针刺联合中药耳浴治疗真菌性外耳道炎的疗效观察  

Efficacy observation of acupuncture plus Chinese medicine ear bath for fungal otitis externa

作　　者：刘娟[1] 帕茹克·鲁提夫拉 赵翠宏 马忠[1] LIU Juan;PARUKE Lutifula;ZHAO Cuihong;MA Zhong(Traditional Chinese Medicine Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院,乌鲁木齐830000

出　　处：《上海针灸杂志》2024年第8期823-829,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：新疆医科大学大学生创新训练计划项目(CX2020004)。

摘　　要：目的观察针刺联合中药耳浴治疗真菌性外耳道炎的临床疗效。方法将108例真菌性外耳道炎患者按随机数字表法分为观察组和对照组,每组54例。两组均予硝酸舍他康唑乳膏治疗,对照组予中药耳浴治疗,观察组予针刺联合中药耳浴治疗。比较两组起效时间、临床疗效和复发率,观察两组治疗前后中医证候积分、瘙痒评分、红细胞沉降率、血清炎症因子[白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)]水平以及血清miR-210和miR-146相对表达量的变化。结果观察组总有效率92.2%,高于对照组的82.4%,差异具有统计学意义(P<0.05)。治疗后,两组血清炎症因子水平、中医证候积分及瘙痒评分均较治疗前降低(P<0.05),且观察组均低于对照组(P<0.05)。治疗后,两组血清miR-146相对表达量较治疗前降低(P<0.05),血清miR-210相对表达量较治疗前升高(P<0.05);且观察组血清miR-146相对表达量低于对照组,血清miR-210相对表达量高于对照组(P<0.05)。观察组平均起效时间短于对照组(P<0.05),观察组复发率低于对照组(P<0.05)。结论在外用硝酸舍他康唑乳膏基础上,针刺联合中药耳浴治疗真菌性外耳道炎的临床疗效优于单纯中药耳浴,起效更快,复发更少,可有效改善瘙痒症状,调节血清炎症因子水平以及miR-210和miR-146的相对表达量。Objective To observe the clinical efficacy of acupuncture plus Chinese medicine ear bath in treating fungal otitis externa.Method A total of 108 patients with fungal otitis externa were divided into an observation group and a control group using the random number table method,with 54 cases in each group.Both groups received Sertaconazole nitrate cream treatment.The control group received Chinese medicine ear bath,and the observation group received acupuncture plus Chinese medicine ear bath.The effect onset time,clinical efficacy,and relapse rate were compared between the two groups.Before and after the treatment,both groups were observed for changes in the symptom score of traditional Chinese medicine(TCM),itching score,erythrocyte sedimentation rate(ESR),serum inflammatory factor levels[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],and the relative expression of serum miR-210 and miR-146.Result The total effective rate was 92.2%in the observation group,higher than 82.4%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the serum inflammatory factor levels,TCM symptom score,and itching score dropped in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After the intervention,the relative expression of serum miR-146 declined in both groups (P<0.05), and the relative expression of serum miR-210 increased (P<0.05);the expression level of miR-146 was lower in the observation group than in the control group, and the level of miR-210 was higher in the observation group (P<0.05). The average effect onset time was earlier in the observation group compared to the control group (P<0.05), and the observation group had a lower relapse rate (P<0.05). Conclusion Based on the external application of Sertaconazole nitrate cream, acupuncture plus Chinese medicine ear bath can produce more significant clinical efficacy than Chinese ear bath in treating fungal otitis externa, working faster with fewer relapses. This method can effect

关 键 词：针刺疗法 针药并用 薰洗 外耳道炎 真菌感染 瘙痒 白介素-6 肿瘤坏死因子-α 

分 类 号：R246.81[医药卫生—针灸推拿学]