升阳益气化瘀法联合针刺治疗老年性突发性耳聋的临床研究

发布时间：2018-07-15 17:16

【摘要】：目的:探讨升阳益气化瘀法联合针刺治疗老年性突发性耳聋的临床研究。材料与方法:选取120例老年性突发性耳聋患者,均是单侧突聋,随机分成治疗组与对照组,治疗组60例,对照组60例,对照组给予0.9%氯化钠注射液250ml或5%葡萄糖注射液250ml、静滴舒血宁注射液70mg日一次,甲钴胺片0.5mg日3次口服,甲泼尼松龙40mg耳后穴位注射,隔日给药1次,共5次。治疗组在对照组基础上给予口服升阳益气化瘀法汤剂联合针刺,两组均以1周为一个疗程,共2个疗程。通过突发性耳聋疗效判定标准评价耳聋疗效、通过耳鸣疗效判定标准评价耳鸣疗效。采用THI耳鸣残障量表评价耳鸣疗效、DHI眩晕残障量表评价眩晕疗效及VAS视觉量表评价耳闷疗效。比较治疗前后血流变学及血浆纤维蛋白原的改变进行疗效评价。以上比较计数资料采用X2检验,计量资料采用配对t检验,等级资料采用Ridit分析。结果:1.两组患者在性别、年龄、伴随症状上均无统计学差异。2.治疗后治疗组听力总有效率70.0%,对照组听力总有效率51.6%,治疗组疗效优于对照组,具有显著性差异。3.治疗后治疗组耳鸣总有效率62.22%,对照组总有效率48.89%,治疗组治疗后THI量表评分低于治疗前,具有显著性差异;对照组治疗后THI量表评分低于治疗前,具有显著性差异,治疗后治疗组THI量表评分低于对照组,具有显著性差异,说明治疗组在耳鸣疗效方面优于对照组,具有显著性差异。4.治疗组治疗后DHI残障量表评分低于治疗前,具有显著性差异。对照组治疗后DHI残障量表评分低于治疗前,具有显著性差异,治疗后治疗组DHI残障量表评分低于对照组,具有显著性差异,说明在眩晕疗效方面治疗组优于对照组。5.治疗组治疗后VAS量表评分低于治疗前,具有显著性差异,对照组治疗后VAS量表评分低于治疗前,具有显著性差异,治疗后治疗组VAS量表评分低于对照组,具有显著性差异,说明在耳闷疗效方面治疗组疗效优于对照组。6.治疗组治疗后血浆粘度、全血低切还原黏度、全血中切还原黏度、血浆纤维蛋白原数值低于治疗前,具有显著性差异,对照组治疗后血浆粘度、全血低切还原黏度、全血中切还原黏度、血浆纤维蛋白原数值低于治疗前,具有显著性差异,治疗后治疗组血浆黏度、全血低切还原黏度、全血中切还原黏度、血浆纤维蛋白原数值低于对照组,具有显著性差异,说明在降低血浆黏度、全血低切还原黏度、全血中切还原黏度、血浆纤维蛋白原方面,治疗组优于对照组。治疗组治疗后全血高切还原黏度数值低于治疗前,具有显著性差异,对照组治疗后全血高切还原黏度数值低于治疗前,具有显著性差异,两组治疗后全血高切还原黏度数值均降低,但不具有显著差异,说明治疗组无改善全血高切还原黏度的作用。结论:升阳益气化瘀法配合针刺治疗老年性突发性耳聋有一定疗效,体现了中医辨证论治的特色,临床上可以推广。
[Abstract]:Objective: to explore the clinical study on the treatment of presbyopic sudden deafness with the combination of Shengyang Yiqi Huayu method and acupuncture. Materials and methods: 120 patients with sudden presbycusis were randomly divided into treatment group (n = 60) and control group (n = 60). In the control group, 0.9% sodium chloride injection 250ml or 5% glucose injection 250ml, intravenous Shuxuening injection 70mg once a day, methylcobalamin tablet 0.5mg three times, meprednisolone 40mg retroear acupoint injection, once every other day, a total of 5 times. The treatment group was treated with Shengyang Yiqi Huayu decoction combined with acupuncture on the basis of the control group. The curative effect of sudden deafness was evaluated by the criterion of curative effect of sudden deafness, and the curative effect of tinnitus was evaluated by the criterion of curative effect of tinnitus. Thi tinnitus disability scale was used to evaluate tinnitus efficacy. DHI dizziness scale was used to evaluate vertigo effect and VAS visual scale was used to evaluate ear stuffing effect. The changes of hemorheology and plasma fibrinogen were compared before and after treatment. The above data were analyzed by X _ 2 test, matched t test and Ridit analysis. The result is 1: 1. There was no significant difference in sex, age, and associated symptoms between the two groups. After treatment, the total effective rate of hearing in the treatment group was 70.0 and that in the control group was 51.6. The curative effect of the treatment group was better than that of the control group, and the difference was significant. The total effective rate of tinnitus in the treatment group was 62.22 and the total effective rate in the control group was 48.89.The Thi scale score of the treatment group was lower than that of the pre-treatment group, and the THI scale score of the control group was lower than that of the pre-treatment group. After treatment, the Thi scale score in the treatment group was lower than that in the control group, which showed that the therapeutic effect of tinnitus in the treatment group was better than that in the control group, and there was significant difference between the treatment group and the control group. 4. The score of DHI disability scale after treatment in the treatment group was lower than that before treatment, and there was significant difference. The DHI disability scale score after treatment in the control group was lower than that before treatment, and the DHI disability scale score in the treatment group was lower than that in the control group after treatment, which indicated that the treatment group was better than the control group in the effect of vertigo. 5. The scores of VAS after treatment in the treatment group were lower than those before the treatment, and there were significant differences between the control group and the control group after treatment, and the scores of the VAS in the treatment group were lower than those in the control group after treatment, and there was significant difference between the treatment group and the control group. It showed that the curative effect of the treatment group was better than that of the control group. There were significant differences in plasma viscosity, whole blood low shear reduction viscosity, whole blood shear reduction viscosity and plasma fibrinogen value after treatment in the treatment group. The plasma fibrinogen value was lower than that of the control group. After treatment, the plasma viscosity, the whole blood low shear reduction viscosity, the whole blood shear reduction viscosity and the plasma fibrinogen value of the treatment group were lower than those of the control group. The results showed that the treatment group was superior to the control group in reducing plasma viscosity, reducing viscosity in whole blood, reducing viscosity in whole blood and fibrinogen in plasma. In the treatment group, the whole blood high shear reduction viscosity value was lower than that before treatment, and the whole blood high shear reduction viscosity value after treatment in the control group was lower than that before treatment, and there was significant difference between the treatment group and the control group. The value of whole blood high shear reduction viscosity decreased after treatment, but there was no significant difference between the two groups, indicating that the treatment group did not improve the whole blood high shear reduction viscosity. Conclusion: Shengyang Yiqi Huayu method combined with acupuncture has certain curative effect on presbyopic sudden deafness, which embodies the characteristics of TCM differentiation and treatment, and can be popularized clinically.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.1

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