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針灸專科難治性面癱26例分析
Analysis and Discussion of 26 Cases of Refractory Facial Paralysis
摘要
目的：討論難治性面癱患者發病及病情等相關資料，分析早期判斷病情和針灸治療時機。方法：採用難治性面癱26例臨床資料，分析發病年齡、就診時機、伴隨症、併發疾病等。結果：26例難治性面癱發病在20歲～49歲年齡段，佔50%；其次是50歲～69歲。大部份的患者在面癱發病1週之內到醫院就診西醫，開始針灸治療則多數在起病1週左右或1週以上，佔84.6%，大多數伴隨有頭頸疼痛、耳後疼痛、聽覺敏感和味覺改變症狀，佔65.38%；同時患有高血壓、糖尿病者或患有其中之一者8例，佔30.76%；無併發病者18例，佔69.23%。結論：該病在中青年患者佔有更大比例，而老年患者所佔比例並不高。就診中醫病例中針灸介入治療時間在起病1週或1週以上。大部份病例除面癱症狀外，還伴隨有頭頸疼痛、耳後疼痛、聽覺敏感、味覺改變症狀，應結合電生理檢查盡早對難治性面癱做出比較準確的診斷和預後判斷。高血壓、糖尿病可能對難治性面癱相關性有限。
並列摘要
Objective. To analyze and discuss the treatment of refractory facial paralysis in terms of initiation time of acupuncture and moxibustion treatment by using relevant patient data. Methods. Clinical data of 26 refractory facial paralysis cases were used. Age of onset, time to treatment initiation, associated symptoms and medical history were analysed. Results. 26 cases with refractory facial paralysis were included in this study. The largest group was those aged 20 - 49 years-old, which accounted for 50 % of all patients. The second largest age group was between 50 - 69. Most of the patients went for western medicine treatment within one week of their onset of facial paralysis. 84.6% of the acupuncture treatment was initiated one week after symptoms onset. 65.38% of associated symptoms were head and neck pain, ear pain, hearing sensitivity and taste sensitivity change. 30.76% of the patient (n=8) had medical history of both hypertension and diabetes. There were 18 cases (69.23 %) without any medicine history. Conclusion. Refractory facial paralysis is more common in the young and middle-aged group than in the old-aged group. Acupuncture intervention was initiated more than one week after symptom onset in the majority of patients. The common associated symptoms were head and neck pain, ear pain, hearing sensitivity, taste sensitivity change. It is suggested to use electrophysiological examination to make a more accurate diagnosis and prognosis of refractory facial paralysis. Hypertension and diabetes have limited association with refractory facial paralysis.