背景:贝尔麻痹是一种影响颅神经VII的疾病,导致急性外周单侧面神经无力或病因不明的麻痹。皮质类固醇是主要的治疗选择,因为它们改善了结果。根据最近的一项研究,泼尼松龙在短期和长期都能有效治疗贝尔氏麻痹。本研究旨在评估单剂量静脉注射甲基强的松龙与口服强的松龙治疗贝尔麻痹患者的有效性和安全性。
方法:使用PRISMA声明指南来设计和进行本系统综述。MEDLINE,科克伦图书馆,在我们的搜索中使用了EMBASE数据库。我们在2022年11月进行了数据库搜索。
结果:作为文献综述的结果,对33篇出版物进行了综述。应用我们的标准后,三项研究被纳入荟萃分析。317名贝尔氏麻痹患者被纳入我们的研究。关于在1个月内完全恢复到1级,静脉注射甲基强的松龙高于口服强的松龙;(logOR=0.52,95%CI[0.08,0.97],P=0.022)。然而,3个月时,两组差异无统计学意义。与口服泼尼松龙相比,4级贝尔麻痹患者在1个月内更有可能完全恢复到1级(logOR=0.73,95%CI[0.19,1.26],P=0.008),但不适用于3级或2级贝尔麻痹患者。
结论:这项研究表明,当使用静脉注射甲基强的松龙代替口服强的松龙时,贝尔麻痹患者可以在1个月内完全恢复到1级。3个月时,然而,两种治疗之间没有明显的差异。症状出现后3天内,可以开始静脉注射甲基强的松龙治疗,这可以帮助患者在1个月内完全恢复到1级。然而,与口服泼尼松龙相比,静脉注射甲基泼尼松龙可能并不总是具有长期优势.
BACKGROUND: Bell\'s palsy is a condition affecting cranial nerve VII that results in acute peripheral unilateral facial weakness or paralysis of unclear etiology. Corticosteroids are the primary therapy choice, because they improve outcomes. According to a recent study,
prednisolone effectively treats Bell\'s palsy in the short and long term. This study aimed to assess the effectiveness and safety of Single-Dose Intravenous Methylprednisolone to Oral
Prednisolone in treating Bell\'s palsy patients.
METHODS: PRISMA statement guidelines were used to design and conduct this systemic
review. MEDLINE, Cochrane Library, and EMBASE databases were used in our search. We conducted the database search in November 2022.
RESULTS: Thirty-three publications were reviewed as a result of the literature
review. Three studies were included in the meta-analysis after applying our criteria. 317 Bell\'s palsy patients were included in our study. Regarding complete recovery to grade 1 in 1 month, IV methylprednisolone was higher than oral
prednisolone; (log OR = 0.52, 95% CI [0.08, 0.97], P = 0.022). However, at 3 months, the two groups had no significant difference. Patients with grade 4 Bell\'s palsy were more likely to fully recover to grade 1 in 1 month with IV methylprednisolone than with oral prednisolone (log OR = 0.73, 95% CI [0.19, 1.26], P = 0.008), but not for patients with grade 3 or grade 2 Bell\'s palsy.
CONCLUSIONS: This study shows evidence that patients with Bell\'s palsy can fully recover to grade 1 in 1 month when IV methylprednisolone is used instead of oral prednisolone. At 3 months, however, there was no discernible difference between the two treatments. Within 3 days of the onset of symptoms, IV methylprednisolone treatment can be started, which may help patients recover fully to grade 1 in 1 month. However, administering IV methylprednisolone may not always have long-term advantages compared to oral prednisolone.