Department of Endocrinology, the Second Hospital of Jilin University, Changchun, Jilin, China.
Research Center, the Second Hospital of Jilin University, Changchun, Jilin, China.
Pain Physician. 2018 Nov;21(6):559-569.
Facial paralysis is the most common cranial nerve injury. Bell's palsy is the name commonly used to describe an acute peripheral facial paralysis of unknown origin. The annual incidence of Bell's palsy is 20-30 cases per 100,000 persons, regardless of age and gender.
Our objective was to appraise the efficacy of steroid and antiviral treatments for facial paralysis.
We conducted a network meta-analysis of studies of steroid and antiviral treatments for facial paralysis.
Second Hospital of Jilin University.
We performed a systematic search of PubMed and Embase databases to retrieve relevant studies. The efficacy outcome was overall recovery, measured in terms of the odds ratio (OR) and a corresponding 95% confidence interval (CI). The comprehensive ranking for each treatment with respect to overall recovery is presented as the value of the surface under the cumulative ranking curve (SUCRA).
A total of 23 articles representing 4,623 patients were eligible for our study. In terms of overall recovery, no significant differences were found in the pairwise meta-analysis. From the results of the network meta-analysis, antiviral combined with steroid treatment was superior to placebo treatment (OR = 3.25; 95% CI, 1.23-8.61), but neither steroid nor antiviral therapy alone resulted in significant benefit compared with placebo. According to the SUCRA, antiviral combined with steroid treatment was the most effective, with a SUCRA value of 0.96, and the probability of ranking first was 90%. Only a small difference was observed between the efficacies of steroid and antiviral treatments (SUCRA values of 0.55 and 0.36, respectively), and they were both better than the placebo (SUCRA value of 0.134).
The major limitation of our study is that, due to the limited number of related studies in the last several years, we were not able to evaluate the safety of these therapies.
Antiviral combined with steroid therapy is significantly better than antiviral or steroid therapy alone with respect to overall recovery, and the efficacies of single antiviral medications or single steroid treatments are nearly equal. In addition, all 3 therapies are more effective than placebo, according to the SUCRA values.
Facial paralysis, Bell´s palsy, steroids, antiviral drugs, efficacy, overall recovery, network meta-analysis, SUCRA.
面瘫是最常见的颅神经损伤。贝尔氏面瘫是一种常见的名称，用于描述一种不明原因的急性周围性面瘫。贝尔氏面瘫的年发病率为每 10 万人 20-30 例，不分年龄和性别。
我们旨在评估类固醇和抗病毒药物治疗面瘫的疗效。
我们对类固醇和抗病毒药物治疗面瘫的研究进行了网络荟萃分析。
吉林大学第二医院。
我们对 PubMed 和 Embase 数据库进行了系统检索，以检索相关研究。疗效结果是整体恢复，用优势比（OR）和相应的 95%置信区间（CI）表示。综合排名是每个治疗方法在整体恢复方面的排名，以累积排序曲线下面积（SUCRA）表示。
共有 23 篇文章代表 4623 名患者符合我们的研究标准。在整体恢复方面，两两荟萃分析没有发现显著差异。从网络荟萃分析的结果来看，抗病毒联合类固醇治疗优于安慰剂治疗（OR=3.25；95%CI，1.23-8.61），但类固醇和抗病毒治疗单独与安慰剂相比均无显著益处。根据 SUCRA，抗病毒联合类固醇治疗最有效，SUCRA 值为 0.96，排名第一的概率为 90%。类固醇和抗病毒治疗的疗效仅略有差异（SUCRA 值分别为 0.55 和 0.36），且均优于安慰剂（SUCRA 值为 0.134）。
我们研究的主要局限性是，由于近年来相关研究数量有限，我们无法评估这些疗法的安全性。
抗病毒联合类固醇治疗在整体恢复方面明显优于抗病毒或类固醇单独治疗，而单一抗病毒药物或单一类固醇治疗的疗效几乎相等。此外，根据 SUCRA 值，所有 3 种疗法均优于安慰剂。
面瘫，贝尔氏面瘫，类固醇，抗病毒药物，疗效，整体恢复，网络荟萃分析，SUCRA。
