针刺疗法对高危儿婴儿期异常BAEP的影响

发布时间：2018-07-01 11:47

  本文选题：高危儿 + 听力障碍　； 参考：《广州中医药大学》2012年硕士论文

【摘要】：研究背景： 近年来随着围生医学的大力发展,新生儿重症监护室的设立以及现代抢救技术的提高,高危儿的生存率大大提高,但这些新生儿常遗留有不同程度的后遗症,其中之一就是听力障碍。有研究表明,高危儿听力障碍的发病率为2.1%,而我国高危儿的发生率较高，，约占新生婴儿的60%,根据我国2009年国民经济和社会发展统计公报数据,我们每年出生1615万新生儿,如果按此数据推算,我国每年将新增二十余万名听力障碍的患儿。听力障碍可直接引起二次障碍,即言语发育障碍及智力发育障碍。故早期识别和治疗,高危儿的听力障碍,可最大程度降低听力损伤所造成的不良后果。脑干听觉诱发电位(BAEP)记录的是听觉传导通路中的神经电位活动.反映耳蜗至脑干相关结构的功能状况。作为听力障碍的一个敏感指标,已被用于婴幼儿听力障碍的诊断和转归。 研究目的： 观察针刺听宫、听会、翳风、晕听区对高危儿婴儿期异常BAEP的影响。 研究方法：本课题采用随机对照研究的试验方法,将脑干听觉诱发电位(BAEP)异常的患儿随机分为针刺治疗组即干预组(32例)和一般治疗组即对照组(31例)。对照组采用常规治疗,干预组在常规治疗基础上加针刺治疗(隔日针刺)(基本穴：晕听区听宫、听会、翳风：实证加双合谷,双太冲；虚证加双三阴交,双太溪),20天/1疗程×3疗程。治疗前后观察脑干听觉诱发电位(BAEP)听阈、各波潜伏期及峰间期的变化。运用统计软件13.0建立数据库并进行统计学分析。 结果： 1.干预组总有效率85.5%,对照组总有效率66.7%,差异有统计学意义(p0.05)。 2.两组患儿治疗后BAEP各指标比较,双耳听阈、Ⅰ波潜伏期、Ⅲ波潜伏期、ⅠⅢ峰间期差异具有统计学意义,Ⅴ波潜伏期、Ⅲ-Ⅴ峰间期、Ⅰ-Ⅴ峰间期差异无统计学意义。 3.两组患儿因核黄疸所导致的听力障碍,治疗前后无变化,听阈均大于102dB,均未见波形分化。 结论： (1)针刺疗法对高危儿的听力障碍具有较好治疗效果,总有效率为85.5%。 (2)针刺疗法对高危儿婴儿期的异常BAEP具有较好的改善作用,在外周障碍型以及病变在脑干下段时明显：对于脑干障碍型,病变在脑干上段,即桥脑与中脑平面,以及整个脑干听觉传导通路受损时改善不明显。 (3)高危因素与BAEP异常的关系：核黄疸所导致的听力障碍,BAEP异常程度最重,疗效最差；其他多高危因素导致的听力障碍,BAEP异常程度较重,治疗后疗效欠佳：单一高危因素导致的听力障碍，BAEP异常程度一般较轻,治疗后疗效较好,甚至完全恢复。
[Abstract]:Background: in recent years, with the development of perinatal medicine, the establishment of neonatal intensive care unit and the improvement of modern rescue technology, the survival rate of high-risk infants has been greatly improved. But these newborns often have varying degrees of sequelae, one of which is hearing impairment. Studies have shown that the incidence of hearing impairment among high-risk children is 2.1, while the incidence of high-risk children in China is relatively high, accounting for about 60% of newborn babies. According to the 2009 National Economic and Social Development Statistics Bulletin of our country, we have 16.15 million newborns born every year. According to this data, China will add more than 200,000 children with hearing impairment each year. Hearing disorders can directly cause secondary disorders, namely speech developmental disorders and intellectual developmental disorders. Therefore, early identification and treatment of high risk children with hearing impairment can minimize the adverse consequences of hearing impairment. Brainstem auditory evoked potential (BAEP) records nerve potential activity in auditory conduction pathway. To reflect the functional status of cochlear to brainstem related structures. As a sensitive indicator of hearing impairment, it has been used in the diagnosis and outcome of hearing impairment in infants. Objective: to observe the effect of acupuncture on abnormal BAEP in infants with high risk infants. Methods: children with abnormal brainstem auditory evoked potential (BAEP) were randomly divided into acupuncture treatment group (32 cases) and general treatment group (31 cases). The control group was treated with routine therapy, the intervention group was treated with acupuncture on the basis of routine treatment (acupuncture every other day) (basic points: hearing area of dizzy hearing area, hearing meeting, Yifeng: positive evidence plus Shuanghegu, Shuangtai Chong, deficiency syndrome plus double Sanyinjiao), Shuang Tai Xi) 20 days / 1 course of treatment 脳 3 courses of treatment. The auditory evoked potential (BAEP) threshold, latency and interpeak period were observed before and after treatment. Statistical software 13.0 was used to establish database and statistical analysis. Results: 1. The total effective rate was 85.5 in the intervention group and 66.7 in the control group, the difference being statistically significant (p0.05). There were significant differences in BAEP indexes between the two groups after treatment. There were significant differences in auditory threshold, latency of wave 鈪

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