葛根素注射液联合长春西汀治疗突发性耳聋的临床研究
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摘要
目的观察葛根素注射液联合长春西汀治疗突发性耳聋的临床疗效。方法选取2018年1月—2018年9月重庆市巴南区人民医院收治的突发性耳聋患者126例,随机分为对照组(63例)和治疗组(63例)。对照组患者静脉滴注长春西汀注射液,30 mg加入生理盐水250 mL,1次/d。治疗组患者在对照组的基础上静脉滴注葛根素注射液,0.4 g加入5%葡萄糖注射液250 mL,1次/d。两组患者治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者平均听阈值、血液流变学和氧化应激指标变化。结果治疗后,对照组和治疗组的总有效率分别为79.36%、93.70%,两组比较差异均具有统计学意义(P<0.05)。治疗3、7、14 d后,两组患者平均听阈值明显降低(P<0.05),且治疗后治疗组患者平均听阈值明显低于同期对照组(P<0.05)。治疗后,两组患者全血黏度、血浆黏度、纤维蛋白原和血小板聚集率显著降低(P<0.05),且治疗组患者这些血液流变学指标明显低于对照组(P<0.05)。治疗后,两组患者NO和超氧化物歧化酶(P-SOD)水平明显上升(P<0.05),内皮素(ET)和过氧化脂质(P-LPO)水平明显下降(P<0.05),且治疗组患者这些氧化应激指标明显好于对照组(P<0.05)。结论葛根素注射液联合长春西汀治疗突发性耳聋临床疗效确切,可有效改善患者血液流变学,减轻氧化应激反应。
Objective To observe the clinical efficacy of Puerarin Injection combined with vinpocetine in treatment of sudden deafness. Methods Patients(126 cases) with sudden deafness in Banan People's Hospital of Chongqing from January 2018 to September 2018 were randomly divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were iv administered with Vinpocetine Injection, 30 mg added into 250 mL normal saline, once daily. Patients in the treatment group were iv administered with Puerarin Injection on the basis of the control group, 0.4 g added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the change of average auditory thresholds,hemorheological indexes and oxidative stress indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.36% and 93.70%, respectively, and there were differences between two groups(P < 0.05). After treatment for 3, 7, and 14 d, the average auditory thresholds in two groups was significantly decreased(P < 0.05), and the average auditory thresholds in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the whole blood viscosity, plasma viscosity, fibrinogen, and platelet aggregation rate in two groups were significantly decreased(P < 0.05), and these hemorheological indexes in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the NO and P-SOD levels in two groups were significantly increased(P < 0.05),but ET and P-LPO levels were significantly decreased(P < 0.05), and the oxidative stress indexes levels in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Puerarin Injection combined with vinpocetine has definite clinical effect on sudden deafness, can effectively improve hemorheology, reduce oxidative stress response.
Objective To observe the clinical efficacy of Puerarin Injection combined with vinpocetine in treatment of sudden deafness. Methods Patients(126 cases) with sudden deafness in Banan People's Hospital of Chongqing from January 2018 to September 2018 were randomly divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were iv administered with Vinpocetine Injection, 30 mg added into 250 mL normal saline, once daily. Patients in the treatment group were iv administered with Puerarin Injection on the basis of the control group, 0.4 g added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the change of average auditory thresholds,hemorheological indexes and oxidative stress indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 79.36% and 93.70%, respectively, and there were differences between two groups(P < 0.05). After treatment for 3, 7, and 14 d, the average auditory thresholds in two groups was significantly decreased(P < 0.05), and the average auditory thresholds in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the whole blood viscosity, plasma viscosity, fibrinogen, and platelet aggregation rate in two groups were significantly decreased(P < 0.05), and these hemorheological indexes in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the NO and P-SOD levels in two groups were significantly increased(P < 0.05),but ET and P-LPO levels were significantly decreased(P < 0.05), and the oxidative stress indexes levels in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Puerarin Injection combined with vinpocetine has definite clinical effect on sudden deafness, can effectively improve hemorheology, reduce oxidative stress response.
引文
[1]孙亮.突发性耳聋的病因及预后因素研究进展[J].海南医学,2013,24(13):1967-1969.
[2]钱怡,钟时勋,胡国华,等.突发性耳聋的分型治疗及预后分析[J].重庆医科大学学报,2015,40(8):1159-1163.
[3]王政林,蔡克万,刘文婷,等.葛根素联合神经节苷脂钠对突发性耳聋患者血液流变学及血管内皮功能的影响[J].中国药业,2018,27(9):60-63.
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[6]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.
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[8]赵丹珩,孙建军,林勇生,等.长春西汀联合巴曲酶治疗老年突发性耳聋的疗效[J].现代生物医学进展,2015,15(15):2904-2906.
[9]汪群红,章灵芝,徐文伟,等.葛根素的药理作用与不良反应分析[J].中华中医药学刊,2015,33(5):1185-1187.
[10]黄晓巍,张丹丹,王晋冀,等.葛根化学成分及药理作用[J].吉林中医药,2018,38(1):87-89.
[11]方新华,卢晓,吴国清.葛根素对妊娠期糖尿病大鼠调节血脂和抗氧化作用的实验研究[J].中华中医药学刊,2016,34(6):1504-1507.
[12]高培国,强辉,凌鸣.葛根素对过氧化氢诱导的血管内皮细胞损伤的保护作用.[J].西安交通大学学报:医学版,2012,33(2):245-248,260.
[13]罗志强.耳蜗微循环的自身调节机制[J].国外医学耳鼻咽喉科分册,2011,25(14):216-219.
[14]施典羽,杨凯,敬光怀,等.特发性突耳聋患者外周血内皮素的变化及其意义[J].海南医学,2010,21(24):57-59.
[15]唐艳艳.突发性耳聋患者血清NO、免疫球蛋白、SOD及LOP水平检测意义研究[J].河南医学研究,2017,26(1):48-49.
[16]吕向光,王倩,刘涛,等.老年性聋与血浆超氧化物歧化酶、丙二醛及红细胞变形性的关系[J].听力学及言语疾病杂志,2000,8(2):92-93.
[17]陈唯唯,徐娅苹,王辉萼.血液中氧自由基浓度与突发性耳聋的关系及其临床意义[J].浙江大学学报:医学版,2000,29(4):160-161,172.
[2]钱怡,钟时勋,胡国华,等.突发性耳聋的分型治疗及预后分析[J].重庆医科大学学报,2015,40(8):1159-1163.
[3]王政林,蔡克万,刘文婷,等.葛根素联合神经节苷脂钠对突发性耳聋患者血液流变学及血管内皮功能的影响[J].中国药业,2018,27(9):60-63.
[4]刘志平,马玲娣,何文建,等.长春西汀治疗青少年突发性耳聋的临床疗效[J].江苏医药,2011,37(13):1574-1576.
[5]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.突发性聋的诊断和治疗指南[J].中华耳鼻咽喉头颈外科杂志,2015,50(6):443-447.
[6]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.
[7]杨剑,刘博,韩德民.突发性耳聋的循环病因机制[J].国际耳鼻咽喉头颈外科杂志,2006,30(3):175-177.
[8]赵丹珩,孙建军,林勇生,等.长春西汀联合巴曲酶治疗老年突发性耳聋的疗效[J].现代生物医学进展,2015,15(15):2904-2906.
[9]汪群红,章灵芝,徐文伟,等.葛根素的药理作用与不良反应分析[J].中华中医药学刊,2015,33(5):1185-1187.
[10]黄晓巍,张丹丹,王晋冀,等.葛根化学成分及药理作用[J].吉林中医药,2018,38(1):87-89.
[11]方新华,卢晓,吴国清.葛根素对妊娠期糖尿病大鼠调节血脂和抗氧化作用的实验研究[J].中华中医药学刊,2016,34(6):1504-1507.
[12]高培国,强辉,凌鸣.葛根素对过氧化氢诱导的血管内皮细胞损伤的保护作用.[J].西安交通大学学报:医学版,2012,33(2):245-248,260.
[13]罗志强.耳蜗微循环的自身调节机制[J].国外医学耳鼻咽喉科分册,2011,25(14):216-219.
[14]施典羽,杨凯,敬光怀,等.特发性突耳聋患者外周血内皮素的变化及其意义[J].海南医学,2010,21(24):57-59.
[15]唐艳艳.突发性耳聋患者血清NO、免疫球蛋白、SOD及LOP水平检测意义研究[J].河南医学研究,2017,26(1):48-49.
[16]吕向光,王倩,刘涛,等.老年性聋与血浆超氧化物歧化酶、丙二醛及红细胞变形性的关系[J].听力学及言语疾病杂志,2000,8(2):92-93.
[17]陈唯唯,徐娅苹,王辉萼.血液中氧自由基浓度与突发性耳聋的关系及其临床意义[J].浙江大学学报:医学版,2000,29(4):160-161,172.