突發(fā)性耳聾風(fēng)熱侵襲型與氣滯血瘀型純音聽(tīng)閾測(cè)定、聽(tīng)性腦干誘發(fā)電位關(guān)系的研究
發(fā)布時(shí)間:2018-02-05 22:57
本文關(guān)鍵詞: 突發(fā)性耳聾 辨證分型 純音聽(tīng)閡測(cè)定 聽(tīng)性腦干誘發(fā)電位 出處:《福建中醫(yī)藥大學(xué)》2010年碩士論文 論文類(lèi)型:學(xué)位論文
【摘要】: 目的:通過(guò)分析風(fēng)熱侵襲型及氣滯血瘀型突發(fā)性耳聾患者的純音聽(tīng)閾測(cè)定、聽(tīng)性腦干誘發(fā)電位各指標(biāo)的差異,探討不同證型在聽(tīng)力學(xué)方面的不同特征,找出證型與聽(tīng)力學(xué)變化的關(guān)系,從而提高辨證客觀性與準(zhǔn)確性,使祖國(guó)醫(yī)學(xué)的優(yōu)勢(shì)得到進(jìn)一步充分的發(fā)揮。方法:選2009年1月—2009年12月在福建省立醫(yī)院耳鼻喉科門(mén)診及住院的符合診斷標(biāo)準(zhǔn)的突發(fā)性耳聾患者,按其典型癥候分為風(fēng)熱侵襲型與氣滯血瘀型2組,分別進(jìn)行純音聽(tīng)閾測(cè)定及聽(tīng)性腦干誘發(fā)電位檢查,分析兩個(gè)證型聽(tīng)力學(xué)檢測(cè)結(jié)果的特征及兩組所存在的差異性。 結(jié)果:本課題風(fēng)熱侵襲組30例(30耳),伴耳鳴27例,眩暈9例,氣滯血瘀組30例(33耳),伴耳鳴26例,眩暈9例。兩組純音聽(tīng)閾測(cè)定氣導(dǎo)平均聽(tīng)閾及0.5-8KHz氣導(dǎo)聽(tīng)閾均有顯著性差異,風(fēng)熱侵襲組氣導(dǎo)平均聽(tīng)閾及0.5-8KHz氣導(dǎo)聽(tīng)閾均較氣滯血瘀組低,聽(tīng)力損失程度較小。風(fēng)熱侵襲組以輕、中度耳聾為主,氣滯血瘀組以中重度耳聾及重度耳聾為主。聽(tīng)力圖形風(fēng)熱侵襲組以高頻型聽(tīng)力下降及平坦型為主,氣滯血瘀型則以平坦型為主。兩組患者聽(tīng)性腦干誘發(fā)電位檢查,Ⅴ波反應(yīng)閾值有顯著性差異。風(fēng)熱侵襲組Ⅴ波反應(yīng)閾值明顯低于氣滯血瘀組,聽(tīng)力損失程度較低。兩組短聲80dB nHL刺激時(shí)聽(tīng)性腦干誘發(fā)電位Ⅰ波、Ⅲ波及Ⅴ波潛伏期及波間期無(wú)明顯差異。 結(jié)論:初步認(rèn)為風(fēng)熱侵襲型、氣滯血瘀型突發(fā)性耳聾患者聽(tīng)力損失程度及聽(tīng)力圖形有差異,提示聽(tīng)力學(xué)檢查可能與中醫(yī)辨證中病位有一些關(guān)系,為臨床突發(fā)性耳聾中醫(yī)客觀辨證提供可能。
[Abstract]:Objective: to analyze the difference of auditory brainstem evoked potentials (BAEP) in patients with sudden deafness of wind-heat invasion type and Qi stagnation and blood stasis type, and to explore the different characteristics of different syndromes in audiology. To find out the relationship between syndrome types and audiology changes, so as to improve the objectivity and accuracy of syndrome differentiation. Make the advantage of motherland medicine get further full play. Method:. Patients with sudden deafness who met the diagnostic criteria were selected from January 2009 to December 2009 in the department of otolaryngology of Fujian Provincial Hospital. According to their typical symptoms, they were divided into two groups: wind and heat invasion type and qi stagnation and blood stasis type. The pure tone hearing threshold and auditory brainstem evoked potential (BAEP) were measured respectively. To analyze the characteristics of audiology test results of the two syndrome types and the differences between the two groups. Results: in the group of wind and heat invasion, there were 30 cases of tinnitus, 27 cases of tinnitus, 9 cases of vertigo, 30 cases of Qi stagnation and blood stasis group (30 cases) and 26 cases of tinnitus. There were significant differences in the mean and 0.5-8kHz air conduction thresholds between the two groups. The average hearing threshold and 0.5-8kHz hearing threshold of wind-heat invasion group were lower than those of Qi stagnation and blood stasis group, and the hearing loss was smaller. The main hearing loss was mild and moderate deafness in wind-heat invasion group. Qi stagnation and blood stasis group was mainly medium and severe deafness, and the hearing pattern wind heat attack group was high frequency hearing loss and flat type. There was significant difference in auditory brainstem evoked potential between the two groups. The threshold of V wave response in wind heat invasion group was significantly lower than that in qi stagnation and blood stasis group. There was no significant difference between the two groups in the latency and interphase of auditory brainstem evoked potentials (wave 鈪,
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