银杏达莫注射液联合醋酸泼尼松治疗突发性耳聋临床研究
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摘要
目的:探讨突发性耳聋(SD)应用银杏达莫注射液联合醋酸泼尼松治疗的临床效果。方法:将SD患者156例,采取随机数字表法分为2组各78例。对照组口服醋酸泼尼松,观察组在此基础上加用银杏莫达注射液治疗。比较2组临床疗效,治疗前后血流变参数[血浆黏度(PV)、红细胞聚集指数(EAI)、红细胞变形指数(EDI)]、血小板参数[平均血小板体积(MPV)、血小板聚集率(PAR)]及血清学指标[中性粒细胞激活肽-78 (ENA-78)、高迁移率蛋白-1 (HMGB1)、一氧化氮(NO)、内皮素(ET)、降钙素基因相关肽(CGRP)]水平变化,不良反应发生情况。结果:观察组总有效率为92.3%,高于对照组的80.8%(P <0.05)。2组治疗后PV、EAI值较治疗前均下降(P <0.05),EDI值均增高(P <0.05);且观察组以上指标改善优于对照组(P <0.05)。与治疗前比较,2组治疗后MPV、PAR值均减低(P <0.05);且观察组下降更显著(P <0.05)。2组治疗后血清ENA-78、HMGB1、ET水平较治疗前均降低(P <0.05),NO、CGRP浓度均上升(P <0.05);且观察组以上指标改善优于对照组(P <0.05)。观察组不良反应率为6.4%,对照组为3.8%,2组比较,差异无统计学意义(P> 0.05)。结论:SD应用银杏达莫注射液联合醋酸泼尼松治疗能迅速消除患者症状,明显减轻炎性损伤,保护血管内皮功能,改善微循环,疗效确切,安全可靠。
Objective: To explore the clinical effect of ginkgo leaf extract and dipyridamole injection combined with prednisone acetate for sudden deafness(SD). Methods: Divided 156 cases of SD patients into two groups according to random number table method, 78 cases in each group. The control group was treated with prednisone acetate orally, while the observation group was additionally treated with ginkgo leaf extract and dipyridamole injection based on the treatment of the control group. Compared the clinical effect, the changes in hemorrheological parameters including plasma viscosity(PV),erythrocyte aggregation index(EAI) and erythrocyte deformation index(EDI), platelet parameters including mean platelet volume(MPV) and platelet aggregation rate(PAR), serum indexes including epithelial neutrophil-activating peptide-78(ENA-78), high mobility group protein-1(HMG-1), nitric oxide(NO), endothelin(ET) and calcitonin gene-related peptide(CGRP) before and after treatment, and the adverse reactions in the two groups. Results: The total effective rate was 92.3% in the observation group,higher than that of 80.8% in the control group(P < 0.05). Values of PV and EAI in the two groups were decreased when compared with those before treatment(P < 0.05), and the value of EDI in the two groups were increased(P < 0.05). The improvement of above indexes in the observation group was better than those in the control group(P< 0.05). Compared with those before treatment,values of MPV and PAR in the two groups were decreased(P < 0.05), and the decrease in the observation group was more obvious than that in the control group(P < 0.05). Levels of ENA-78,HMGB1 and ET in serum in the two groups were decreased when compared with those before treatment(P < 0.05), and the concentration of NO and CGRP in the two groups were increased(P < 0.05). The improvement of above indexes in the observation group was better than those in the control group(P< 0.05). The incidence of adverse reactions was 6.4% in the observation group and 3.8% in the control group,there being no significance in the difference(P > 0.05). Conclusion: The therapy of ginkgo leaf extract and dipyridamole injection combined with prednisone acetate for SD can rapidly eliminate the symptoms, obviously relieve inflammatory injury, protect vascular endothelial function and improve microcirculation with definite effect and high safety.
Objective: To explore the clinical effect of ginkgo leaf extract and dipyridamole injection combined with prednisone acetate for sudden deafness(SD). Methods: Divided 156 cases of SD patients into two groups according to random number table method, 78 cases in each group. The control group was treated with prednisone acetate orally, while the observation group was additionally treated with ginkgo leaf extract and dipyridamole injection based on the treatment of the control group. Compared the clinical effect, the changes in hemorrheological parameters including plasma viscosity(PV),erythrocyte aggregation index(EAI) and erythrocyte deformation index(EDI), platelet parameters including mean platelet volume(MPV) and platelet aggregation rate(PAR), serum indexes including epithelial neutrophil-activating peptide-78(ENA-78), high mobility group protein-1(HMG-1), nitric oxide(NO), endothelin(ET) and calcitonin gene-related peptide(CGRP) before and after treatment, and the adverse reactions in the two groups. Results: The total effective rate was 92.3% in the observation group,higher than that of 80.8% in the control group(P < 0.05). Values of PV and EAI in the two groups were decreased when compared with those before treatment(P < 0.05), and the value of EDI in the two groups were increased(P < 0.05). The improvement of above indexes in the observation group was better than those in the control group(P< 0.05). Compared with those before treatment,values of MPV and PAR in the two groups were decreased(P < 0.05), and the decrease in the observation group was more obvious than that in the control group(P < 0.05). Levels of ENA-78,HMGB1 and ET in serum in the two groups were decreased when compared with those before treatment(P < 0.05), and the concentration of NO and CGRP in the two groups were increased(P < 0.05). The improvement of above indexes in the observation group was better than those in the control group(P< 0.05). The incidence of adverse reactions was 6.4% in the observation group and 3.8% in the control group,there being no significance in the difference(P > 0.05). Conclusion: The therapy of ginkgo leaf extract and dipyridamole injection combined with prednisone acetate for SD can rapidly eliminate the symptoms, obviously relieve inflammatory injury, protect vascular endothelial function and improve microcirculation with definite effect and high safety.
引文
[1]Muhlmeier G,Baguley D,Cox T,et al.Characteristics and spontaneous recovery of tinnitus related to idiopathic sudden sensorineural hearing loss[J].Otol Neurotol,2016,37(6):634-641.
[2]Koo M,Chen JC,Hwang JH.Risk of peripheral artery occlusive disease in patients with vertigo,tinnitus,or sudden deafness:a secondary case-control analysis of a nationwide,population-based health claims database[J].PLo S One,2016,11(9):e0162629.
[3]付建梅.鼓室注射类固醇激素联合改善微循环药物治疗突发性耳聋疗效观察[J].山西医药杂志,2018,47(1):71-72.
[4]张宇,高中,刘亚军,等.早期联合鼓室注射糖皮质激素治疗突发性聋效果分析[J].中国耳鼻咽喉头颈外科,2016,23(2):73-77.
[5]徐翔,何庆文,肖才文,等.巴曲酶联合银杏达莫注射液对突发性耳聋患者血流动力学、凝血功能、纤维蛋白溶解功能及相关因子水平的影响[J].海南医学院学报,2017,23(22):3161-3164.
[6]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.
[7]Im GJ,Park E.Sudden sensorineural hearing loss[J].Hanyang Med Rev,2015,35(2):92-96.
[8]Chen WT,Lee JW,Yuan CH,et al.Oral steroid treatment for idiopathic sudden sensorineural hearing loss[J].Saudi Med J,2015,36(3):291-296.
[9]管红霞,张志坚,江洋,等.糖皮质激素治疗突发性聋的研究进展[J].中国医药导报,2016,13(5):41-45.
[10]于玲,徐静.银杏叶提取物治疗突发性耳聋气滞血瘀证临床研究[J].中医学报,2018,33(1):145-148.
[11]李淦峰,李志海.巴曲酶联合银杏达莫注射液治疗突发性耳聋的临床疗效及安全性评价[J].中国临床药理学杂志,2016,32(8):675-677.
[12]黄芳,蒋玉欢,郭飞波,等.银杏达莫注射液联合醋酸泼尼松治疗突发性耳聋患者疗效观察及其对患者血液流变学和细胞因子影响[J].湖南中医药大学学报,2018,38(1):85-88.
[13]黄智强,李洁,喇新军,等.突发性耳聋患者血液流变学水平及血脂变化的临床意义[J].中国听力语言康复科学杂志,2017,15(2):103-106.
[14]Sun Y,Guo Y,Wang H,et al.Differences in plateletrelated parameters among patients with audiographically distinct sudden sensorineural hearing loss:A retrospective study[J].Medicine(Baltimore),2017,96(36):e7877.
[15]周群,侯东彬.银杏达莫注射液的药理作用及不良反应研究进展[J].中国药房,2013,24(28):2686-2688.
[16]王慧敏,余文发,周航,等.银杏叶片联合高压氧对老年突发性耳聋患者血清CRP水平影响及临床疗效研究[J].中华中医药学刊,2017,35(5):1246-1249.
[17]施典羽,杨凯,敬光怀,等.特发性突聋患者外周血ET、CGRP和NO的检测分析[J].中国中西医结合耳鼻咽喉科杂志,2012,20(4):246-248.
[18]宾驰.银杏达莫注射液的药理作用及临床应用研究进展[J].中国药业,2010,19(14):88.
[2]Koo M,Chen JC,Hwang JH.Risk of peripheral artery occlusive disease in patients with vertigo,tinnitus,or sudden deafness:a secondary case-control analysis of a nationwide,population-based health claims database[J].PLo S One,2016,11(9):e0162629.
[3]付建梅.鼓室注射类固醇激素联合改善微循环药物治疗突发性耳聋疗效观察[J].山西医药杂志,2018,47(1):71-72.
[4]张宇,高中,刘亚军,等.早期联合鼓室注射糖皮质激素治疗突发性聋效果分析[J].中国耳鼻咽喉头颈外科,2016,23(2):73-77.
[5]徐翔,何庆文,肖才文,等.巴曲酶联合银杏达莫注射液对突发性耳聋患者血流动力学、凝血功能、纤维蛋白溶解功能及相关因子水平的影响[J].海南医学院学报,2017,23(22):3161-3164.
[6]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.
[7]Im GJ,Park E.Sudden sensorineural hearing loss[J].Hanyang Med Rev,2015,35(2):92-96.
[8]Chen WT,Lee JW,Yuan CH,et al.Oral steroid treatment for idiopathic sudden sensorineural hearing loss[J].Saudi Med J,2015,36(3):291-296.
[9]管红霞,张志坚,江洋,等.糖皮质激素治疗突发性聋的研究进展[J].中国医药导报,2016,13(5):41-45.
[10]于玲,徐静.银杏叶提取物治疗突发性耳聋气滞血瘀证临床研究[J].中医学报,2018,33(1):145-148.
[11]李淦峰,李志海.巴曲酶联合银杏达莫注射液治疗突发性耳聋的临床疗效及安全性评价[J].中国临床药理学杂志,2016,32(8):675-677.
[12]黄芳,蒋玉欢,郭飞波,等.银杏达莫注射液联合醋酸泼尼松治疗突发性耳聋患者疗效观察及其对患者血液流变学和细胞因子影响[J].湖南中医药大学学报,2018,38(1):85-88.
[13]黄智强,李洁,喇新军,等.突发性耳聋患者血液流变学水平及血脂变化的临床意义[J].中国听力语言康复科学杂志,2017,15(2):103-106.
[14]Sun Y,Guo Y,Wang H,et al.Differences in plateletrelated parameters among patients with audiographically distinct sudden sensorineural hearing loss:A retrospective study[J].Medicine(Baltimore),2017,96(36):e7877.
[15]周群,侯东彬.银杏达莫注射液的药理作用及不良反应研究进展[J].中国药房,2013,24(28):2686-2688.
[16]王慧敏,余文发,周航,等.银杏叶片联合高压氧对老年突发性耳聋患者血清CRP水平影响及临床疗效研究[J].中华中医药学刊,2017,35(5):1246-1249.
[17]施典羽,杨凯,敬光怀,等.特发性突聋患者外周血ET、CGRP和NO的检测分析[J].中国中西医结合耳鼻咽喉科杂志,2012,20(4):246-248.
[18]宾驰.银杏达莫注射液的药理作用及临床应用研究进展[J].中国药业,2010,19(14):88.