龙胆泻肝丸联合鼓室内注射倍他米松治疗分泌性中耳炎疗效研究  

Efficacy of Longdan Xiegan pill combined with intratympanic injection of betamethasone in the treatment of secretory otitis media

作　　者：袁萍[1] 刘敏[1] 刘建兵 康厚墉[2] YUAN Ping;LIU Min;LIU Jianbing;KANG Houyong(The Third Hospital of Mianyang Otolaryngology Department,Mianyang 621000,China)

机构地区：[1]绵阳市第三人民医院耳鼻咽喉科,四川绵阳621000 [2]重庆医科大学附属第一医院耳鼻咽喉头颈外科,重庆400700

出　　处：《陕西中医》2024年第9期1218-1221,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：重庆市卫生和计划生育委员会中医药科技项目(ZY201802143)。

摘　　要：目的:探讨龙胆泻肝丸联合鼓室内注射倍他米松治疗分泌性中耳炎(OME)临床疗效及其对患者外周血T淋巴细胞亚群和中耳积液中高迁移率族蛋白1(HMGB1)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-33水平的影响。方法:选取252例OME患者,随机分为两组各126例。对照组给予鼓室内注射倍他米松治疗,在此基础上,观察组联合龙胆泻肝丸治疗。比较两组临床疗效、外周血T淋巴细胞亚群和中耳积液中HMGB1、TNF-α、IL-33等水平。结果:观察组总有效率91.37%高于对照组的82.54%(P<0.05)。治疗后,两组病情严重程度评分、气导平均听阈、骨导平均听阈、外周血CD8+和中耳积液中HMGB1、TNF-α、IL-33水平都显著降低,而外周血CD3+、CD4+水平和CD4+/CD8+都显著增加,都以观察组为甚(P<0.05)。观察组不良反应率10.3%与对照组8.7%比较无统计学差异(P>0.05)。结论:龙胆泻肝丸联合鼓室内注射倍他米松治疗OME的总体疗效确切,可改善患者听力,改善外周血T淋巴细胞亚群失衡以及抑制中耳积液中HMGB1、TNF-α、IL-33表达,且安全性好。Objective:To investigate the clinical efficacy of Longdan Xiegan pill combined with intratympanic injection of betamethasone in the treatment of secretory otitis media(OME)and its effect on the levels of high mobility group protein 1(HMGB1),tumor necrosis factor-α(TNF)-αand interleukin(IL)-33 in peripheral blood T lymphocyte subsets and middle ear effusion.Methods:A total of 252 OME patients were randomly divided into two groups with 126 patients in each group.The control group was treated with betamethasone injection in tympanic chamber.On this basis,the observation group was treated with Longdan Xiegan pill.The clinical efficacy,levels of HMGB1,TNF-αand IL-33 in peripheral blood T lymphocyte subsets and middle ear effusion were compared between the two groups.Results:The total effective rate of 91.37%in the observation group was higher than that of 82.54%in the control group(P<0.05).After treatment,disease severity score,mean audibility threshold of air conduction,mean audibility threshold of bone conduction,HMGB1,TNF-αand IL-33 levels of peripheral blood CD8+and middle ear effusion were significantly decreased in both groups,while peripheral blood CD3+,CD4+and CD4+/CD8+levels were significantly increased,especially in the observation group(P<0.05).The adverse reaction rate was 10.3%in the observation group and 8.7%in the control group(P>0.05).Conclusion:The overall efficacy of Longdan Xiegan pill combined with betamethasone injection in tympanic cavity in the treatment of OME is accurate,and it can improve the hearing of patients,improve the imbalance of peripheral blood T lymphocyte subgroups,and inhibit the expression of HMGB1,TNF-αand IL-33 in middle ear effusions,with good safety.

关 键 词：分泌性中耳炎 龙胆泻肝丸 鼓室内注射治疗 倍他米松 T淋巴细胞亚群 中耳积液 炎症因子 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]