镇肝熄风汤加减联合腺苷钴胺治疗耳鸣肝阳上亢证疗效及对患者血液流变学和氧化应激水平的影响  

Effect of Zhengan Xifeng decoction combined with adenosine cobaltamine on tinnitus hyperactive liver-yang syndrome and its effects on hemorheology and oxidative stress level

作　　者：张太 支纪治 闫勇 ZHANG Tai;ZHI Jizhi;YAN Yong(Otolaryngology Department,Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201900,China)

机构地区：[1]上海市宝山区中西医结合医院耳鼻喉科,上海201900

出　　处：《陕西中医》2024年第8期1065-1069,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：上海市自然科学基金资助项目(21ZR1568802)。

摘　　要：目的:探讨镇肝熄风汤加减联合腺苷钴胺治疗耳鸣肝阳上亢证的临床疗效以及对患者血液流变学和氧化应激水平的影响。方法:选择86例耳鸣肝阳上亢证患者作为研究对象,按随机数字表法分成两组,每组43例。对照组给予腺苷钴胺治疗,观察组采用镇肝熄风汤加减联合腺苷钴胺治疗,4周疗程结束后观察两组疗效。比较治疗前后两组耳鸣响度视觉模拟量表(VAS)评分、耳鸣严重程度评分、耳鸣致残量表(THI)评分、中医证候积分、血液流变学指标以及血清氧化应激指标[谷胱甘肽还原酶(GR)、过氧化物歧化酶(SOD)]水平和外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)。结果:观察组总有效率高于对照组(P<0.05)。治疗后,两组耳鸣响度VAS评分、耳鸣严重程度评分、THI评分、中医证候积分显著下降(均P<0.05),且观察组低于对照组(均P<0.05)。治疗后,观察组全血还原黏度5(1/S)、血浆黏度、红细胞聚集指数、全血还原黏度200(1/S)显著降低(均P<0.05),且观察组低于对照组(均P<0.05)。治疗后,两组血清GR、SOD水平较治疗前显著升高,NLR、PLR水平显著降低(均P<0.05),观察组改善优于对照组(均P<0.05)。结论:镇肝熄风汤加减联合腺苷钴胺治疗耳鸣肝阳上亢证能有效改善机体血液流变学状态,降低体内氧化应激和炎症水平,减轻病情严重程度,提高临床疗效。Objective:To investigate the clinical efficacy of Zhengan Xifeng decoction combined with adenosine cobaltamine in the treatment of hyperactivity of tinnitus hyperactive liver-yang syndrome,as well as the effects on hemorheology and oxidative stress level.Methods:A total of 86 patients with tinnitus and hyperactive liver-yang syndrome were selected as research objects and divided into two groups according to random number table method,with 43 cases in each group.The control group was treated with adenosine cobalamin,and the observation group was treated with Zhengan Xifeng decoction combined with adenosine cobalamine.The efficacy of the two groups was observed after the 4-week course of treatment.Tinnitus loudness visual Simulation Scale(VAS)score,tinnitus severity score,tinnitus Disability Scale(THI)score,TCM syndrome score,hemorheology index,serum oxidative stress index[glutathione reductase(GR),peroxide dismutase(SOD)]level and peripheral blood neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)were compared between the two groups before and after treatment.Results:The total effective rate of observation group was higher than that of control group(P<0.05).After treatment,tinnitus loudness VAS score,tinnitus severity score,THI score and TCM syndrome score were significantly decreased in both groups(all P<0.05),the observation group were lower than the control group(all P<0.05).After treatment,whole blood reductive viscosity 5(1/S),plasma viscosity,red blood cell aggregation index and whole blood reductive viscosity 200(1/S)in the observation group were significantly decreased(all P<0.05),and the observation group were lower than the control group(all P<0.05).After treatment,serum GR and SOD levels in two groups were significantly higher than before treatment,NLR and PLR levels were significantly decreased(all P<0.05),the improvement of the above indexes in the observation group were better than that in the control group(all P<0.05).Conclusion:Zhengan Xifeng decoction combined with adenosine

关 键 词：耳鸣 镇肝熄风汤 氧化应激 肝阳上亢证 血液流变学 腺苷钴胺 炎症反应 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]