耳后骨膜下注射甲泼尼龙治疗合并2型糖尿病的突发性聋的疗效分析
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摘要
目的:探讨耳后骨膜下注射甲泼尼龙联合银杏叶提取物注射液及鼠神经生长因子在合并2型糖尿病的突发性聋中的治疗效果及对血糖水平的影响,探讨治疗该类型突发性聋有效且安全的方法。方法:选择伴发2型糖尿病的突发性聋患者84例,随机分为试验组(耳后骨膜下注射甲泼尼龙+银杏叶提取物注射液、鼠神经生长因子)48例及对照组(单纯给予银杏叶提取物注射液、鼠神经生长因子)36例,每组按不同听力曲线类型分为低频下降、高频下降及平坦与全聋3个小组。比较试验组与对照组患者的临床疗效及试验组治疗前后血糖波动和糖化血红蛋白的差异。结果:(1)试验组治疗的有效率为79.17%,高于对照组的有效率58.33%,差异有统计学意义(P<0.05)。说明耳后骨膜下注射甲泼尼龙联合银杏叶提取物注射液、鼠神经生长因子在合并2型糖尿病的突发性聋中疗效确切。(2)试验组治疗前后血糖浓度波动及糖化血红蛋白水平差异无统计学意义,说明该治疗方式可以有效避免激素的全身不良反应,保证治疗的安全性。结论:耳后骨膜下注射甲泼尼龙联合银杏叶提取物注射液及鼠神经生长因子治疗合并2型糖尿病的突发性聋患者有显著疗效,且激素使用不会对血糖产生影响,避免激素全身不良反应的发生。
Objective:To investigate the therapeutic effect of post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor in sudden deafness with type 2 diabetesmellitus.To understand the effect of post-auricular subperiosteal injection of methylprednisolone on type 2 diabetesmellitus complicated with sudden deafness and its effect on blood-glucose level,and to explore a more effective and safe method for treating this special group of sudden deafness.Method:Total 84 patients suffered from type 2 diabetesmellitus with sudden deafness and treated in Shaanxi Provincial People's Hospital from March 2017 to June 2018 were randomly divided into experimental group(post-auricular subperiosteal injection of methylprednisolone+ginkgo biloba injection,mouse nerve growth factor)(n=48)and a control group(ginkgo biloba injection,mouse nerve growth factor)(n=36).Each group was divided into high frequency,low frequency and flat and total deafness group.Then to compare the clinical efficacy of the two groups and the difference of the fluctuation of blood glucose and HbA1 cbefore treatment and 2 hours after treatment.Result:(1)The effective rate of treatment in the experimental group was 79.17%,higher than that in the control group(58.33%),P<0.05.The results indicated that the effect of post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor was effective in sudden deafness with type 2 diabetesmellitus.(2)There was no significant difference in the fluctuation of blood glucose and HbA1 cbefore treatment and 2 hours after treatment in the experimental group,and it indicated that this treatment can effectively avoid systemic side effects of steroid and ensure the safety of the treatment.Conlusion:Post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor is effective in patients with sudden deafness with type 2 diabetesmellitus,furthermore,blood glucose will not be affected by the using of steroid,and it will aviod systemic hormonal side effects.
Objective:To investigate the therapeutic effect of post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor in sudden deafness with type 2 diabetesmellitus.To understand the effect of post-auricular subperiosteal injection of methylprednisolone on type 2 diabetesmellitus complicated with sudden deafness and its effect on blood-glucose level,and to explore a more effective and safe method for treating this special group of sudden deafness.Method:Total 84 patients suffered from type 2 diabetesmellitus with sudden deafness and treated in Shaanxi Provincial People's Hospital from March 2017 to June 2018 were randomly divided into experimental group(post-auricular subperiosteal injection of methylprednisolone+ginkgo biloba injection,mouse nerve growth factor)(n=48)and a control group(ginkgo biloba injection,mouse nerve growth factor)(n=36).Each group was divided into high frequency,low frequency and flat and total deafness group.Then to compare the clinical efficacy of the two groups and the difference of the fluctuation of blood glucose and HbA1 cbefore treatment and 2 hours after treatment.Result:(1)The effective rate of treatment in the experimental group was 79.17%,higher than that in the control group(58.33%),P<0.05.The results indicated that the effect of post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor was effective in sudden deafness with type 2 diabetesmellitus.(2)There was no significant difference in the fluctuation of blood glucose and HbA1 cbefore treatment and 2 hours after treatment in the experimental group,and it indicated that this treatment can effectively avoid systemic side effects of steroid and ensure the safety of the treatment.Conlusion:Post-auricular subperiosteal injection of methylprednisolone combined with ginkgo biloba injection and mouse nerve growth factor is effective in patients with sudden deafness with type 2 diabetesmellitus,furthermore,blood glucose will not be affected by the using of steroid,and it will aviod systemic hormonal side effects.
引文
[1]中华耳鼻咽喉头颈外科杂志编辑委员会.突发性聋诊断和治疗指南(2015)[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-447.
[2]中国突发性聋多中心临床研究协作组.中国突发性聋分型治疗的多中心临床研究[J].中华耳鼻咽喉头颈外科杂志,2013,48(5):355-361.
[3] CVOROVICL1,DERICD,PAVICEVICL,et al.[Does acute sensorineural deafness befall to urgent conditions][J]?Vojnosanit Pregl,2009,66:35-38.
[4] TRUNE D R,CANLON B.Corticosteroid therapy for hearing and balance disorders[J].Anat Rec(Hoboken),2012,295:1928-1943.
[5] BIRD P A,BEGG E J,ZHANG M,et al.Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph[J].Otol Neurotol,2007,28:1124-1130.
[6]李代波,周松,徐文均.鼓室注射地塞米松与耳后骨膜下注射甲泼尼龙治疗突发性聋的疗效及不良反应对比[J].临床耳鼻咽喉头颈外科杂志,2017,31(16):1265-1268.
[7]杨晓琦,余力生,马鑫.耳后注射复方倍他米松治疗顽固性低频型感音神经性聋[J].中华耳鼻咽喉头颈外科杂志,2007,42(11):814-816.
[8]覃宏康,何中扬,零兴勤,等.耳后注射与全身用激素治疗突发性耳聋的疗效分析[J].微创医学,2015,10(4):551-554.
[9]陈爱平,王海波.耳后注射糖皮质激素治疗突发性聋的研究进展[J].临床耳鼻咽喉头颈外科杂志,2016,30(19):1572-1575.
[10]张天宇,尚小领,谢亚学,等.耳后注射甲泼尼龙在中高频听力下降型突发性聋治疗中的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2018,32(7):537-540.
[11]许鹏,赵群,王英力,等.耳后注射甲泼尼龙对全聋型突发性聋疗效分析[J].兰州大学学报(医学版),2017,43(1):56-59.
[2]中国突发性聋多中心临床研究协作组.中国突发性聋分型治疗的多中心临床研究[J].中华耳鼻咽喉头颈外科杂志,2013,48(5):355-361.
[3] CVOROVICL1,DERICD,PAVICEVICL,et al.[Does acute sensorineural deafness befall to urgent conditions][J]?Vojnosanit Pregl,2009,66:35-38.
[4] TRUNE D R,CANLON B.Corticosteroid therapy for hearing and balance disorders[J].Anat Rec(Hoboken),2012,295:1928-1943.
[5] BIRD P A,BEGG E J,ZHANG M,et al.Intratympanic versus intravenous delivery of methylprednisolone to cochlear perilymph[J].Otol Neurotol,2007,28:1124-1130.
[6]李代波,周松,徐文均.鼓室注射地塞米松与耳后骨膜下注射甲泼尼龙治疗突发性聋的疗效及不良反应对比[J].临床耳鼻咽喉头颈外科杂志,2017,31(16):1265-1268.
[7]杨晓琦,余力生,马鑫.耳后注射复方倍他米松治疗顽固性低频型感音神经性聋[J].中华耳鼻咽喉头颈外科杂志,2007,42(11):814-816.
[8]覃宏康,何中扬,零兴勤,等.耳后注射与全身用激素治疗突发性耳聋的疗效分析[J].微创医学,2015,10(4):551-554.
[9]陈爱平,王海波.耳后注射糖皮质激素治疗突发性聋的研究进展[J].临床耳鼻咽喉头颈外科杂志,2016,30(19):1572-1575.
[10]张天宇,尚小领,谢亚学,等.耳后注射甲泼尼龙在中高频听力下降型突发性聋治疗中的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2018,32(7):537-540.
[11]许鹏,赵群,王英力,等.耳后注射甲泼尼龙对全聋型突发性聋疗效分析[J].兰州大学学报(医学版),2017,43(1):56-59.