通窍活血汤加减配合针灸治疗突发性耳聋
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摘要
目的:探讨通窍活血汤加减配合针灸治疗突发性耳聋气滞血瘀证的疗效及对血液流变学水平的影响。方法:将突发性耳聋患者90例随机分为治疗组45例和对照组45例。对照组口服甲钴胺片,每次500μg,每天3次;前列地尔注射液静脉滴注,每次10μg,每天1次。治疗组在对照组基础上加用通窍活血汤加减配合针灸治疗。两组连续治疗2周。比较两组听力、眩晕、耳鸣、耳闷的改善时间、听力损失评分、听力阈值及临床疗效。检测两组血液流变学水平。结果:治疗后,治疗组听力、眩晕、耳鸣、耳闷改善时间明显短于对照组,听力损失评分和听力阈值显著低于对照组,差异有统计学意义(P<0.01)。治疗组有效率为91.11%,明显高于对照组的71.11%(P<0.05)。治疗组治疗后血液流变学水平明显优于对照组(P<0.01)。结论:在常规西医基础上,通窍活血汤加减配合针灸治疗突发性耳聋气滞血瘀证效果明显,改善患者血液流变学水平,从而缓解血瘀症状可能是其发挥作用的途径之一。
Objective:To investigate efficacy of Modified Tongqiao Huoxue Decoction combined with acupuncture in treating sudden deafness with syndrome of qi stagnation and blood stasis and the influence on hemorheology level.Methods:90 sudden deafness cases were randomly divided into control group(45 cases) and treatment group(45 cases).The control group was orally treated with mecobalamin tablets(500μg each time,three times a day) and alprostadil fat emulsiom injection(10 μg each time,once a day).Based on the control group,the treatment group was treated with Modified Tongqiao Huoxue Decoction combined with acupuncture.All cases were treated for 2 weeks.The improving time of hearing,vertigo,tinnitus,and ear fullness,hearing loss score,hearing threshold,and efficacy were compared between two groups.Hemorheology level was detected in two groups.Result:After treatment,the improving time of hearing,vertigo,tinnitus,and ear fullness,hearing loss score,and hearing threshold of the treatment group were obviously shorter than that in the control group(P<0.01).Total efficacy of the treatment group was 91.11%,which was obviously higher than 71.11% of the control group(P<0.05).Hemorheology level of the treatment group was obviously lower than that in the control group after treatment(P<0.01).Conclusion:On the basis of routine western medicine,the efficacy of Modified Tongqiao Huoxue Decoction combined with acupuncture in treating sudden deafness with syndrome of qi stagnation and blood stasis is significant,and improving the level of hemorheology and alleviating the symptoms of blood stasis may be one of the ways to play its role.
Objective:To investigate efficacy of Modified Tongqiao Huoxue Decoction combined with acupuncture in treating sudden deafness with syndrome of qi stagnation and blood stasis and the influence on hemorheology level.Methods:90 sudden deafness cases were randomly divided into control group(45 cases) and treatment group(45 cases).The control group was orally treated with mecobalamin tablets(500μg each time,three times a day) and alprostadil fat emulsiom injection(10 μg each time,once a day).Based on the control group,the treatment group was treated with Modified Tongqiao Huoxue Decoction combined with acupuncture.All cases were treated for 2 weeks.The improving time of hearing,vertigo,tinnitus,and ear fullness,hearing loss score,hearing threshold,and efficacy were compared between two groups.Hemorheology level was detected in two groups.Result:After treatment,the improving time of hearing,vertigo,tinnitus,and ear fullness,hearing loss score,and hearing threshold of the treatment group were obviously shorter than that in the control group(P<0.01).Total efficacy of the treatment group was 91.11%,which was obviously higher than 71.11% of the control group(P<0.05).Hemorheology level of the treatment group was obviously lower than that in the control group after treatment(P<0.01).Conclusion:On the basis of routine western medicine,the efficacy of Modified Tongqiao Huoxue Decoction combined with acupuncture in treating sudden deafness with syndrome of qi stagnation and blood stasis is significant,and improving the level of hemorheology and alleviating the symptoms of blood stasis may be one of the ways to play its role.
引文
[1]王翔,李淑芳,谢柳,等.龙胆泻肝汤合葛根方辅助治疗突发性耳聋[J].中国实验方剂学杂志,2016,22(13):169-172.
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[3]韩丽.针刺治疗突发性耳聋36例[J].河南中医,2013,33(5):765.
[4]张东霞.中医药在突发性耳聋综合治疗中的应用概况[J].中医学报,2010,25(3):584-586.
[5]吴飞虎,朱丹华.通窍活血汤联合脑蛋白水解物治疗气滞血瘀型突发性耳聋的临床观察[J].中成药,2017,39(1):228-230.
[6]黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2008:751.
[7]中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.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.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:103-104.
[9]SLATTERY W H,FISHER L M,IQBAL Z.Intratympanic steriod injection for treatment of idiopathic sudden hearing loss[J].Otolarngol Head Neck Surg,2005,133(2):251-259.
[10]任基浩.突发性感音神经聋诊治进展[J].中国医师杂志,2000,5(2):260-261.
[11]虞娴波,殷建军.马来酸桂哌齐特治疗突发性耳聋的疗效及安全性观察[J].药物流行病学杂志,2013,22(4):171-178.
[12]孙宏赢.通窍活血汤加鼓室注药治打突发性耳聋42例[J].河南中医,2014,34(2):304.
[13]庄晓鸣.脉血康联合甲钴胺片治疗糖尿病周围神经病变的临床观察[J].中医临床研究,2015,7(9):60-62.
[14]谢天宏,刘江滨.前列地尔对老年突发性耳聋患者血液流变学的影响及疗效[J].中国老年学杂志,2015,35(18):5263-5264.
[15]张宇丽,李庆红,毕静,等.甲泼尼龙琥珀酸钠联合前列地尔治疗低频下降突发性耳聋41例[J].中国药业,2015,2(11):95-96.
[16]徐隽彦,刘春丽,倪丽群.前列地尔注射液治疗突发性耳聋的临床疗效及预后分析[J].浙江创伤外科,2016,21(1):86-88.
[17]孟亚军.益气聪明汤合葛根素注射液治疗突发性耳聋疗效观察[J].陕西中医,2015,36(5):569-570.
[18]池闽川,叶汝超,黄泽芳.生物陶瓷烫熨治疗血瘀耳窍型突发性耳聋效果观察[J].亚太传统医药,2016,12(17):114-115.
[19]吴飞虎,朱丹华.通窍活血汤联合脑蛋白水解物治疗气滞血瘀型突发性耳聋的临床观察[J].中成药,2017,39(1):228-230.
[20]李漫,沈红强,信莉,等.中药联合针刺治疗突发性耳聋100例临床观察[J].中医杂志,2012,53(20):1737-1741.
[21]唐爱华.通窍活血汤加减联合针灸辨治气滞血瘀证突发性耳聋患者的临床研究[J].中医药学报,2016,44(6):78-81.
[22]谢国旗,尚万兵,高延玲,等.清脑片对血瘀模型大鼠血液流变学的影响[J].中医学报,2016,31(11):1738-1741.
[23]曲莉.长春西汀联合巴曲酶治疗老年突发性耳聋的疗效及对血液指标的影响[J].中国老年学杂志,2015,35(16):4675-4676.
[2]颜玺,付维.通窍汤辨治突发性耳聋60例临床观察[J].中国实验方剂学杂志,2014,20(3):190-193.
[3]韩丽.针刺治疗突发性耳聋36例[J].河南中医,2013,33(5):765.
[4]张东霞.中医药在突发性耳聋综合治疗中的应用概况[J].中医学报,2010,25(3):584-586.
[5]吴飞虎,朱丹华.通窍活血汤联合脑蛋白水解物治疗气滞血瘀型突发性耳聋的临床观察[J].中成药,2017,39(1):228-230.
[6]黄选兆,汪吉宝,孔维佳.实用耳鼻咽喉头颈外科学[M].北京:人民卫生出版社,2008:751.
[7]中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.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.
[8]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:103-104.
[9]SLATTERY W H,FISHER L M,IQBAL Z.Intratympanic steriod injection for treatment of idiopathic sudden hearing loss[J].Otolarngol Head Neck Surg,2005,133(2):251-259.
[10]任基浩.突发性感音神经聋诊治进展[J].中国医师杂志,2000,5(2):260-261.
[11]虞娴波,殷建军.马来酸桂哌齐特治疗突发性耳聋的疗效及安全性观察[J].药物流行病学杂志,2013,22(4):171-178.
[12]孙宏赢.通窍活血汤加鼓室注药治打突发性耳聋42例[J].河南中医,2014,34(2):304.
[13]庄晓鸣.脉血康联合甲钴胺片治疗糖尿病周围神经病变的临床观察[J].中医临床研究,2015,7(9):60-62.
[14]谢天宏,刘江滨.前列地尔对老年突发性耳聋患者血液流变学的影响及疗效[J].中国老年学杂志,2015,35(18):5263-5264.
[15]张宇丽,李庆红,毕静,等.甲泼尼龙琥珀酸钠联合前列地尔治疗低频下降突发性耳聋41例[J].中国药业,2015,2(11):95-96.
[16]徐隽彦,刘春丽,倪丽群.前列地尔注射液治疗突发性耳聋的临床疗效及预后分析[J].浙江创伤外科,2016,21(1):86-88.
[17]孟亚军.益气聪明汤合葛根素注射液治疗突发性耳聋疗效观察[J].陕西中医,2015,36(5):569-570.
[18]池闽川,叶汝超,黄泽芳.生物陶瓷烫熨治疗血瘀耳窍型突发性耳聋效果观察[J].亚太传统医药,2016,12(17):114-115.
[19]吴飞虎,朱丹华.通窍活血汤联合脑蛋白水解物治疗气滞血瘀型突发性耳聋的临床观察[J].中成药,2017,39(1):228-230.
[20]李漫,沈红强,信莉,等.中药联合针刺治疗突发性耳聋100例临床观察[J].中医杂志,2012,53(20):1737-1741.
[21]唐爱华.通窍活血汤加减联合针灸辨治气滞血瘀证突发性耳聋患者的临床研究[J].中医药学报,2016,44(6):78-81.
[22]谢国旗,尚万兵,高延玲,等.清脑片对血瘀模型大鼠血液流变学的影响[J].中医学报,2016,31(11):1738-1741.
[23]曲莉.长春西汀联合巴曲酶治疗老年突发性耳聋的疗效及对血液指标的影响[J].中国老年学杂志,2015,35(16):4675-4676.