Valacyclovir and prednisolone treatment for Bell's palsy: A multicenter, randomized, placebo-controlled study

被引:180
作者
Hato, Naohito
Yamada, Hiroyuki
Kohno, Hisashi
Matsumoto, Shuichi
Honda, Nobumitsu
Gyo, Kiyofumi
Fukuda, Satoshi
Furuta, Yasushi
Ohtani, Fumio
Aizawa, Hiroshi
Aoyagi, Masaru
Inamura, Hiroo
Nakashima, Tsutomu
Nakata, Seiichi
Murakami, Shingo
Kiguchi, Jun
Yamano, Koji
Takeda, Taizo
Hamada, Masashi
Yamakawa, Kazuhiro
机构
[1] Ehime Univ, Sch Med, Dept Otolaryngol, Toon, Ehime 7910295, Japan
[2] Hokkaido Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sapporo, Hokkaido 060, Japan
[3] Yamagata Univ, Sch Med, Dept Otolaryngol, Yamagata 990, Japan
[4] Nagoya Univ, Sch Med, Dept Otolaryngol, Nagoya, Aichi 464, Japan
[5] Nagoya City Univ Hosp, Dept Otolaryngol, Nagoya, Aichi, Japan
[6] Kochi Med Sch, Dept Otolaryngol, Kochi, Japan
关键词
Bell's palsy; Zoster sine herpete; valacyclovir; prednisolone; RCT;
D O I
10.1097/01.mao.0000265190.29969.12
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To investigate the effects of valacyclovir and prednisolone in comparison with those of placebo and prednisolone for the treatment of Bell's palsy, excluding zoster sine herpete. Study Design: Prospective, multicenter, randomized placebo-controlled study. Setting: Six academic tertiary referral centers. Patients: Ultimately, 221 patients with Bell's palsy who were treated within 7 days of the onset. Serological and polymerase chain reaction examinations were performed to distinguish Bell's palsy from zoster sine herpete. Intervention: The patients were treated with either valacyclovir (dosage, 1,000 mg/d for 5 days) plus prednisolone (VP [n = 114]) or placebo plus prednisolone (PP [n = 107]) administered orally. Main Outcome Measure: Recovery from the palsy was defined as a score higher than 36 using Yanagihara 40-point scoring system without facial contracture or synkinesis. The patients were followed up until complete recovery occurred or for more than 6 months in cases with a poor prognosis. Results: The overall rate of patient recovery among those treated with VP (96.5%) was significantly better (p < 0.05) than the rate among those treated with PP (89.7%). The rate of patient recovery was also analyzed by classifying the initial severity of facial palsy. In cases of complete or severe palsy, the rates of patients treated with VP and PP who recovered were 95.7% (n = 92) and 86.6% (n = 82), respectively; the recovery rate for treatment with VP was significantly better than that with PP (p < 0.05). Conclusion: The valacyclovir and prednisolone therapy was more effective in treating Bell's palsy, excluding zoster sine herpete, than the conventional prednisolone therapy. To our knowledge, this is the first controlled study of an antiviral agent in the treatment of a sufficient number of Bell's palsy cases based on an etiologic background.
引用
收藏
页码:408 / 413
页数:6
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