针刺治疗气滞血瘀型突发性耳聋的临床疗效观察

发布时间：2018-01-05 18:27

本文关键词：针刺治疗气滞血瘀型突发性耳聋的临床疗效观察　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察针刺治疗气滞血瘀型突发性耳聋的临床疗效。方法1、选取2015年2月至2017年1月期间,就诊于我院针灸科和耳鼻喉科的符合研究标准的气滞血瘀型突发性耳聋患者60例,通过查随机数字表将60例病例分为针刺组和西药组,每组各30例。2、针刺组采用毫针针刺,取主穴:率谷透曲鬓、耳门、听会、翳风(皆患侧),配穴:血海、足窍阴、太冲(皆双侧),一日一次。西药组口服长春西汀片和甲钴胺片,长春西汀片餐后服,每次5mg,一日三次;甲钴胺片餐后服,每次0.5mg,一日三次。两组都以十日作为一个疗程,两疗程间休息五日,治疗两个疗程。3、观察并记录两组治疗前后的听力值并进行耳鸣严重程度评分,统计分析发病相关因素,所有数据都采用SPSS20.0统计软件进行统计分析。分析统计数据结果,比较针刺和口服西药的临床疗效。结果1、两组治疗前后组内比较:针刺、西药组患者治疗后听力情况和伴随耳鸣症状与治疗前比较,差异均具有统计学意义(P0.05),说明两种方法均能提高患者听力情况和改善伴随耳鸣症状。2、两组治疗后组间比较:①听力改善方面:治疗后针刺组与西药组比较,平均听阈值明显提高(P0.05)。②改善耳鸣程度方面:治疗后针刺组与西药组比较,耳鸣程度评分下降无明显差别(P0.05)。3、两组临床疗效比较:①耳聋临床疗效:针刺组痊愈率24.14%,显效率41.38%,有效率20.69%,总有效率86.21%;西药组治愈率6.90%,显效率20.69%,有效率34.48%,总有效率62.07%。两组临床疗效经统计学处理,差异具有统计学意义(P0.05)。提示针刺组耳聋临床疗效优于西药组。②耳鸣临床疗效:针刺组痊愈率15.00%,显效率30.00%,有效率35.00%,总有效率80.00%;西药组治愈率10.53%,显效率31.58%,有效率31.58%,总有效率73.68%。两组临床疗效经统计学处理,差异不具有统计学意义(P0.05)。提示耳鸣改善方面两组临床疗效没有明显区别。4、部分因素与耳聋疗效相关性:①病程与耳聋疗效关系:针刺组与西药组所选病例的病程和疗效关系均具有统计学意义(P0.05),病程7天组疗效优于7～14天病程组疗效,考虑病程可能是影响听力疗效的因素之一。②有无伴随耳鸣与耳聋疗效关系:两组所选病例有无伴随耳鸣与听力疗效关系均无统计学意义(P0.05),故有无伴随耳鸣与疗效的关系尚需进一步大样本研究。结论1、针刺和口服长春西汀、甲钴胺两种治疗方法都可有效治疗气滞血瘀型突发性耳聋。2、针刺在改善气滞血瘀型突发性耳聋的听力损失情况上确有疗效,对比西药组具有明显优势,在改善耳鸣方面与西药组疗效相当。3、病程与耳聋疗效可能存在相关性,建议突发性耳聋患者发现症状后,尽早明确诊断进行干预治疗,预后较好;有无伴随耳鸣是否成为影响耳聋疗效的因素之一尚不确切,需进一步大样本研究。
[Abstract]:Objective to observe the clinical effect of acupuncture on sudden deafness with qi stagnation and blood stasis. Sixty patients with sudden deafness due to Qi stagnation and Blood stasis were selected from acupuncture department and otolaryngology department of our hospital. 60 cases were randomly divided into acupuncture group and western medicine group with 30 cases in each group. In the acupuncture group, the main points were selected as follows: the rate of the grain through the temples, the ear door, the hearing session, the Yifeng (all affected side), the matching points: blood sea, foot orifices and yin, Taichong (both sides). In 1st, the western medicine group took vinpocetine tablets and mecobalamin tablets, vinpocetine tablets, 5 mg each time, three times on 1st; Megabalamin tablets were taken after meals, 0.5 mg each time, three times on 1st. The two groups took 10th as a course of treatment, two courses of rest 5th, treatment of two courses of treatment. 3. To observe and record the hearing value of the two groups before and after treatment and to score the severity of tinnitus. All data were analyzed by SPSS20.0 statistical software. The results were analyzed to compare the clinical efficacy of acupuncture and oral western medicine. Results 1. The comparison between the two groups before and after treatment: acupuncture. Western medicine group patients after treatment with hearing and associated tinnitus symptoms compared with before treatment, the differences were statistically significant (P 0.05). The two methods can improve the hearing condition of the patients and improve the symptoms of tinnitus. The comparison of hearing improvement between the two groups after treatment: acupuncture group and western medicine group after treatment. The average auditory threshold increased significantly (P 0.05n.2) to improve the degree of tinnitus: there was no significant difference in the score of tinnitus between the acupuncture group and the western medicine group after treatment. Comparison of clinical efficacy between the two groups: the acupuncture group had a cure rate of 24.14%, a markedly effective rate of 41.38, an effective rate of 20.6910 and a total effective rate of 86.21; The cure rate of the western medicine group was 6.90, the markedly effective rate was 20.69m, the effective rate was 34.48m, the total effective rate was 62.07.The clinical efficacy of the two groups was treated statistically. The difference was statistically significant (P 0.05). It suggested that the clinical curative effect of acupuncture group was better than that of western medicine group. The cure rate of acupuncture group was 15.00, and the effective rate was 30.00%. The effective rate is 35.000.The total effective rate is 80.00; The cure rate of the western medicine group was 10.53, the effective rate was 31.58, the effective rate was 31.58, and the total effective rate was 73.68.The clinical efficacy of the two groups was treated statistically. The difference was not statistically significant (P 0.05). It suggested that there was no significant difference in clinical efficacy between the two groups in tinnitus improvement. Some factors were related to the curative effect of deafness: the relationship between the course of disease and the curative effect of deafness: the course of disease and the curative effect of acupuncture group and western medicine group were all statistically significant (P 0.05). The curative effect of 7 day group was better than that of 7 day 14 day group. Considering the course of disease may be one of the factors that affect the effect of hearing. 2 whether there is associated tinnitus and the effect of deafness: there is no significant relationship between tinnitus and hearing effect in the two groups (P 0.05). Conclusion 1 Acupuncture, oral vinpocetine and mecobalamin can effectively treat sudden deafness caused by stagnation of qi and blood stasis. Acupuncture is effective in improving hearing loss of sudden deafness of qi stagnation and blood stasis type. Compared with western medicine group, acupuncture has obvious advantages, and the curative effect is equivalent to that of western medicine group in improving tinnitus. There may be correlation between the course of disease and the curative effect of deafness. It is suggested that the patients with sudden deafness should be diagnosed and treated with intervention as soon as possible after finding the symptoms, and the prognosis is better. Whether tinnitus is one of the factors influencing the curative effect of deafness is uncertain and needs further study.
【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】：2017
【分类号】：R246.81

【参考文献】