高压氧联合泼尼松治疗无听力变化耳鸣的临床疗效及其作用机制  

Clinical efficacy and mechanism of action of hyperbaric oxygen combined with prednisone in the treatment of tinnitus without hearing loss

作　　者：邱艾嘉 张微微 叶晓玲 Qiu Aijia;Zhang Weiwei;Ye Xiaoling(Department of Otorhinolaryngology,Enze Hospital of Taizhou Enze Medical Center,Taizhou 317000,China;Hyperbaric Oxygen Center,Taizhou Rehabilitation Hospital,Taizhou 318050,China;Department of Ophthalmology,Taizhou Hospital of Zhejiang Province,Taizhou 317099,China)

机构地区：[1]台州恩泽医疗中心(集团)恩泽医院耳鼻咽喉科,台州317000 [2]台州市康复医院高压氧中心,台州318050 [3]台州医院眼科,台州317099

出　　处：《中华航海医学与高气压医学杂志》2024年第1期51-54,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧(HBO)联合泼尼松治疗无听力变化耳鸣的临床疗效及其作用机制。方法选取2020年8月至2022年4月在台州恩泽医院耳鼻咽喉科就诊的150例无听力变化耳鸣患者作为研究对象。按照随机数字表法分为对照组(n=75)和研究组(n=75)。对照组患者口服泼尼松,研究组在对照组的基础上给予HBO治疗。评估2组患者治疗后的临床疗效,检测2组患者治疗前后耳鸣程度、气导听力及听力障碍的变化。采用高效液相色谱荧光法和荧光分光光度法检测2组患者治疗前后静脉血中γ-氨基丁酸(GABA)和5-羟色胺(5-HT)水平,采用硝酸还原酶法酶联免疫吸附法测定血清一氧化氮(NO)水平、采用血清连接子蛋白26(connexin 26)水平。结果研究组患者治疗后总有效率(93.33%)明显高于对照组(81.33%),差异有统计学意义(P<0.05)。与治疗前比较,2组患者治疗后耳鸣程度、气导听力水平、听力障碍评分均明显降低(P<0.01),且研究组患者治疗后明显低于对照组(P<0.01)。研究组患者治疗后GABA水平明显高于对照组,5-HT水平明显低于对照组(P<0.05或P<0.01)。与治疗前比较,2组患者治疗后血清NO和connexin 26水平均明显升高(P<0.01),且研究组患者治疗后明显高于对照组(P<0.01)。结论HBO联合泼尼松治疗无听力变化耳鸣取得较好临床疗效,主要是通过调节中枢神经递质水平和内耳微环境平衡实现的。Objective To investigate the clinical efficacy and mechanism of action of hyperbaric oxygen(HBO)therapy combined with prednisone in the treatment of tinnitus without hearing loss.Methods A total of 150 patients with tinnitus without hearing loss treated at the Department of Otorhinolaryngology of Enze Hospital of Taizhou Enze Medical Center from August 2020 to April 2022 were selected as the study subjects.They were randomly divided into control group(n=75)and study group(n=75).The patients in the control group were given prednisone orally,while the patients in the study group were given HBO therapy on the basis of treatments in the control group.After treatment,the clinical therapeutic effects of the two groups were evaluated,and the changes in the severity of tinnitus,air-conduction hearing level,and hearing impairment were measured before and after treatment in both groups.The levels of gamma-aminobutyric acid(GABA)and 5-hydroxytryptamine(5-HT)in venous blood were determined using high-performance liquid chromatography-fluorescence detection and fluorescence spectrophotometry.The level of serum nitric oxide(NO)was measured by nitrate reductase assay,and the level of connexin 26(Cx26)in serum was determined by enzyme-linked immunosorbent assay.Results The overall effective rate in the study group(93.33%)was significantly higher than that in the control group(81.33%),with a statistically significant difference(P<0.05).Compared with before treatment,the severity of tinnitus,air-conduction hearing level,and hearing impairment score in both groups were significantly decreased after treatment(P<0.01),and the scores in the study group were significantly lower than those in the control group(P<0.01).The post-treatment level of GABA in the study group was significantly higher,and the level of 5-HT in the study group was significantly lower,compared with the control group(P<0.01).Compared with before treatment,the post-treatment levels of serum NO and Cx26 were significantly increased in both groups(P<0.01),and the stud

关 键 词：无听力变化耳鸣 高压氧 泼尼松 中枢神经递质 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]