“鸣安方”治疗心脾两虚型特发性耳鸣的短期疗效观察及EEG脑电机制研究  

Observation on the short-term efficacy of"Ming An Decoction"in treating idiopathic tinnitus of heart and spleen deficiency type and study on its EEG mechanism

作　　者：霍岩 陈泽勋 刘广宇 郑伟[1] 陈斯 纪万里 李明[1] 张剑宁[1] Huo Yan;Chen Zexun;Liu Guangyu;Zheng Wei;Chen Si;Ji Wanli;Li Ming;Zhang Jianning(Department of Otorhinolaryngology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院耳鼻喉科,200437 [2]上海健康医学院

出　　处：《中国中西医结合耳鼻咽喉科杂志》2025年第1期11-17,5,共8页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：国家自然科学基金青年项目(82405492);国家自然科学基金面上项目(82474263)。

摘　　要：目的 观察“鸣安方”治疗心脾两虚型特发性耳鸣的短期疗效,运用生物反馈仪采集分析患者EEG,探讨其脑电中枢机制。方法 选取于上海中医药大学附属岳阳中西医结合医院耳鼻咽喉科耳鸣专病门诊2022年7月~2023年10月期间就诊的心脾两虚型特发性耳鸣患者304例,随机分为基础治疗组(耳鸣交流解惑+声治疗,例=152)和“鸣安方”组(基础治疗+鸣安方治疗,例=152)。治疗2周后对两组患者治疗前后进行耳鸣残疾量表(THI)、阿森斯失眠量表(AIS)、视觉模拟评分(VAS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)及纯音听阈(PTA)评估,比较两组的临床疗效。同时运用生物反馈仪采集分析鸣安方组患者治疗前后EEG,分析治疗前后δ波、θ波、α波、β波能量值及SMR节律变化,比较心脾两虚型主观特发性耳鸣患者在“鸣安方”治疗前后的脑电波变化趋势。结果 (1)两组治疗后THI评分较治疗前均明显降低(P<0.001),鸣安方组THI评分较基础治疗组低(P<0.05);(2)两组治疗后VAS评分较治疗前均明显降低(P<0.05),治疗结束后,鸣安方组VAS评分较基础治疗组明显降低(P<0.05);(3)鸣安方组治疗后AIS、SDS评分较治疗前均明显降低(P<0.001),治疗后鸣安方组AIS、SDS评分较基础治疗组明显降低(P<0.001,P<0.05);(4)鸣安方组治疗后SAS评分较治疗前降低(P<0.05),治疗结束后两组SAS评分无差异(P>0.05);(5)鸣安方组患者δ波、β波能量值较治疗前明显降低(P<0.01,P<0.001),α波能量值显著升高(P<0.05),基础治疗组δ波、β波能量值较治疗前明显降低(P<0.001,P<0.01)。治疗后两组间比较,鸣安方组α波能量值高于基础治疗组(P<0.05),β波能量值显著低于基础治疗组(P<0.05)。结论 鸣安方可改善心脾两虚型耳鸣患者主观感受,尤其对缓解焦虑、抑郁及睡眠障碍等不良伴随症状疗效显著,可能与提高患者α波、降低β波能量值有关。Objective To observe the short-term efficacy of"Ming An Decoction"in treating idiopathic tinnitus of heart and spleen deficiency type,collect and analyze the EEG of patients using biofeedback instrument,and explore its central mechanism of EEG.Methods A total of 304 patients with idiopathic tinnitus of heart and spleen deficiency type who visited the tinnitus clinic of the Department of Otolaryngology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from July 2022 to October 2023 were selected and randomly divided into a basic treatment group(tinnitus communication and demystification+sound therapy,n=152)and a"Ming An Decoction"(MAD)group(basic treatment+MAD treatment,n=152).After 2 weeks of treatment,the two groups of patients were evaluated with tinnitus handicap inventory(THI),athens insomnia scale(AIS),visual analogue scale(VAS),self-rating anxiety scale(SAS),self-rating depression scale(SDS)and pure tone audiometry(PTA)before and after treatment,and the clinical efficacy was compared between the two groups.At the same time,the biofeedback instrument was used to collect and analyze the EEG of patients in the MAD group before and after treatment, and the energy values of δ waves, θ waves, α waves, β waves and SMR rhythm changes before and after treatment were analyzed, and the EEG change trends of patients with idiopathic tinnitus of heart and spleen deficiency type before and after "MAD" treatment were compared. Results ① After treatment, the THI scores of both groups were significantly lower than those before treatment(P<0.001), and the THI score of the MAD group was lower than that of the basic treatment group(P<0.05);②After treatment, the VAS scores of both groups were significantly lower than those before treatment(P<0.05). After treatment, the VAS score of the MAD group was significantly lower than that of the basic treatment group (P<0.05). ③After treatment, the AIS and SDS scores of the MAD group were sig

关 键 词：鸣安方 特发性耳鸣 心脾两虚 EEG 

分 类 号：R276.1[医药卫生—中医五官科学]