针刺治疗老年感音神经性耳聋患者疗效与耳闷胀感的相关分析

摘要

Objective:To investigate the relationship between clinical effects of acupuncture for elderly patients with sensorineural deafness and ear distending sensation.Methods:A total of 120 elderly patients with sensorineural deafness were randomly divided into a comprehensive treatment group,an acupuncture group and a Western medicine group,with 40 cases in each group.The acupuncture group received acupuncture treatment,the Western medicine group received oral mecobalamin tablets and the comprehensive treatment group received acupuncture plus acupoint injection and auricular acupoint sticking.The values of pure tone hearing threshold test of the three groups were observed before and after treatment,and the relationship between clinical effects and ear distending sensation was compared.Results:The total effective rate of the comprehensive treatment group was 82.5％ versus 67.0％ in the acupuncture group and 62.5％ in the Western medicine group.The inter-group comparisons showed statistically significant differences in the comprehensive treatment group versus the Western medicine group (P＜0.01) and the acupuncture group (P＜0.05).In the comprehensive treatment group,there were 23 cases (57.5％) with ear distending sensation,the clinical total effective rate was 86.9％;there were 17 cases (42.5％) without the sensation,the clinical total effective rate was 76.5％.In the acupuncture group,there were 24 cases (60.0％) with ear distending sensation,the clinical total effective rate was 71.0％;there were 16 cases (40.0％) without the sensation,the clinical total effective rate was 63.0％.In the Western medicine group,there were 21 cases (52.5％) with ear distending sensation,the clinical total effective rate was 66.7％;there were 19 cases (47.5％) without the sensation,the clinical total effective rate was 57.9％.The total effective rate of patients with ear distending sensation were higher than the rates of those without ear distending sensation in the three groups,but the differences were insignificant (all P＞0.05).Conclusion:The comprehensive therapy is one of the effective methods to treat elderly patients with sensorineural deafness.In the three groups of elderly patients with sensorineural deafness,the relief of ear distending sensation and the hearing loss were basically simultaneous,and the hearing recovery in the patients with ear distending sensation may be slightly better than that in those without ear distending sensation.Nevertheless,further research is needed.%目的:探讨针刺治疗老年感音神经性耳聋患者疗效与耳闷胀感之间的关系.方法:采用随机对照方法将120例老年感音神经性耳聋的患者分为综合治疗组、针刺组和西药组,每组40例.针刺组给予针刺治疗;西药组采用口服甲钴胺片剂治疗;综合治疗组给予针刺配合穴位注射及耳穴贴压治疗.观察三组治疗前后患者纯音听阈测试值的变化,并比较耳闷胀感与疗效之间的关系.结果:综合治疗组、针刺组和西药组临床总有效率分别是82.5％、67.0％和62.5％;组间临床疗效比较:综合治疗组明显优于西药组(P＜0.01)和针刺组(P＜0.05).综合治疗组中伴耳闷胀者23例(57.5％),临床总有效率为86.9％;无耳闷胀者17例(42.5％),临床总有效率为76.5％.针刺组中伴耳闷胀者24例(60.0％),临床总有效率为71.0％;无耳闷胀者16例(40.0％),临床总有效率为63.0％.西药组中伴耳闷胀者21例(52.5％),临床总有效率为66.7％;无耳闷胀者19例(47.5％),临床总有效率为57.9％.三组有耳闷胀的患者的总有效率均高于同组无耳闷胀者,但差异均无统计学意义(均P＞0.05).结论:综合疗法是治疗老年感音神经性耳聋的有效方法之一.三组老年感音神经性耳聋患者耳闷胀症状的缓解与听力恢复情况基本上是平行的,且伴有耳闷胀感的患者听力恢复效果可能会略好于不伴有耳闷胀者,但尚需进一步研究.