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面瘫是什么引起的?面瘫怎么治疗?

发布时间:2016-05-09   问大夫  责任编辑:红豆

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面瘫是一种常发病,发病快,不受时间年龄的限制,在几个小时或者几天内,就可以很严重,面肌达到高峰,严重影响患者的身心健康。中毒、感冒引起的病毒性、外伤都可以引起面瘫,增加对面瘫的认识,才能有效预防和治疗面瘫。下面和小编一起来看看面瘫是什么引起的,面瘫的症状又是如何的,又该如何治疗。

面瘫

颜面肌分表情肌和咀嚼肌两部分,前者由面神经支配,后者由三叉神经运动支支配。此处所叙述面肌瘫痪仅讨论表情肌麻痹,即面神经麻痹的有关内容,面神经麻痹在脑神经疾患中较为多见,依据病因将其分成特发性(Bell)、外伤、感染、肿瘤、神经源性等5种主要类型。特发性面神经麻痹即Bell麻痹,作为单独的疾病详细介绍。其他类型面神经麻痹在此处叙述。

面瘫的症状

1、突然起病,在面瘫出现前几小时可有耳后疼痛。瘫痪局限于一侧面部,程度不等,可在数小时至12天内达高峰。

2、瘫痪侧面部平坦无表情,伴有麻木、沉重感,而且感觉好像面部被扭曲,但实际上感觉仍然正常。当面部上份受累时,常出现受累侧闭目困难。

3、少见的情况下,面瘫可以影响到涎腺、泪腺分泌、味觉等功能。


面瘫是什么引起的?

1、炎症性:可能由潜伏性的分泌性中耳炎所致。在面瘫的治疗过程中,行减压手术时,常发现乳突气房内含有棕黑色粘性液体,与非化脓性中耳炎中的分泌性中耳炎鼓室内分泌物颇相似。

2、血运性:可能由于血运供给紊乱致面神经缺血,一般认为这一学说比较合理,这种面瘫的原因是由于受凉风吹袭引起血管神经机能紊乱,致小动脉痉挛。当面神经发生水肿,因血管被压迫,则缺血更为严重,使面神经的血液供应受到障碍,从而影响神经的传导,支配面肌运动的功能暂失。若面神经血供的侧支循环建立,则面神经的功能可以恢复。

3、病毒性:带状疱疹病毒、腮腺炎病毒、流感病毒和风疹病毒侵入机体后,均易与面神经亲和,使之充血、水肿,影响其功能的传导,亦可能为引发面瘫的原因。

面瘫怎么治疗?

(一)面瘫西医治疗

1、糖皮质激素:糖皮质激素是治疗贝尔面瘫常用的方法,可阻止组织变性,防止面肌抽搐,降低连带运动的发生,防止病情进一步恶化。一般认为轻度麻痹治愈率与给药与否关系不大,而中度以上麻痹则用药能使治愈时间缩短,提高治愈率。神经的Wallerian变性在麻痹症状出现后2周完成,故应在神经变性前早期给药,否则预后不良。

2、抗病毒药物:较多医生认为贝尔面瘫是因面神经受病毒感染导致神经肿胀,由于面神经管内压力增高压迫神经,引起神经缺血,导致面瘫症状。因此用抗病毒药物,药物对多种RNADNA病毒有抑制作用,能阻碍病毒的复制,从而抑制病毒合成,显示抗病毒效力。如利巴韦林每日100200ml,静脉点滴,共57日;无环鸟苷每次200mg,口服,每日5次,共57日,或400mg溶于葡萄糖注射液或生理盐水内静脉滴注,每日1次,共57日;还有病毒唑、干扰素及中药板蓝根等等。


(二)面瘫中医治疗

以针灸治疗,并以手法为主,治疗过程中不加用药物或电针。

法则:祛风通络。

处方:合谷、太冲、牵正、颊车透地仓,地仓透颊车,风池,下关,迎香,承浆或颊承浆。每次选三或四穴。

加减法:眼睑不能下合、露睛流泪者,加攒竹、鱼腰、丝竹空,阳白透鱼腰。耳后痛者,加翳风。味觉减退者,加廉泉。

手法:平补平泻,抽针法。

操作:合谷,太冲,风池针用泻法,下关,牵正,迎香,平刺,采用平补平泻法,阳白向下平刺透鱼腰,地仓向颊车平刺,颊车向地仓斜刺,并采用抽针法,使面肌向后抽动,留针20分钟。余穴均用平补平泻法。

(三)自我按摩治面瘫

本病治疗除根治原发病外,主要疗法为针灸、理疗、按摩、药物等,自我按摩可提高疗效,缩短病程,现将具体操作方法介绍如下:

1、准备,取卧床位者枕好;若坐位者头靠墙壁,患者思想集中排除杂念,按摩前先做热敷或中药煎汤(桂枝9克,防风9克,苏叶9克)浸湿毛巾热敷,谨防药液误入眼内。

2、轮刮眼睑,以两手食指及中指的罗纹面为术端,分别从眼内眦向外均衡刮上下眼睑各50次,然后轻揉眼皮20-30转。

3、指擦鼻翼,以两手食指罗纹面为术端,分别从鼻根两侧向下擦至鼻翼两旁迎相穴50次,在该穴处轻按揉1-2分钟(迎香穴在鼻翼旁开0.5公分),指端按压由轻渐重,可治口角歪斜,鼻塞之症。

4、点捻四白穴,该穴在眶下孔凹陷处,瞳孔直下,以食指为术端捻四白穴,边捻边渐施压力,持续1-2分钟。

5、掌揉颊车,地仓穴,以同侧手之大鱼肌紧贴病侧颊车穴(咀嚼肌),边揉边移至地仓穴(口角旁开0.5公分),往返50次。

面瘫患者在治疗期间,需要多食新鲜蔬菜、粗粮、黄豆制品、大枣、瘦肉等。平时面瘫患者需要减少光源刺激忌辛辣刺激食物。如白酒、大蒜、海鲜、浓茶、麻辣火锅等。遇到寒冷天气时,需要注意头部保暖。


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