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彭明慧中醫師 : 小兒面癱 .....!

6/10/2014

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图片
{東周刊中西匯醫} (連結) 最近,歌手官恩娜表示自己患了顏面神經麻痹症,螢幕前明顯見到她面部出現口眼喎斜的現象,不禁使人對這個疾病多了關注。

顏面神經麻痹症又稱貝爾氏麻痹(Bell's palsy),屬於中醫學的「痹症」範疇,任何人都可能發生顏面神經麻痹,小兒患者亦屢見不鮮。

病徵及成因

人體腦神經共有十六對,顏面神經為十二對腦神經之中的第七對。顏面神經麻痹的主要症狀是嘴歪、眼皮不能閉合、流眼水、味覺障礙、食物在口內有停滯感、喝水會流出來等,並有嘴歪和眼斜的變化。最明顯的症狀是在麻痹的半邊臉部失去了表情動作的能力,額頭和嘴巴旁邊的皺紋也會消失不見;其他的症狀還有:耳朵附近的疼痛、臉麻、口齒不清、失去味覺、流口水及眼瞼合不起來等等。病者因為不能眨眼睛,晚上睡覺時,眼睛也閉不起來,所以常常會因為眼睛乾澀而產生後遺症。(註:臉上歪斜的一側是健側,沒有歪斜的一側是病側;因為病側的神經麻痹乏力,所以顏面肌肉被抽扯到健側。)
麻痹的確切原因迄今尚未完全明確,大部分可能是由病毒所引起,或常常因為吹到冷風或是感冒而突然發生。中醫學認為,痹症的成因乃為「風寒濕」或「風濕熱」集之而為痹;總結而言,成因皆離不開「風」。求診者中曾見一位約五歲小朋友在感冒初癒後進行跑步鍛煉,由於其抵抗力尚未完全恢復,結果因防禦力不足而被風邪侵襲,在第二天睡醒時明顯地出現嘴部側歪的情況。
治療及預防

如有上述病徵,必需把握黃金治療期,特別以七十二小時內接受治療效果最佳,愈早治療,效果愈明顯。如果錯過了黃金治療期,將可能造成一輩子臉部癱瘓、嘴角歪斜的遺憾。

中醫治療以內服和針刺法為主要方向,其中以著名代表方劑「牽正散」(選藥:製附子、白僵蠶、全蝎)為首選,但用量和服法必須諮詢中醫師。針刺治療選穴為合谷穴、地倉穴、頰車穴、風池穴等,七天為一個療程。父母們可以為小朋友多揉按合谷穴(位於手背虎口處,於第一掌骨與第二掌骨間凹陷處)。中醫經絡學說中有一口訣:「面口合谷收」,可見合谷穴是治療顏面神經麻痹症的一個必要穴位。

此外,閃罐治療亦是能夠加速恢復拉正面容的中醫治療手法,用拔火罐的方法,罐子在病側拔上後,立即起下,反復吸拔多次,至皮膚潮紅為止;以七天為一個療程,配合針灸一同進行,效果理想。

顏面神經麻痹症沒有很直接的方式可預防,但保持正常生活作息、不熬夜、不暴飲暴食、攝取均衡營養是基本要求。日常避免吹風,慎防感冒,多進行規律運動,可以讓我們身體保持最佳狀態,提升免疫功能。



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