激痛点联合穴位针刺治疗主观性耳鸣临床研究

摘要

Objective To assess the therapeutic efficacy of trigger points (TrPs) combined with acupoints by acupuncture for subjective tinnitus (ST);To discuss the correlation of TrPs acupuncture inactivation and the releasing of symptom. Methods Sixty patients with ST were randomly divided into trial group and control group, 30 cases in each group. Those in trial group were acupunctured by TrPs combined with acupoints, and those in control group received regular acupuncture treatment. The scores of tinnitus severity assessment were available for effect evaluation after 3 treatment course. The size and tenderness degree of TrPs contraction knots were checked, and TrPs local thermal infrared spectrum was compared by infrared camera. Results The post-treatment tinnitus severity scores had significant difference compared with pre-therapy in each group (P<0.01). The total effective percentage of trial group with 93.33%(28/30) was obviously higher than control group with 86.67%(26/30) (P<0.05). The post-treatment and pre-therapy contraction knots size, tenderness and temperature difference of TrPs within trial groups had a very significant difference (P<0.01), and difference of tenderness and temperature of patients’ TrPs had a positive correlation with the difference of tinnitus severity scores before and after treatment (P<0.01). The contraction knots area of TrPs had not significant correlation with the difference of tinnitus severity scores (P>0.05). Conclusion TrPs combined with acupoints by acupuncture for ST patients are better than conventional acupoints in improving clinical symptoms. The deactivation of TrPs is closely related to tinnitus symptoms, therefore, temperature and tenderness of TrPs can be employed to assist in the diagnosis, or evaluated the tinnitus severity and therapeutic efficacy.%目的：评价激痛点（TrPs）联合穴位针刺治疗主观性耳鸣（ST）的疗效，并探讨TrPs针刺灭活与耳鸣缓解程度的相关性。方法将60例ST患者随机分为试验组和对照组各30例，试验组采用TrPs联合穴位针刺治疗，对照组采用常规针刺治疗，3个疗程后根据耳鸣严重程度进行疗效评价，比较针刺前后 TrPs 结节面积、压痛程度变化，并利用红外热像仪采集 TrPs 局部红外热谱进行温度分析。结果2组患者治疗后耳鸣严重程度积分及治疗前后积分差值比较差异均有统计学意义（P＜0.01）；试验组总有效率为93.33%（28/30），对照组为86.67%（26/30），组间比较差异有统计学意义（P＜0.05）。ST患者治疗前后TrPs结节面积、压痛及温度比较差异均有统计学意义（P＜0.01）；TrPs压痛差值、温度差值与耳鸣严重程度积分差值均呈正相关（P＜0.01），而TrPs面积差值与耳鸣严重程度积分差值无明显相关性（P＞0.05）。结论 TrPs联合穴位针刺治疗ST疗效显著。TrPs的灭活程度与耳鸣症状的改善程度呈正相关，可将TrPs的压痛、温度指标用于ST的辅助诊断和疗效评价。