特定穴针灸干预对中耳炎听力障碍患者的预后影响
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摘要
目的:探讨特定穴针灸干预治疗分泌性中耳炎患者听力障碍的临床疗效。方法:选择2013年7月—2017年6月在本院治疗的860例分泌性中耳炎患儿纳入研究,按照随机数字表法分成观察组和对照组,各430例。两组均给予手术和药物治疗,观察组辅以特定穴针灸治疗。比较两组的临床疗效、纯音测听试验以及鼓室声导纳测试结果。结果:观察组的总有效率91.16%明显高于对照组的86.05%(P<0.05);两组治疗后的纯音测听试验中250~4000 Hz听力阈值均明显降低,且观察组治疗后的听力阈值明显低于对照组(P<0.05);两组治疗后的鼓室声导纳测试B型、C型明显向A型转移,C型数量明显下降(P<0.05),观察组治疗后的鼓室声导纳测试A型人数和耳数明显多于对照组(P<0.05)。结论:特定穴针灸有疏通经络、行气活血、消肿止痛、开窍益聪等功效,临床辅助手术和药物治疗中耳炎听力障碍能有效调节耳窍气血、促进中耳积液吸收,改善咽鼓管功能,有助于听力恢复。
Objective:To investigate the clinical effect of acupuncture intervention at specific acupoints on hearing impairment in patients with secretory otitis media. Methods:A total of 860 cases of children with secretory otitis media who were treated in our hospital from July 2013 to June 2017 were selected and divided into observation group and control group according to random number table,with 430 cases in each group. The two groups were given surgery and drug treatment,the observation group was also treated with specific acupuncture. The clinical efficacy,the results of pure tone audiometry test and tympanum admittance test in 2 groups were observed and compared. Results:The effective rate in the observation group was significantly higher than that in the control group(91. 16% vs 86. 05%,P < 0. 05). The hearing thresholds were significantly decreased after treatment in 2 groups,and the hearing threshold in the observation group after treatment was significantly lower than that in the control group( P <0. 05). The tympanic acoustic admittance test showed that type B and C obviously shifted to A type,and the number of C type decreased significantly in 2 groups( P < 0. 05). The number of type A in the observation group was significantly more than that in the control group( P < 0. 05). Conclusion: Acupuncture at specific acupoints can clear the meridians,promote Qi and activate blood,relieve pain and induce resuscitation to benefit the hearing. Surgery and drugs in the treatment of hearing impairment in patients with secretory otitis media can effectively regulate Qi and blood,promote middle ear effusion absorption and improve the function of eustachian tube,contributing to the recovery of hearing.
Objective:To investigate the clinical effect of acupuncture intervention at specific acupoints on hearing impairment in patients with secretory otitis media. Methods:A total of 860 cases of children with secretory otitis media who were treated in our hospital from July 2013 to June 2017 were selected and divided into observation group and control group according to random number table,with 430 cases in each group. The two groups were given surgery and drug treatment,the observation group was also treated with specific acupuncture. The clinical efficacy,the results of pure tone audiometry test and tympanum admittance test in 2 groups were observed and compared. Results:The effective rate in the observation group was significantly higher than that in the control group(91. 16% vs 86. 05%,P < 0. 05). The hearing thresholds were significantly decreased after treatment in 2 groups,and the hearing threshold in the observation group after treatment was significantly lower than that in the control group( P <0. 05). The tympanic acoustic admittance test showed that type B and C obviously shifted to A type,and the number of C type decreased significantly in 2 groups( P < 0. 05). The number of type A in the observation group was significantly more than that in the control group( P < 0. 05). Conclusion: Acupuncture at specific acupoints can clear the meridians,promote Qi and activate blood,relieve pain and induce resuscitation to benefit the hearing. Surgery and drugs in the treatment of hearing impairment in patients with secretory otitis media can effectively regulate Qi and blood,promote middle ear effusion absorption and improve the function of eustachian tube,contributing to the recovery of hearing.
引文
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[10]王颍,孟向文,牟明园,等.从“理、法、方、穴、术”的角度试述针灸处方思路[J].辽宁中医杂志,2015,42(12):2397-2398.
[11]王琼,牟建蛟,杨建琼.针刺结合苇管灸治疗分泌型中耳炎验案1则[J].湖南中医杂志,2016,32(12):113-114.
[12]林子升,孙旭鸯,刘晓华.针刺蝶腭神经节治疗分泌性中耳炎疗效观察[J].上海针灸杂志,2014,33(1):47-49.
[2]杜丽君,童军,陈文文,等.单侧听力耳中耳炎手术经验再探讨[J].山东大学耳鼻喉眼学报,2016,30(6):8-10.
[3]廖剑绚,周芝芳,李明.儿童分泌性中耳炎听力学检查结果分析及意义探讨[J].中华耳科学杂志,2015,13(3):433-435.
[4]胡莹,孙海波,王爱平.中西医结合综合治疗肝火上扰型突发性耳聋的临床研究[J].辽宁中医杂志,2016,43(5):1018-1020.
[5]王世贞.中医耳鼻咽喉科学[M].北京:中国中医药出版社,2007:57-62.
[6]马胜民,刘福官,徐永兴,等.行气化湿活血通窍法治疗急性分泌性中耳炎疗效观察[J].辽宁中医杂志,2014,41(9):1912-1913.
[7]冯晓华,龙孝斌,汪建,等.难治性分泌性中耳炎术后听力影响因素分析[J].中华耳科学杂志,2013,11(3):444-447.
[8]李成光.通气散和二陈汤加味治疗分泌性中耳炎临床研究[J].中医学报,2013,28(8):1245-1246.
[9]刘晓亭,张志星,徐琳,等.论按伴随症状和体征选穴在针灸治疗中的应用[J].中国针灸,2013,33(7):658-660.
[10]王颍,孟向文,牟明园,等.从“理、法、方、穴、术”的角度试述针灸处方思路[J].辽宁中医杂志,2015,42(12):2397-2398.
[11]王琼,牟建蛟,杨建琼.针刺结合苇管灸治疗分泌型中耳炎验案1则[J].湖南中医杂志,2016,32(12):113-114.
[12]林子升,孙旭鸯,刘晓华.针刺蝶腭神经节治疗分泌性中耳炎疗效观察[J].上海针灸杂志,2014,33(1):47-49.
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