Bell's palsy - Combined treatment of famciclovir and prednisone is superior to prednisone alone
Bell's palsy - Combined treatment of famciclovir and prednisone is superior to prednisone alone
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DOI：
10.1007/s00415-008-0008-6
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发表时间：
2008-11-01
影响因子：
6
通讯作者：
Wuellner, Ullrich
中科院分区：
文献类型：
--
作者：
Minnerop, Martina;Herbst, Martin;Wuellner, Ullrich
关于贝尔麻痹（BP）的抗病毒治疗的疗效没有足够的证据。因此，我们比较了泼尼松和泛昔洛韦单独泼尼松治疗BP的疗效。共纳入167例未经治疗的急性BP患者。使用House-Brackmann量表（HBS）评估BP的严重程度，并进行病毒抗体检测（单纯疱疹病毒、水痘带状疱疹病毒）。双日入院的患者用泼尼松治疗（P组），奇数日入院的患者用泼尼松和泛昔洛韦治疗（P+F组）。117例患者在3个月或之后完成随访（67例P/51例P+F）。虽然大多数患者在两种治疗类型下均显示至少部分恢复，但HBS至少4级改善在“P+F组”中更常见（29.4% vs. 11.9%），而小于3级的较小变化在“P组”中更常见（29.9% vs. 17.6%;卡方检验，p = 0.02）。完全BP患者（HBS 5或6级）如果额外接受泛昔洛韦治疗，而不是单独接受泼尼松治疗，则达到正常功能的机会明显更好（73.7% vs. 47.1%; Cochran-Armitage趋势检验，p = 0.03）。这些结果表明，泛昔洛韦和泼尼松龙的联合治疗，应考虑（至少）在严重的BP患者。
There is insufficient evidence concerning the efficacy of antiviral treatment of Bell's palsy (BP). We therefore compared the efficacy of prednisone and famciclovir to prednisone treatment alone in BP. A total of 167 consecutive patients with untreated acute BP were included. Severity of BP was evaluated using the House-Brackmann scale (HBS) and virus antibody tests (herpes simplex virus, varicella zoster virus) were performed. Patients admitted on even dates were treated with prednisone ("P group") and patients admitted on odd dates were treated with prednisone and famciclovir ("P+F group"). 117 patients completed the follow-up after 3 months or later (67 P/51 P+F). While most patients showed at least partial recovery with both treatment types, improvement of at least 4 grades in the HBS was more common in the "P+F group" (29.4 % vs. 11.9 %), whereas smaller changes of less than 3 grades were more common in the "P group" (29.9 % vs. 17.6 %; Chi-square test, p = 0.02). Patients with complete BP (HBS grade of 5 or 6) had significantly better chances of reaching normal function if treated with famciclovir additionally instead with prednisone alone (73.7 % vs. 47.1 %; Cochran-Armitage trend test, p = 0.03). These results suggest that the combined treatment of famciclovir and prednisolone should be considered (at least) in patients with severe BP.