerve function score and adverse reactions before treatment, 7 d and 21 d after treatment were compared between two groups.
Results After two courses of stellate ganglion block treatment, compared with the control group, the observation group had higher clinical efficacy and longer duration of ropivacaine action, with a statistically significant difference（P＜0.05）. Compared with the control group, the neurological function scores of the observation group was higher after 7 d and 21 d of treatment（P＜0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups（3.39% vs 5.77%， χ2=0.021， P=0.885）.
Conclusion The treatment of faical paralysis with 0.25% concentration of ropivacaine in stellate ganglion block can effectively prolong the action time of ropivacaine, effectively promote the improvement of facial paralysis symptoms and facial nerve function. There is no obvious adverse reaction during the treatment, and the safety is guaranteed.
keywords: Ropivacaine Stellate ganglion block Abdominal acupuncture therapy Facial paralysis Efficacy Adverse reactions
文章编号： 中图分类号：R246.6 R614.3 文献标志码：B
基金项目:河北省中医药管理局科研计划项目（2022424）
| 作者 | 单位 |
| 刘敏肖1 | 1. 河北北方学院附属第二医院神经内科,河北 张家口 075100 |
| 李鑫2 | 2. 河北北方学院附属第二医院针灸科,河北 张家口 075100 |
| 肖志娟1 | 1. 河北北方学院附属第二医院神经内科,河北 张家口 075100 |
| 王刚3 | 3. 河北北方学院附属第一医院神经内科,河北 张家口 075000 |
| 苏心镜4 | 4. 河北北方学院附属第二医院麻醉科,河北 张家口 075100 |
| Author Name | Affiliation |
| LIU Minxiao*, LI Xin, XIAO Zhijuan, WANG Gang, SU Xinjing | *Department of Neurology, The Second Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075100, China |
引用文本：
刘敏肖,李鑫,肖志娟,等.不同浓度罗哌卡因星状神经节阻滞联合腹针疗法治疗面瘫的疗效[J].中国临床研究,2023,36(4):581-585.
刘敏肖,李鑫,肖志娟,等.不同浓度罗哌卡因星状神经节阻滞联合腹针疗法治疗面瘫的疗效[J].中国临床研究,2023,36(4):581-585.