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背景:应用Ca2+通道拮抗剂对周围神经损害保护作用的实验研究较多,但在临床应用中其剂量大小对受损神经保护作用的效果差异尚需探讨。目的:应用不同剂量Ca2+通道拮抗剂氟桂利嗪治疗面神经麻痹(简称面瘫),观察治疗1个月后电生理学量化评估结果。设计:随机分组,空白对照,随访1个月。单位:南京医科大学第一附属医院神经科。对象:1999-11/2001-05南京医科大学第一附属医院神经内科门诊面瘫患者35例,男19例,女16例,年龄16～58岁,病程≤3d,未经过任何治疗且瘫痪均为完全性。采用随机抽样方法将初诊患者分为对照组12例、治疗Ⅰ组10例,治疗Ⅱ组13例。方法:对照组采用基础治疗,强的松1mg/(kg·d),1次/d,晨服,最大剂量≤60mg/d,每隔5d减半量,1个疗程15d,甲钴胺口服500μg,3次/d。呋喃硫胺口服25mg,3次/d。超短波理疗,1次/d,治疗15d。共治疗1个疗程。治疗Ⅰ组和治疗Ⅱ组在此基础上进行Ca2+通道拮抗剂治疗:治疗Ⅰ组:氟桂利嗪5mg,1次/晚,治疗Ⅱ组:氟桂利嗪10mg,1次/晚。治疗前及治疗后1个月分别检测各组患者的Blink反射潜伏期及波幅的变化。主要观察指标:各组患者治疗1个月后Blink反射潜伏期和波幅。结果:按意向处理分析,35例患者均进入结果分析。①治疗前3组患者Blink反射均呈现面瘫侧传出型阻断,R1,R2均消失。②治疗
BACKGROUND: There are many experimental studies on the protective effect of Ca2 + channel antagonists on peripheral nerve damage. However, the difference in the effect of dosage on the neuroprotective effect in clinical application remains to be explored. OBJECTIVE: To apply different dosage of flunarizine antagonist flunarizine to treat facial paralysis (facial paralysis), and to observe the result of electrophysiological quantification after one month of treatment. Design: randomized, blank control, followed up for 1 month. SETTING: Department of Neurology, First Affiliated Hospital of Nanjing Medical University. PARTICIPANTS: From November 1999 to May 2001, 35 patients with facial paralysis in Department of Neurology, First Affiliated Hospital of Nanjing Medical University were enrolled in this study. There were 19 males and 16 females, aged from 16 to 58 years. The course of disease was less than or equal to 3 days. All cases were paralyzed without any treatment Completeness. The newly diagnosed patients were divided into control group (n = 12), treatment group (n = 10) and treatment group (n = 13). Methods: The control group was treated with prednisone 1mg / (kg · d), once a day, morning service, maximum dose ≤60mg / d, 500μg, 3 times / d. Furan thiamine oral 25mg, 3 times / d. Ultrashort wave therapy, 1 time / d, treatment 15d. A total of 1 course of treatment. Group Ⅰ and group Ⅱ were treated with Ca2 + channel antagonists: group Ⅰ: flunarizine 5 mg once daily, group Ⅱ flunarizine 10 mg once daily. Before treatment and 1 month after treatment, the changes of Blink reflex latency and amplitude of each group were detected. MAIN OUTCOME MEASURES: Blink reflex latency and amplitude after 1 month of treatment in each group. Results: According to intention-to-treat analysis, 35 patients entered the result analysis. ① Blink reflex in the three groups before treatment showed an outward blocking on the facial paralysis side, R1, R2 disappeared. ② treatment