四藤龙牡汤辨证加减联合甲钴胺治疗神经性耳鸣及对中枢神经递质表达的影响  

Therapeutic Effect of Siteng Longmu Decoction(四藤龙牡汤)Combined with Mecobalamin in Treatment of Neurological Tinnitus and Its Influence on Expression of Central Neurotransmitter in Patients

作　　者：李淑芳[1] 曾俊峰 符国庆[1] 谢柳[1] 王翔[1] LI Shufang;ZENG Junfeng;FU Guoqing;XIE Liu;WANG Xiang(Hainan Traditional Chinese Medicine Hospital,Haikou 570100,Hainan,China;Hainan Lingnan Medical Research Institute,Haikou 570100,Hainan,China)

机构地区：[1]海南省中医院,海南海口570100 [2]海南省岭南医学研究院,海南海口570100

出　　处：《中华中医药学刊》2023年第9期111-115,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81660823);海南省重点研发计划项目(SQ2017HFZ0093)。

摘　　要：目的探讨四藤龙牡汤辨证加减联合甲钴胺治疗神经性耳鸣的效果。方法选取2019年1月—2021年12月就诊的神经性耳鸣患者220例为研究对象,采用随机数字表法分为两组。对照组110例采用甲钴胺治疗,观察组110例在服用甲钴胺的同时加用四藤龙牡汤辨证加减治疗。两组均以1周为1个疗程,治疗4个疗程后进行疗效评估。治疗前、治疗2个疗程及4个疗程两组均评估耳鸣严重程度,并检测基底动脉血流舒张末期峰值(Vd)、收缩末期峰值(Vs)及中枢神经递质含量。对两组治疗过程情况进行安全性评价。结果观察组治疗总有效率高于对照组(P<0.05),观察组中肝气郁结型、痰湿困结型患者疗效较为显著;治疗2个周期、4个周期两组耳鸣严重程度各项评分逐渐降低,且观察组低于对照组(P<0.05);治疗2个周期、4个周期两组基底动脉Vd、Vs水平逐渐升高,且观察组高于对照组(P<0.05);治疗2个周期、4个周期两组血清5-羟色胺(5-HT)、γ-氨基丁酸(GABA)水平均明显改善,且观察组血清5-HT水平低于对照组,GABA水平高于对照组(P<0.05);两组均未出现3~4级不良反应,组间安全性评价结果比较,差异无统计学意义(P>0.05)。结论四藤龙牡汤辨证加减联合甲钴胺治疗神经性耳鸣效果显著,可有效减轻患者耳鸣程度,其作用机制可能与调节5-HT、GABA水平有关,且有助于改善局部微循环,安全性较高。Objective To explore the effect of Siteng Longmu Decoction(四藤龙牡汤)combined with methylcobalamin in the treatment of neurological tinnitus.Methods A total of 220 patients with neurological tinnitus who were treated in the hospital from January 2019 to December 2021 were selected as the research objects,and they were divided into two groups by random number table method.110 cases in the control group were treated with mecobalamin,and the other 110 cases in the observation group were treated with Siteng Longmu Decoction based on syndrome differentiation while taking mecobalamin.One week was regarded as a course of treatment in both groups,and the efficacy was evaluated after 4 courses of treatment.Before treatment,2 and 4 courses of treatment,the severity of tinnitus was evaluated in both groups,and the values of peak end-diastolic(Vd)and peak end-systolic(Vs)and central neurotransmitter contents of basilar artery blood flow were detected.The safety evaluation of the treatment process of the two groups was carried out.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).In the observation group,the patients with liver-Qi stagnation type and phlegm-dampness type were more effective.After 2 and 4 courses of treatment,the scores of tinnitus severity in the two groups gradually decreased,and the score of the observation group was lower than that of the control group(P<0.05).After 2 and 4 courses of treatment,the values of Vd and Vs in the basilar artery of the two groups gradually increased,and the values of the ob-servation group were higher than those of the control group(P<0.05).After 2 and 4 courses of treatment,the serum levels of 5-hydroxytryptamine(5-HT)andγ-aminobutyric acid(GABA)in the two groups were significantly improved,and the serum 5-HT level in the observation group was lower than that in the control group,and the GABA level was higher than that in the control group(P<0.05).There were no grade 3~4 adverse reactions in the two g

关 键 词：四藤龙牡汤 辨证加减 甲钴胺 神经性耳鸣 中枢神经递质 

分 类 号：R246.81[医药卫生—针灸推拿学]