Study On The Distribution Of TCM Syndromes Of Idiopathic Facial Paralysis And The Correlation Between The Degree Of Nerve Injury And Prognosis

Objective:Through investigation and statistics on the degree of facial nerve damage,TCM syndrome differentiation and prognosis of patients with idiopathic facial nerve palsy,the distribution of TCM syndrome types of idiopathic facial nerve palsy is analyzed,and the correlation between the degree of facial nerve damage and its prognosis is explored.Provide a scientific basis for evaluating the prognosis of patients.Methods:A total of 142 inpatients with idiopathic facial nerve paralysis who met the inclusion criteria from the Department of Neurology,Acupuncture and Rehabilitation Department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from November 2018 to January 2020 were included.Gender,age,liver and kidney function,second stool routine,electrocardiogram,TCM syndromes,and House-Brackmann grading score and modified Portmann score after treatment),and statistical analysis was performed using SPASS 25.0.Results: 1.Of the 142 patients with idiopathic facial paralysis,64 were male(45.1%)and 78 were woman(54.9%).The male to female ratio was 1: 1.21,and the chi-square test P >0.05,and there was no difference in the distribution of the sex Statistical significance.The age range of the included patients was 16-75 years,with an average age of 46.68±16.89 years.There were 66 young patients,34 middle-aged patients,and 42 elderly patients.The chi-square test had P <0.01,and there were differences in the distribution of the disease.Statistical significance,with the highest incidence among young people.Gender differences in different age groups in the distribution of the disease,Chi-square test P>0.05,no statistical significance.2.Among the 142 patients with idiopathic facial nerve palsy,84 patients with mild facial nerve injury,55 patients with moderate injury,and 3 patients with severe injury.distribution of facial nerve damage in different age groups was different.After a pairwise comparison,the difference in the distribution of facial nerve injury between the young group and the elderly group was statistically significant.The young patients were dominated by mild facial nerve injury;the young group and the middle-aged group,the middle-aged group and the elderly group The difference in damage distribution was not statistically significant.By chi-square test,P<0.05,the difference in the distribution of facial nerve damage in different age groups is statistically significant.Young and middle-aged patients are mainly mild facial nerve injury,and the number of young patients in mild facial nerve injury is young most.3.Among the 142 patients with idiopathic facial paralysis,55cases(38.7%)of wind-cold attack syndrome,17 cases(12.0%)of wind-heat attack syndrome,65 cases(45.8%)of wind-phlegm obstruction syndrome,Qi deficiency and blood stasis There were 5 cases(3.5%)of syndromes,with goodness-of-fit chi-square test,P<0.001.The TCM syndrome types of patients were statistically significant in the distribution of the disease,of which the wind phlegm obstruction syndrome and the wind cold attack syndrome were the main.The distribution of TCM syndromes of patients with idiopathic facial nerve palsy of different genders and ages has no statistical significance.By non-parametric rank sum test,P <0.05,patients with idiopathic facial nerve palsy with different degrees of facial muscle damage have statistically significant differences in the distribution of TCM syndromes.Compared with each other,the distribution of TCM syndromes in the mild and moderate facial nerve injury groups was significantly different.The patients with mild facial nerve injury were mainly wind-phlegm obstruction syndrome,followed by the wind-cold attack syndrome;the patients with moderate facial nerve injury were wind-cold attack Based on the network card.4.Among the 142 patients with idiopathic facial nerve palsy,the prognosis of patients with idiopathic facial nerve palsy was evaluated according to the HB score standard,of which 72 patients were cured(50.7%),55 patients were markedly effective(38.9%),14 patients were effective,and ineffective patients 1 case.According to the modified Portmann score,72 of the 142 patients were cured,56 were markedly effective,13 were improved,and 1 was ineffective.After Kapp--a consistency test,Z=14.837,P<0.001,modified Portmann score The criteria and the HB scoring criteria are consistent in evaluating the prognosis of idiopathic facial paralysis.Kappa=0.998,the two are very consistent.Chi-square test,P<0.05,the difference in the distribution of prognosis of patients with idiopathic facial nerve palsy is statistically significant,the vast majority of patients with all or obvious recovery of symptoms,only a reduction in some patients will leave serious sequelae.5.The difference in the prognosis distribution of patients with idiopathic facial nerve palsy with different degrees of facial nerve damage showed that:P<0.001,the difference was statistically significant,after the rank count test,χ 2 =39.624,P<0.001,two by two The comparison results show that the prognosis of patients with mild facial nerve injury is better than that of patients with moderate and severe facial nerve injury;there is no difference in the distribution of prognosis between patients with moderate and severe facial nerve injury.Among them,the recovery rate of patients with mild injury was 69.05% and the apparent efficiency was 30.95%;the recovery rate of patients with moderate facial nerve injury was 25.45% and the apparent efficiency was 52.73%;the effective rate of patients with severe facial nerve injury was 66.67% and the inefficiency was 33.3%.The age,degree of facial muscle injury,and TCM syndrome types of the disease were analyzed by multi-class Logit analysis.Age and degree of facial nerve injury were positively correlated with the prognosis of patients,and had no correlation with the distribution of TCM syndrome types.After multi-class logistic regression analysis,P<0.05,age was positively correlated with the prognosis(cure rate,apparent efficiency,effective rate)of patients with idiopathic facial nerve palsy.The younger the age,the better the prognosis;the degree of facial muscle injury and idiopathic The prognosis(healing rate,efficiency)of patients with facial nerve palsy is positively correlated.The lighter the facial nerve injury,the higher the recovery rate.Conclusion: 1.Idiopathic facial paralysis is mostly in young patients,and there is no difference in distribution between men and women.In patients with idiopathic paralysis,the degree of facial nerve injury is mainly mild to moderate facial nerve injury.There is no difference in the distribution of gender,age,and location of facial nerve injury in the degree of facial nerve injury.2.In patients with idiopathic paralysis,facial nerve injury is mainly mild to moderate facial nerve injury,and mild facial nerve injury is predominantly young;gender,left or right facial nerve injury,buccal branch or temporal branch facial nerve injury are not distributed in the degree of facial nerve injury difference.3.Patients with idiopathic facial nerve palsy mainly have wind-phlegm collateral syndrome and wind-cold attack syndrome,followed by wind-heat attack collateral syndrome,and there is no difference in the distribution of gender and age in TCM syndrome types of the disease.Patients with mild facial nerve injury are mainly due to wind-phlegm obstruction syndrome,followed by wind-cold attack syndrome;patients with moderate facial nerve injury are mainly due to wind-cold attack syndrome.4.The majority of patients with idiopathic facial nerve palsy have a better prognosis,and those with mild facial nerve injury have the best prognosis.Age and the degree of facial nerve injury are positively correlated with the prognosis of idiopathic facial nerve palsy.The correlation is:age>degree of facial nerve injury.The younger the age,the better the prognosis.