【摘要】：目的:探討升陽益氣化瘀法聯(lián)合針刺治療老年性突發(fā)性耳聾的臨床研究。材料與方法:選取120例老年性突發(fā)性耳聾患者,均是單側(cè)突聾,隨機(jī)分成治療組與對(duì)照組,治療組60例,對(duì)照組60例,對(duì)照組給予0.9%氯化鈉注射液250ml或5%葡萄糖注射液250ml、靜滴舒血寧注射液70mg日一次,甲鈷胺片0.5mg日3次口服,甲潑尼松龍40mg耳后穴位注射,隔日給藥1次,共5次。治療組在對(duì)照組基礎(chǔ)上給予口服升陽益氣化瘀法湯劑聯(lián)合針刺,兩組均以1周為一個(gè)療程,共2個(gè)療程。通過突發(fā)性耳聾療效判定標(biāo)準(zhǔn)評(píng)價(jià)耳聾療效、通過耳鳴療效判定標(biāo)準(zhǔn)評(píng)價(jià)耳鳴療效。采用THI耳鳴殘障量表評(píng)價(jià)耳鳴療效、DHI眩暈殘障量表評(píng)價(jià)眩暈療效及VAS視覺量表評(píng)價(jià)耳悶療效。比較治療前后血流變學(xué)及血漿纖維蛋白原的改變進(jìn)行療效評(píng)價(jià)。以上比較計(jì)數(shù)資料采用X2檢驗(yàn),計(jì)量資料采用配對(duì)t檢驗(yàn),等級(jí)資料采用Ridit分析。結(jié)果:1.兩組患者在性別、年齡、伴隨癥狀上均無統(tǒng)計(jì)學(xué)差異。2.治療后治療組聽力總有效率70.0%,對(duì)照組聽力總有效率51.6%,治療組療效優(yōu)于對(duì)照組,具有顯著性差異。3.治療后治療組耳鳴總有效率62.22%,對(duì)照組總有效率48.89%,治療組治療后THI量表評(píng)分低于治療前,具有顯著性差異;對(duì)照組治療后THI量表評(píng)分低于治療前,具有顯著性差異,治療后治療組THI量表評(píng)分低于對(duì)照組,具有顯著性差異,說明治療組在耳鳴療效方面優(yōu)于對(duì)照組,具有顯著性差異。4.治療組治療后DHI殘障量表評(píng)分低于治療前,具有顯著性差異。對(duì)照組治療后DHI殘障量表評(píng)分低于治療前,具有顯著性差異,治療后治療組DHI殘障量表評(píng)分低于對(duì)照組,具有顯著性差異,說明在眩暈療效方面治療組優(yōu)于對(duì)照組。5.治療組治療后VAS量表評(píng)分低于治療前,具有顯著性差異,對(duì)照組治療后VAS量表評(píng)分低于治療前,具有顯著性差異,治療后治療組VAS量表評(píng)分低于對(duì)照組,具有顯著性差異,說明在耳悶療效方面治療組療效優(yōu)于對(duì)照組。6.治療組治療后血漿粘度、全血低切還原黏度、全血中切還原黏度、血漿纖維蛋白原數(shù)值低于治療前,具有顯著性差異,對(duì)照組治療后血漿粘度、全血低切還原黏度、全血中切還原黏度、血漿纖維蛋白原數(shù)值低于治療前,具有顯著性差異,治療后治療組血漿黏度、全血低切還原黏度、全血中切還原黏度、血漿纖維蛋白原數(shù)值低于對(duì)照組,具有顯著性差異,說明在降低血漿黏度、全血低切還原黏度、全血中切還原黏度、血漿纖維蛋白原方面,治療組優(yōu)于對(duì)照組。治療組治療后全血高切還原黏度數(shù)值低于治療前,具有顯著性差異,對(duì)照組治療后全血高切還原黏度數(shù)值低于治療前,具有顯著性差異,兩組治療后全血高切還原黏度數(shù)值均降低,但不具有顯著差異,說明治療組無改善全血高切還原黏度的作用。結(jié)論:升陽益氣化瘀法配合針刺治療老年性突發(fā)性耳聾有一定療效,體現(xiàn)了中醫(yī)辨證論治的特色,臨床上可以推廣。
[Abstract]:Objective: to explore the clinical study on the treatment of presbyopic sudden deafness with the combination of Shengyang Yiqi Huayu method and acupuncture. Materials and methods: 120 patients with sudden presbycusis were randomly divided into treatment group (n = 60) and control group (n = 60). In the control group, 0.9% sodium chloride injection 250ml or 5% glucose injection 250ml, intravenous Shuxuening injection 70mg once a day, methylcobalamin tablet 0.5mg three times, meprednisolone 40mg retroear acupoint injection, once every other day, a total of 5 times. The treatment group was treated with Shengyang Yiqi Huayu decoction combined with acupuncture on the basis of the control group. The curative effect of sudden deafness was evaluated by the criterion of curative effect of sudden deafness, and the curative effect of tinnitus was evaluated by the criterion of curative effect of tinnitus. Thi tinnitus disability scale was used to evaluate tinnitus efficacy. DHI dizziness scale was used to evaluate vertigo effect and VAS visual scale was used to evaluate ear stuffing effect. The changes of hemorheology and plasma fibrinogen were compared before and after treatment. The above data were analyzed by X _ 2 test, matched t test and Ridit analysis. The result is 1: 1. There was no significant difference in sex, age, and associated symptoms between the two groups. After treatment, the total effective rate of hearing in the treatment group was 70.0 and that in the control group was 51.6. The curative effect of the treatment group was better than that of the control group, and the difference was significant. The total effective rate of tinnitus in the treatment group was 62.22 and the total effective rate in the control group was 48.89.The Thi scale score of the treatment group was lower than that of the pre-treatment group, and the THI scale score of the control group was lower than that of the pre-treatment group. After treatment, the Thi scale score in the treatment group was lower than that in the control group, which showed that the therapeutic effect of tinnitus in the treatment group was better than that in the control group, and there was significant difference between the treatment group and the control group. 4. The score of DHI disability scale after treatment in the treatment group was lower than that before treatment, and there was significant difference. The DHI disability scale score after treatment in the control group was lower than that before treatment, and the DHI disability scale score in the treatment group was lower than that in the control group after treatment, which indicated that the treatment group was better than the control group in the effect of vertigo. 5. The scores of VAS after treatment in the treatment group were lower than those before the treatment, and there were significant differences between the control group and the control group after treatment, and the scores of the VAS in the treatment group were lower than those in the control group after treatment, and there was significant difference between the treatment group and the control group. It showed that the curative effect of the treatment group was better than that of the control group. There were significant differences in plasma viscosity, whole blood low shear reduction viscosity, whole blood shear reduction viscosity and plasma fibrinogen value after treatment in the treatment group. The plasma fibrinogen value was lower than that of the control group. After treatment, the plasma viscosity, the whole blood low shear reduction viscosity, the whole blood shear reduction viscosity and the plasma fibrinogen value of the treatment group were lower than those of the control group. The results showed that the treatment group was superior to the control group in reducing plasma viscosity, reducing viscosity in whole blood, reducing viscosity in whole blood and fibrinogen in plasma. In the treatment group, the whole blood high shear reduction viscosity value was lower than that before treatment, and the whole blood high shear reduction viscosity value after treatment in the control group was lower than that before treatment, and there was significant difference between the treatment group and the control group. The value of whole blood high shear reduction viscosity decreased after treatment, but there was no significant difference between the two groups, indicating that the treatment group did not improve the whole blood high shear reduction viscosity. Conclusion: Shengyang Yiqi Huayu method combined with acupuncture has certain curative effect on presbyopic sudden deafness, which embodies the characteristics of TCM differentiation and treatment, and can be popularized clinically.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R276.1

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