四藤龙牡汤辨证加减治疗神经性耳鸣的临床研究  

Clinical study on the treatment based on syndrome differentiation of neurogenic fitinnitus with modified Siteng Longmu decoction

作　　者：杨春煦 邓雅玲[1] 王琦 YANG Chunxu;DENG Yaling;WANG Qi(Department of Otolaryngology,Pengzhou People's Hospital,Pengzhou 611930,China)

机构地区：[1]彭州市人民医院耳鼻喉科,四川彭州611930

出　　处：《长春中医药大学学报》2025年第3期288-291,共4页Journal of Changchun University of Chinese Medicine

基　　金：四川省耳鼻咽喉头颈外科学会科研项目(ChiCTR1900021725)。

摘　　要：目的 探讨神经性耳鸣患者应用四藤龙牡汤辨证加减治疗的临床效果。方法 将神经性耳鸣患者84例随机分为对照组和试验组,各42例。对照组和试验组分别给予甲钴胺、四藤龙牡汤辨证加减联合甲钴胺治疗,均治疗4个疗程。比较2组临床疗效、中医症候积分、耳鸣严重程度、甲襞微循环状态、中枢神经递质及氧化应激指标水平及不良反应。结果 试验组治疗后的总有效率较对照组高(P<0.05)。治疗后,2组头晕目眩、耳鸣耳聋、腰膝酸软、心悸气短、耳鸣严重程度、中文版耳鸣功能指数(TFI-CH)、中文版耳鸣残疾量表(THI)评分、流态、管襻、襻周积分、总积分及血清5-羟色胺(5-HT)水平较治疗前降低,试验组更低;血清γ-氨基丁酸(GABA)、总抗氧化能力(T-AOC)、谷胱甘肽过氧化物酶(GSH-Px)水平升高,试验组更高(P<0.05)。2组均未明显出现不良反应。结论 神经性耳鸣患者应用四藤龙牡汤辨证加减治疗后可改善中医症候、耳鸣严重程度及甲襞微循环状态,调节中枢神经递质及氧化应激指标,改善神经功能及减轻机体应激反应。Objective To investigate the therapeutic effect of modified Siteng Longmu decoction on patients with neurogenic tinnitus based on syndrome differentiation.Methods 84 patients with neurogenic tinnitus were randomly divided into the control group and the experiment group,with 42 cases in each group.The control group and the experiment group were respectively treated with methylcobalamin,and Sitong Longmu decoction combined with methylcobalamin based on syndrome differentiation for 4 courses of treatment.The clinical efficacy,traditional Chinese medicine(TCM)syndrome scores,tinnitus severity,nailfold microcirculation status,levels of central neurotransmitters and oxidative stress indexes,and adverse reactions were compared between two groups.Results The total effective rate of the experiment group after treatment was higher than that of the control group(P<0.05).After treatment,dizziness,vertigo,tinnitus,hearing loss,soreness and weakness of the waist and knees,palpitations and shortness of breath,severity of tinnitus,Chinese version of the Tinnitus Function Index(TFI-CH),Chinese version of the Tinnitus Disability Inventory(THI)score,flow state,tube loops,loop circumference score,total score,and serum 5-hydroxytryptamine(5-HT)level in both groups decreased compared with before treatment,and the experiment group was even lower;The levels of serum gamma aminobutyric acid(GABA),total antioxidant capacity(T-AOC)and glutathione peroxidase(GSH-Px)increased,with higher levels observed in the experiment group(P<0.05).Both groups did not show significant adverse reactions.Conclusion The application of Siteng Longmu Tang for the treatment of neurogenic tinnitus can improve TCM syndrome,tinnitus severity and nail fold microcirculation status,regulate the levels of central neurotransmitters and oxidative stress indexes,improve neurological function,and reduce the stress response of the organism.

关 键 词：神经性耳鸣 四藤龙牡汤 中医症候 神经递质 

分 类 号：R276.1[医药卫生—中医五官科学]