增益牵正散治疗周围性面瘫

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　　【摘要】周围性面瘫,即西医面神经炎,表现为一侧面部麻木(偶有双侧),鼻唇沟变浅,不能做皱媚、露齿及鼓腮等动作,口角歪斜,漱口漏水,眼裂不能闭合或闭合不全,但无半身不遂及神志不清等症状。
　　【关键词】增益牵正;治疗;周围性面瘫
　　The gain pulls is dispersing periphery the treatment the facial paralysis
　　Wang Haizhen
　　【Abstract】The surroundings facial paralysis, namely the doctor practicing western medicine facial nerve inflammation, displays numbly for one side face (occasionally has two-sided), the nose palpal gutter shoal, cannot make the wrinkle to flatter, movements and so on dew tooth and drum cheek, the argument is crooked, rinses mouth the water leakage, the eye crack cannot close or closed not entire, but not is paralyzed and unconscious and so on symptoms.
　　【Key words】The gain pulls positively; Treatment; Surroundings facial paralysis
　　【中图分类号】R573【文献标识码】B【文章编号】1002-574X(2010)09-0108-01
　　周围性面瘫,即西医面神经炎,表现为一侧面部麻木(偶有双侧),鼻唇沟变浅,不能做皱媚、露齿及鼓腮等动作,口角歪斜,漱口漏水,眼裂不能闭合或闭合不全,但无半身不遂及神志不清等症状。笔者以牵正散为基础进行加减治疗,组成 “增益牵正散”,方药组成为:全蝎、僵蚕各50g,白附子60g,地龙、当归各45g,川芎35g,黄芪100g,防风35g。用法为:上方共研细末,用黄洒热饮,每次10g,每日2次,儿童用量酌减。伴体虚明显者,将黄芪增至200g;血压高者,加天麻20g,钩藤30g。
　　体会:周围性面瘫为常见多发病,男女老幼均可见,春秋发病率较高。中医认为,此病多因脉络空虚,外感风邪,风痰阻于头面经络,经隧不利,筋肉失养而致。方中以白附子、僵蚕祛风化痰通络,且白附子长于治头面之风;以全蝎、地龙搜风舒筋活络;当归补血活血;川芎祛风活血;黄芪益卫固表,且现代药理研究认为黄芪有降低血管通透性、解毒及增强免疫的功能,可以减轻面神经水肿;防风祛除风邪。热酒调服,以宣通血脉,引药入络,直达病所。全方共奏祛风化痰,通经活络之功。若患者就诊及时,按上方量服用6周可痊愈,病程长者,可延长用药时间,并适当配合针灸、理疗等,效果更好。应注意的事项是:用药期间要防止外感,并尽早开始功能训练,只要患侧面肌能动,即应进行自我功能训练,可对着镜子做皱眉、举额、闭眼、鼓腮和吹口哨等动,每日数次,并辅以面部肌肉按摩,这样可以缩短疗程,提高治疗效果。

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