针灸结合中药治疗神经性耳鸣的临床疗效观察
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摘要
目的:观察分析针灸结合中药治疗神经性耳鸣的临床疗效。方法:选取承德医学院附属医院中医科门诊诊治的120例神经性耳鸣(中医辨证为痰瘀内阻证)患者作为研究对象,按就诊顺序随机分为对照组和观察组。对照组采用口服甲钴胺片联合银杏叶片治疗,观察组给予中医综合疗法(针灸结合口服中药汤剂)治疗,比较两组患者的临床治疗效果。结果:观察组的有效率为86.7%,显著高于对照组的66.7%,差异具有统计学意义(P<0.01)。两组治疗后耳鸣严重程度均有明显改善,而观察组改善优于对照组,差异具有显著性(P<0.01)。观察组与对照组在治疗后SF-36生活质量量表评分均有显著升高,观察组升高幅度更明显,与对照组相比差异具有显著性(P<0.05)。治疗后两组汉密尔顿焦虑量表总分均有降低,观察组与对照组相比较,总分降低的程度更显著,差异有统计学意义(P<0.05)。结论:针灸结合中药治疗神经性耳鸣的疗效显著,可改善患者生活质量,减轻焦虑症状,有临床推广应用价值。
Objective: To observe and analyze the clinical efficacy of acupuncture and moxibustion combined with traditional Chinese medicine in the treatment of nervous tinnitus. Methods: A total of 120 patients with neurogenic tinnitus(TCM syndrome differentiation is internal obstruction of phlegm and blood stasis) in the traditional Chinese medicine outpatient department of the affiliated hospital of chengde medical college were randomly divided into control group and observation group according to the order of visit. The control group was treated with oral mecobalamine tablets combined with ginkgo biloba leaves, while the observation group was treated with traditional Chinese medicine comprehensive therapy(acupuncture combined with oral Chinese medicine decoction), and the clinical therapeutic effects of the two groups were compared. Results: The effective rate of the observation group was 86.7%, which was significantly higher than that of the control group(66.7%), and the difference was statistically significant(P<0.01). The severity of tinnitus was significantly improved in both groups after treatment, while the improvement in the observation group was better than that in the control group, and the difference was significant(P<0.01). After treatment, the sf-36 quality of life scale score of both the observation group and the control group was significantly increased, and the increase rate of the sf-36 quality of life scale of the observation group was more significant, with a significant difference compared with the control group(P<0.05). After treatment, the total scores of Hamilton anxiety scale in both groups were reduced, and the degree of reduction was more significant in the observation group and the control group, with statistically significant difference(P<0.05). Conclusion: Acupuncture and moxibustion combined with traditional Chinese medicine in the treatment of neurogenic tinnitus has significant efficacy, can improve the quality of life of patients, reduce anxiety symptoms, clinical application value.
Objective: To observe and analyze the clinical efficacy of acupuncture and moxibustion combined with traditional Chinese medicine in the treatment of nervous tinnitus. Methods: A total of 120 patients with neurogenic tinnitus(TCM syndrome differentiation is internal obstruction of phlegm and blood stasis) in the traditional Chinese medicine outpatient department of the affiliated hospital of chengde medical college were randomly divided into control group and observation group according to the order of visit. The control group was treated with oral mecobalamine tablets combined with ginkgo biloba leaves, while the observation group was treated with traditional Chinese medicine comprehensive therapy(acupuncture combined with oral Chinese medicine decoction), and the clinical therapeutic effects of the two groups were compared. Results: The effective rate of the observation group was 86.7%, which was significantly higher than that of the control group(66.7%), and the difference was statistically significant(P<0.01). The severity of tinnitus was significantly improved in both groups after treatment, while the improvement in the observation group was better than that in the control group, and the difference was significant(P<0.01). After treatment, the sf-36 quality of life scale score of both the observation group and the control group was significantly increased, and the increase rate of the sf-36 quality of life scale of the observation group was more significant, with a significant difference compared with the control group(P<0.05). After treatment, the total scores of Hamilton anxiety scale in both groups were reduced, and the degree of reduction was more significant in the observation group and the control group, with statistically significant difference(P<0.05). Conclusion: Acupuncture and moxibustion combined with traditional Chinese medicine in the treatment of neurogenic tinnitus has significant efficacy, can improve the quality of life of patients, reduce anxiety symptoms, clinical application value.
引文
[1] 范小利,李丽.针药并用配合心理干预治疗神经性耳鸣疗效观察[J].上海针灸杂志,2014,33(5):430～432.
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[8] 王洪田,李明,刘蓬等.耳鸣的诊断和治疗指南(建议案)。中华耳科学杂志,2009,7(3):185.
[9] 世界中医药学会联合会中医耳鼻喉口腔科专业标准审定委员会,中华中医药学会耳鼻咽喉科分会.耳鸣严重程度评估与疗效评定参考标准[J].世界中医药,2008,3(2):71.
[10] 杨萍,戴伟。温针灸治疗气血亏虚型神经性耳鸣疗效观察[J].按摩与康复医学,2015,6(19):35～36.
[11] 郭佳,费兰波.神经性耳鸣现代针灸腧穴谱[J].中医研究,2017,30(9):43～45.
[12] 李艳,徐兰凤,刘兰英,等.赵氏雷火灸治疗痛证疗效评价及效应机制研究[J].吉林中医药,2016,36(6):619～622.
[13] 冯明波.中西医结合治疗神经性耳鸣的疗效观察[J].大家健康,2016,10(32):36～37.
[14] 袁景和.星状神经节阻滞联合甲钴胺、维生素B12治疗神经性耳鸣的疗效观察[J].内科急危重症杂志,2018,24(5):403～405.
[2] 刘志庆,张瑾,张慧敏,等.针刺治疗神经性耳鸣伴失眠30例疗效观察[J].湖南中医杂志,2018,34(12):68～69.
[3] 刘雪兰,万文蓉.针灸治疗神经性耳鸣研究进展[J].亚太传统医药,2018(14)1:104～106.
[4] 段建雪,杨和艳,于亚婷等.针灸治疗神经性耳鸣近10年的临床研究进展[J].云南中医中药杂志,2016,37(5):69～71.
[5] 陈忠辉.论中医针药并用过程中针灸和中药的关系[J].健康必读,2018,2(4):163.
[6] 国家中医药管理局.中华人民共和国中医药行业标准-中医病证诊断疗效标准[M].南京:南京大学出版社,2012.20～21.
[7] 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,2011.1031～1037.
[8] 王洪田,李明,刘蓬等.耳鸣的诊断和治疗指南(建议案)。中华耳科学杂志,2009,7(3):185.
[9] 世界中医药学会联合会中医耳鼻喉口腔科专业标准审定委员会,中华中医药学会耳鼻咽喉科分会.耳鸣严重程度评估与疗效评定参考标准[J].世界中医药,2008,3(2):71.
[10] 杨萍,戴伟。温针灸治疗气血亏虚型神经性耳鸣疗效观察[J].按摩与康复医学,2015,6(19):35～36.
[11] 郭佳,费兰波.神经性耳鸣现代针灸腧穴谱[J].中医研究,2017,30(9):43～45.
[12] 李艳,徐兰凤,刘兰英,等.赵氏雷火灸治疗痛证疗效评价及效应机制研究[J].吉林中医药,2016,36(6):619～622.
[13] 冯明波.中西医结合治疗神经性耳鸣的疗效观察[J].大家健康,2016,10(32):36～37.
[14] 袁景和.星状神经节阻滞联合甲钴胺、维生素B12治疗神经性耳鸣的疗效观察[J].内科急危重症杂志,2018,24(5):403～405.