中西医结合治疗气滞血瘀型神经性耳鸣的临床观察

发布时间：2018-04-27 01:01

本文选题：神经性耳鸣 + 耳穴压豆　；参考：《福建中医药大学》2016年硕士论文

【摘要】：目的：通过对通窍活血汤合通气散(《医林改错》)、耳穴压豆(内耳、外耳、肾、肝)联合氟桂利嗪胶囊、甲钴胺片治疗气滞血瘀型神经性耳鸣临床疗效的观察,探讨通窍活血汤合通气散、耳穴压豆治疗气滞血瘀型神经性耳鸣的临床疗效,为神经性耳鸣的治疗提供一种思维,丰富临床治疗方法。方法：将符合纳入标准的气滞血瘀型神经性耳鸣患者60例,按随机对照原则分为治疗组与对照组。其中治疗组30例41耳,采用通窍活血汤合通气散加减、耳穴压豆联合氟桂利嗪胶囊、甲钴胺片治疗；对照组30例38耳,采用口服氟桂利嗪胶囊、甲钴胺片治疗。治疗1疗程,4周为1疗程。按照制定的疗效评定标准,对治疗1周后、治疗2周后、治疗1个月后、停药后1个月随访的临床疗效进行观察。结果：1.治疗1周后,治疗组总有效率为58.53%,对照组总有效率为39.47%,两组疗效比较,P=0.0760.05,差异无统计学意义。2.治疗2周后,治疗组总有效率为73.17%，,对照组总有效率为52.63%,两组疗效比较,P=0.0450.05,差异有统计学意义,说明治疗组疗效优于对照组。3.治疗1个月后,治疗组总有效率为78.04%,对照组总有效率为57.89%,两组疗效比较,P＝0.0420.05,差异有统计学意义,说明治疗组疗效优于对照组。4.停药1个月后对患者进行临床随诊,治疗组总有效率为75.60%,对照组总有效率为52.63%,两组疗效比较，，P=0.0160.05,差异有统计学意义,说明治疗组远期疗效优于对照组。5.耳鸣病程与耳鸣疗效比较,差异有统计学意义,说明耳鸣疗效与病程有关。病程在2周内的疗效最佳,其次是病程2周-1月。病程在2周以内的总有效率100%,疗效明显优于其他组。6.听力损失与耳鸣疗效比较,差异有统计学意义,说明耳鸣疗效与听力损失有关。听力正常患者,疗效最好,中重度听力损失患者,疗效最差。结论：1.通窍活血汤合通气散加减、耳穴压豆联合氟桂利嗪胶囊、甲钴胺片对气滞血瘀型神经性耳鸣有较显著的疗效,且无明显不良反应。安全有效,值得推广。2.通窍活血汤合通气散加减、耳穴压豆联合氟桂利嗪胶囊、甲钴胺片治疗气滞血瘀型神经性耳鸣远期疗效更好。
[Abstract]:Objective: to observe the clinical effect of Tongqiao Huoxue decoction and ventilation Powder ("Yilin Correction"), auricular acupoint pressure (inner ear, external ear, kidney, liver) combined with flunarizine capsule and mecobalamin tablet in the treatment of nervous tinnitus with qi stagnation and blood stasis type. To explore the clinical effect of Tongqiao Huoxue decoction and ventilation Powder and auricular acupoint pressing beans in the treatment of nervous tinnitus with qi stagnation and blood stasis type, and to provide a kind of thinking for the treatment of neurotic tinnitus and enrich the clinical treatment methods. Methods: sixty patients with tinnitus of Qi stagnation and blood stasis type were divided into treatment group and control group according to the principle of random control. The treatment group (30 cases, 41 ears) was treated with Tongqiao Huoxue decoction combined with ventilation powder, auricular acupoint pressing bean combined with flunarizine capsule and methylcobalamin tablet, while the control group of 30 cases (38 ears) was treated by oral flunarizine capsule and metcoamin tablet. One course of treatment for 4 weeks was a course of treatment. According to the established evaluation criteria, the clinical efficacy was observed after 1 week, 2 weeks, 1 month and 1 month after the treatment. The result is 1: 1. After one week of treatment, the total effective rate was 58.53 in the treatment group and 39.47 in the control group. After 2 weeks of treatment, the total effective rate of the treatment group was 73.17g and the total effective rate of the control group was 52.63.The difference between the two groups was statistically significant, indicating that the curative effect of the treatment group was better than that of the control group. After one month of treatment, the total effective rate of the treatment group was 78.04, and the total effective rate of the control group was 57.89.The difference between the two groups was statistically significant, indicating that the curative effect of the treatment group was better than that of the control group. The total effective rate of the treatment group was 75.600.The total effective rate of the control group was 52.63B. the difference between the two groups was statistically significant, indicating that the long-term curative effect of the treatment group was better than that of the control group. The difference between the course of tinnitus and the curative effect of tinnitus was statistically significant, indicating that the curative effect of tinnitus was related to the course of disease. The course of disease was the best within 2 weeks, followed by 2 weeks-1 month course of disease. The total effective rate of the disease course within 2 weeks was 100 and the curative effect was obviously superior to that of the other group. 6. The difference between hearing loss and tinnitus was statistically significant, indicating that tinnitus was related to hearing loss. The patients with normal hearing had the best curative effect and the patients with moderate and severe hearing loss had the worst curative effect. Conclusion 1. Tongqiao Huoxue decoction plus or minus ventilation powder, auricular acupoint pressing bean combined with flunarizine capsule, metcobalt amine tablet had significant curative effect on nervous tinnitus with Qi stagnation and blood stasis type, and no obvious adverse reaction. Safe and effective, worth popularizing. 2. Tongqiao Huoxue decoction plus or minus ventilation powder, auricular acupoint pressing bean combined with flunarizine capsule, methylcobalamin tablet in the treatment of Qi stagnation and blood stasis type neurotic tinnitus is more effective in the long term.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R764.45

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