丹参酮ⅡA磺酸钠联合耳内镜下咽鼓管鼓室吹张甲泼尼龙治疗突发性耳聋的临床疗效  

Clinical effect of tanshinoneⅡA sodium sulfonate combined with methylprednisolone in the treatment of sudden deafness under otoscope

作　　者：郭卉[1] 黄萍[2] 熊莉娜 Guo Hui;Huang Ping;Xiong Lina(Department of Otorhinolaryngology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430077,China;Department of Ophthalmology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430077,Chian;Department of Gastroenterology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430077,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院耳鼻喉科,湖北武汉430077 [2]华中科技大学同济医学院附属梨园医院眼科,湖北武汉430077 [3]华中科技大学同济医学院附属梨园医院消化内科,湖北武汉430077

出　　处：《中国医刊》2021年第12期1320-1323,共4页Chinese Journal of Medicine

基　　金：湖北省自然科学基金面上项目(2013CFB117)。

摘　　要：目的探讨丹参酮ⅡA磺酸钠联合耳内镜下咽鼓管鼓室吹张甲泼尼龙治疗突发性耳聋的临床疗效。方法选取2020年3月至2021年3月华中科技大学同济医学院附属梨园医院收治的96例突发性耳聋患者,采用随机数字表法分为对照组和观察组,每组48例。对照组给予耳内镜引导下导管法咽鼓管吹张甲泼尼龙治疗,观察组在对照组的基础上联合丹参酮ⅡA磺酸钠静脉滴注治疗。比较两组的治疗效果、症状消失时间,治疗前后的气导纯音听阈水平、血液流变学指标、内耳微循环指标(脂质过氧化物、胱抑素、超氧化物歧化酶、内皮素)、免疫指标(IgM、IgA、IgG),以及不良反应发生情况。结果观察组的治疗总有效率(91.67%)明显高于对照组(77.08%),差异有显著性(P<0.05),不良反应发生率(25.00%)与对照组(29.17%)比较差异无显著性(P>0.05)。与对照组相比,观察组耳堵塞感、耳鸣、眩晕等症状消失的时间明显缩短(P<0.05),气导纯音听阈水平明显降低(P<0.05)。治疗后观察组的全血黏度、红细胞聚集指数、纤维蛋白原、血细胞比容等血液流变学指标及脂质过氧化物、胱抑素、内皮素水平等内耳微循环指标明显低于对照组,而超氧化物歧化酶及IgM、IgA、IgG水平明显高于对照组,差异均有显著性(P<0.05)。结论丹参酮ⅡA磺酸钠联合耳内镜下咽鼓管鼓室吹张甲泼尼龙治疗突发性耳聋疗效满意,可有效改善血液流变学及内耳微循环指标,提高患者听力和机体免疫功能,且用药安全性好。Objective To explore the clinical efficacy of tanshinoneⅡA sodium sulfonate combined with methylprednisolone in the treatment of sudden deafness under ear endoscopy.Method Select 96 patients with sudden deafness admitted to liyuan hospital,tongji medical college,huazhong university of science and technology from March 2020 to March 2021.They were randomly divided into a control group and an observation group,with 48 cases in each group.The control group was treated with inflatable methylprednisolone by catheter-guided Eustachian tube under the guidance of ear endoscopy.On the basis of the control group,the observation group was combined with tanshinoneⅡA sodium sulfonate intravenous drip treatment.Compare the treatment effect,time of symptom disappearance,air conduction pure tone hearing threshold level before and after treatment,blood rheology index,inner ear microcirculation index(lipid peroxide,cystatin,superoxide dismutase,endothelin),Immune indicators(IgM,IgA,IgG),and the occurrence of adverse reactions.Result The total effective rate of treatment in the observation group(91.67%)was significantly higher than that of the control group(77.08%)(P<0.05).The incidence of adverse reactions(25.00%)was compared with that of the control group(29.17%),difference was not significant(P>0.05).Compared with the control group,the time for the obstruction of ear blockage,tinnitus,dizziness and other symptoms to disappear was significantly shorter in the observation group(P<0.05),and the air conduction pure tone hearing threshold level was significantly reduced(P<0.05).After treatment,the whole blood viscosity,erythrocyte aggregation index,fibrinogen,hematocrit and other hemorheological indicators in the observation group and inner ear microcirculation indicators such as lipid peroxide,cystatin and endothelin levels were significantly lower than those in the control group,And the levels of superoxide dismutase,IgM,IgA,and IgG were significantly higher than those of the control group,and the differences were significant(P

关 键 词：丹参酮ⅡA磺酸钠 甲泼尼龙 免疫功能 突发性耳聋 耳内镜下咽鼓管鼓室吹张 内耳微循环 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]