针灸缪刺法联合清肝通窍汤治疗突发性耳聋临床研究

摘要

目的 观察针灸缪刺法联合清肝通窍汤治疗突发性耳聋(SSHL)的临床疗效及对血浆内皮素(ET)、血清一氧化氮(NO)水平的影响.方法 将110例患者随机分为治疗组和对照组各55例.对照组予清肝通窍汤+常规针刺,治疗组在对照组基础上予针灸缪刺法,均14 d为1个疗程.观察治疗前后血浆ET、血清NO水平变化,纯音听阈值改变情况,评价耳鸣、听力疗效.结果 治疗组耳鸣疗效总有效率为94.54%(52/55),对照组为85.45%(47/55),2组比较差异有统计学意义(u=2.038,P=0.040);治疗组听力疗效总有效率为96.46%(53/55),对照组为81.82%(45/55),2组比较差异有统计学意义(u=2.913,P=0.004);与治疗前比较,治疗后2组血浆ET水平下降,血清NO水平升高(P<0.05);治疗后治疗组ET低于对照组,NO高于对照组(P<0.05);2组纯音听阈值评分治疗3、7、14 d较治疗前明显改善(P<0.05),治疗后及治疗3、7、14 d,治疗组明显低于对照组(P<0.05).结论 针灸缪刺法联合清肝通窍汤能明显减轻SSHL患者临床症状,提高听力水平,其机制与调节血浆ET、血清NO水平,改善内耳微循环相关.%Objective To observe the clinical efficacy of acupuncture and miuci therapy combined with Qinggan Tongqiao Decoction for sudden sensor-neural hearing loss (SSHL) and the effects on level of plasma endothelin (ET) and serum nitrate oxide (NO). Methods Totally 110 patients with SSHL were randomly divided into treatment group and control group, with 55 patients in each group. The control group was given Qinggan Tongqiao Decoction combined with acupuncture routine treatment, and treatment group was given miuci therapy on the basis of the control group, two weeks as a course of two groups. Level changes of plasma ET and serum NO, and pure tone listening threshold changes before and after treatment were observed. Tinnitus and hearing efficacy was evaluated. Results The total effective rate for tinnitus efficacy was 94.54% (52/55) in the treatment group and 85.45% (47/55) in the control group, with statistical significance (u=2.038, P=0.040). The total effective rate for hearing efficacy was 96.46%(53/55) in the treatment group and 81.82% (45/55) in the control group, with statistical significance (u=2.913, P=0.040). Compared with before treatment, the level of plasma ET decreased and the level of serum NO increased after the treatment (P<0.05); After the treatment, the level of plasma ET in the treatment was lower than the control group, and the level of serum NO in the treatment group was higher than the control group (P<0.05). Pure tone threshold scores in the two groups on treatment 3, 7, 14 d were significantly improved (P<0.05), and pure tone threshold scores in the treatment group were significantly lower than the control group (P<0.05). Conclusion Acupuncture and miuci therapy combined with Qinggan Tongqiao Decoction can significantly reduce clinical symptoms and enhance the hearing level of SSHL patients. The mechanism mainly lies in regulating levels of plasma ET and serum NO, and improving the inner ear micro-circulation.