鼓室内注射地塞米松联合褪黑素治疗单侧急性耳鸣疗效研究  

Efficacy of Injection of Dexamethasone Into Tympanum Combined With Melatonin for Unilateral Acute Tinnitus

作　　者：贺海霞[1] 袁琨[1] 陈伟[1] 

机构地区：[1]湖北省武汉市中心医院耳鼻喉科,430014

出　　处：《中国全科医学》2016年第17期2024-2027,共4页Chinese General Practice

基　　金：湖北省科技计划项目(2013CFC082)

摘　　要：目的：探讨鼓室内注射地塞米松联合褪黑素治疗单侧急性耳鸣的疗效。方法选取2015年1—7月武汉市中心医院收治的单侧急性耳鸣患者100例，根据其采用的治疗方法不同分为试验组和对照组，各50例。试验组患者采用鼓室内注射地塞米松联合褪黑素治疗，鼓室内注射地塞米松1次/3 d，每晚睡前服用褪黑素片3 mg；对照组患者每晚睡前服用褪黑素片3 mg，两组均持续治疗3周。评价两组患者治疗0、1、2、3周时耳鸣响度评分、耳鸣意识评分、耳鸣残疾量表（THI）、匹兹堡睡眠质量指数表（PSQI）、贝克抑郁自评量表（ BDI）评分；评价两组患者的治疗效果及不良反应发生情况。结果两组治疗前后耳鸣响度评分、耳鸣意识评分、THI、PSQI、BDI 评分时间与组间无交互作用（P ＞0.05）；两组组间耳鸣响度评分、耳鸣意识评分、THI、PSQI、BDI 评分比较，差异均有统计学意义（P ＜0.05）；两组组内不同时间点耳鸣响度评分、耳鸣意识评分、THI、PSQI、BDI 评分比较，差异均有统计学意义（ P ＜0.05）。两组急性耳鸣治疗效果比较，差异有统计学意义（ U ＝771，P ＜0.001）。对照组不良反应发生率为22.0％（11/50），试验组不良反应发生率为24.0％（12/50），两组不良反应发生率比较，差异无统计学意义（χ2＝0.056，P＝0.812）。结论鼓室内注射地塞米松联合褪黑素能够显著改善单侧急性耳鸣的临床治疗效果，且安全性较好。Objective To investigate the efficacy of the injection of dexamethasone into tympanum combined with melatonin for unilateral acute tinnitus. Methods A total of 100 patients with unilateral acute tinnitus who received treatment in Wuhan Central Hospital from January to July in 2015 were enrolled. According to different treatment methods,we divided these patients into trial group and control group,with 50 patients in each group. Trial group was administrated with injection of dexamethasone into tympanum combined with melatonin,with the injection conducted once every three days and 3 mg melatonin taken before sleep every night. Patients in control group took 3 mg melatonin before sleep every night. The intervention lasted for 3 weeks for both groups. The scores of tinnitus volume,tinnitus consciousness,tinnitus handicap inventory（THI）,pittsburgh sleep quality fares（PSQI）,and Beck depression inventory（BDI）of the two groups were evaluated at 0,1,2,3 week;the therapeutic effect and adverse reactions of the two groups were assessed. Results There were no interaction between time and group in the scores of tinnitus volume,tinnitus consciousness,THI,PSQI,and BDI（ P 〉 0. 05 ）;the two groups were significantly different in the scores of tinnitus volume,tinnitus consciousness,THI,PSQI,and BDI（P 〈 0. 05）;the scores of tinnitus volume,tinnitus consciousness,THI,PSQI,and BDI were significantly different among different time points within each group（P 〈 0. 05）. The two groups were significantly different in the efficacy of unilateral acute tinnitus treatment（ U= 771,P 〈 0. 001）. The incidence of adverse reactions of control group and trial group was 22. 0% （11 / 50） and 24. 0%（12 / 50）respectively;the two groups were not significantly different in the incidence of adverse reactions（ χ2 = 0. 056,P= 0. 812）. Conclusion Injection of dexamethasone into tympanum combined with melatonin can significantly improve the clinical efficacy for unilateral acute tinnitus with good safety.

关 键 词：耳鸣 褪黑激素 地塞米松 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]