A型肉毒毒素耳后注射治疗帕金森病合并神经性耳鸣患者的疗效探讨  

Retroauricular Injection of Botulinum Toxin Type A in the Treatment of Parkinson's Disease Patients with Neuropathic Tinnitus

作　　者：李瀛[1] 罗颜[1] 卫红齐[1] 李文全[1] 罗蔚锋[2] LI Ying;LUO Yan;WEI Hong-qi;LI Wen-quan;LUO Wei-feng(Otolaryngology department,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215000,China;Neurology department,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215000,China)

机构地区：[1]苏州大学附属第二医院耳鼻喉科,江苏苏州215000 [2]苏州大学附属第二医院神经内科,江苏苏州215000

出　　处：《现代生物医学进展》2023年第7期1329-1333,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(81671270)。

摘　　要：目的:探讨A型肉毒毒素耳后注射治疗帕金森病合并神经性耳鸣患者的疗效。方法:收集2016年3月至2021年6月苏州大学附属第二医院耳鼻喉科或神经内科门诊就诊或住院的帕金森病患者,追问病史,发现部分患者有单侧或双侧耳鸣症状,并进行电测听+声导抗检查回报,其中有73%患者有神经性听力下降,根据治疗方法将其分为A型肉毒毒素耳后注射组(实验组,22例)和地塞米松耳后注射组(对照组,22例),A型肉毒毒素注射组予以100U A型肉毒毒素耳垂后方自上而下3个点注射,地塞米松注射组予以5 mg地塞米松耳垂后方自上而下3个点注射,对比两组鸣残疾评估量表(THI)评分、耳鸣评价量表(TEQ)评分、治疗总有效率、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)评分。结果:两组治疗前THI和TEQ评分比较无差异(P>0.05),两组治疗后THI和TEQ评分均有所降低,且实验组均低于对照组(P<0.05);实验组治疗后1周、治疗后4周、治疗后14周治疗总有效率为63.64%、81.82%、90.91%,对照组治疗总有效率分别为63.64%、63.64%、72.73%,两组治疗总有效率比较无差异(P>0.05),但实验组略高于对照组;两组治疗前HAMA、HAMD评分比较无差异(P>0.05),两组治疗后14周HAMA、HAMD评分均有多下降,且实验组均低于对照组(P<0.05);两组治疗前入睡时间、睡眠时间、睡眠质量、睡眠效率、睡眠障碍、日间功能障碍、安眠药物评分以及总分比较无差异(P>0.05),两组治疗后14周上述各项评分均有所降低,且实验组均低于对照组(P<0.05)。结论:A型肉毒毒素耳后注射治疗帕金森病合并神经性耳鸣患者,可改善耳鸣症状,提高临床治疗效果,缓解焦虑抑郁情绪,改善睡眠质量,值得临床不断深入研究。Objective:To investigate the efficacy of retroauricular injection of botulinum toxin type A in the treatment of Parkinson's disease patients with neuropathic tinnitus.Methods:From March 2016 to June 2021,patients with Parkinson's disease who visited or were hospitalized in the Department of Otolaryngology or Neurology of the Second Affiliated Hospital of Soozhou University were collected.Medical history was examined.It was found that some patients had unilateral or bilateral tinnitus symptoms,and the results of electrical audiometry plus acoustic conductance test were returned.According to treatment will be divided into ear after injection of botulinum toxin A group(experimental group,22 cases)and ear after injection of dexamethasone group(the control group,22 cases),type A botulinum toxin injection group shall be 100 u botulinum toxin A earlobe rear top-down 3 point injection,dexamethasone injection shall be 5 mg group dexamethasone earlobe rear top-down 3 point injection,The Tinnitus Handicap Inventory(Tinnitus Handicap Inventory,THI score,Tinnitus Assessment Scale(TEQ)score,total response rate,Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)score,Pittsburgh Sleep Quality Index(PSQI)score.Results:The THI and TEQ scores of the two groups were compared before treatment(P>0.05),and the THI and TEQ scores of the two groups were decreased after treatment,and the experimental group was lower than the control group(P<0.05).The total effective rates were 63.64%,81.82%and 90.91%in the experimental group,and 63.64%,63.64%and 72.73%in the control group,respectively.The total effective rates of the two groups were compared(P>0.05),but the total effective rates of the experimental group were slightly higher than the control group.The HAMA and HAMD scores of the two groups were compared before treatment(P>0.05),and the HAMA and HAMD scores of the two groups were decreased at 14 weeks after treatment,and the experimental group was lower than the control group(P<0.05).The sleep time,sleep time,sleep quality,slee

关 键 词：A型肉毒毒素 帕金森病合并神经性耳鸣 疗效 睡眠质量 

分 类 号：R742.5[医药卫生—神经病学与精神病学]