龙胆泻肝丸联合天麻素穴位注射治疗急性中重度耳聋耳鸣临床研究  

Clinical study on Longdanxiegan pills combined with gastrodin acupoint injection in treating acute,moderate and severe deafness and tinnitus

作　　者：蒋玉欢 何本超[1] 郑志刚[1] 陈绪清[1] Jiang Yuhuan;He Benchao;Zheng Zhigang;Chen Xuqing(Department of Otolaryngology Head and Neck Surgery,Tianmen First People's Hospital,Hubei Province,Tianmen 431700,China)

机构地区：[1]天门市第一人民医院耳鼻咽喉头颈外科,431700

出　　处：《疑难病杂志》2020年第12期1256-1260,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：湖北省卫生和计划生育委员会科研项目(WJ2018MB177)。

摘　　要：目的探讨龙胆泻肝丸联合天麻素穴位注射治疗急性中重度耳聋耳鸣的临床疗效。方法选取2018年2月—2019年11月天门市第一人民医院收治的急性中重度耳聋耳鸣患者82例作为研究对象,按照随机数字表法将其分为观察组与对照组各41例。对照组应用天麻素穴位注射治疗,观察组在对照组基础上服用龙胆泻肝丸。治疗2周后,观察2组患者临床疗效,临床症状改善时间,并比较治疗前后血液流变学、氧化应激、体液免疫水平变化,以及不良反应发生情况。结果观察组总有效率为97.56%,高于对照组的78.05%(χ2/P=5.581/0.018)。治疗后观察组耳鸣、眩晕、耳闷症状改善时间短于对照组(t=14.066、7.090、8.665,P均<0.01)。治疗后2组全血高切黏度、全血低切黏度、血浆黏度及红细胞压积水平与治疗前相比均明显下降(P<0.01),且观察组低于对照组(t=7.830、7.276、2.753、5.400,P均<0.01)。治疗后2组血清可溶性血管细胞黏附分子-1(sVCAM-1)水平低于治疗前,缝隙连接蛋白26(Cx26)、超氧化物歧化酶(SOD)水平高于治疗前(P<0.01),且观察组改善程度优于对照组(t=8.997、12.427、5.775,P均<0.01);治疗后2组IgG、IgA及IgM水平与治疗前相比均明显下降(P<0.01),且观察组低于对照组(t=7.411、8.657、6.307,P均<0.01)。治疗期间2组不良反应比较差异无统计学意义(P>0.05)。结论急性中重度耳聋耳鸣患者应用龙胆泻肝丸联合天麻素穴位注射治疗可明显缓解临床症状,缩短恢复时间,利于快速恢复患者听力,还可改善血液流变学,提高机体免疫力,用药安全性高。Objective To explore the clinical efficacy of Longdanxiegan pills combined with gastrodin injection in the treatment of acute moderate to severe deafness and tinnitus.Methods A total of 82 patients with acute,moderate-to-severe deafness and tinnitus who were admitted to the Tianmen First People's Hospital from February 2018 to November 2019 were selected as the research objects,and they were divided into an observation group and a control group with 41 cases each according to a random number table.The control group was treated with acupoint injection of gastrodin,and the observation group took Longdanxiegan pills on the basis of the control group.After 2 weeks of treatment,observe the clinical efficacy of the two groups of patients,the time to improve clinical symptoms,and compare the changes in hemorheology,oxidative stress,humoral immunity before and after treatment,and the occurrence of adverse reactions.Results The total effective rate of the observation group was 97.56%,which was higher than 78.05%of the control group(χ2/P=5.581/0.018).After treatment,the disappearance of tinnitus,dizziness,and ear fullness in the observation group was shorter than that in the control group(t=14.066,7.090,8.665,all P<0.01).After treatment,the levels of whole blood high-shear viscosity,whole blood low-shear viscosity,plasma viscosity and hematocrit in the two groups were significantly lower than those before treatment(P<0.01),and the observation group was lower than the control group(t=7.830,7.276,2.753,5.400,P<0.01).After treatment,the levels of serum soluble vascular cell adhesion molecule 1(sVCAM-1)in the two groups were lower than before treatment,and the levels of connexin 26(Cx26)and superoxide dismutase(SOD)were higher than before treatment(P<0.01),and observation The improvement of the group was better than that of the control group(t=8.997,12.427,5.775,P<0.01);after treatment,the levels of IgG,IgA and IgM in the two groups were significantly lower than before treatment(P<0.01),and the observation group was lower tha

关 键 词：龙胆泻肝丸 天麻素穴位注射 耳聋耳鸣 血液流变学 免疫球蛋白 

分 类 号：R28[医药卫生—中药学]