针药结合治疗感音神经性耳鸣临床研究

目的:探讨腹针联合补肾开窍方治疗感音神经性耳鸣肾精亏损证的疗效及对血清中5-羟色胺(5-hydroxy tryptamine,5-HT)水平的影响。方法:筛选感音神经性耳鸣患者108例,随机分为治疗组和对照组均54例。对照组口服盐酸氟桂利嗪胶囊,每天1次,每次10 mg;谷维素,每次20 mg,每天3次。治疗组在对照组基础上予腹针和中药内服。两组连续治疗1个月。比较两组听阈水平、耳鸣响度、耳鸣程度评分及临床疗效。检测两组血清中5-HT水平。结果:治疗后,治疗组各频率(1 k Hz、2 k Hz、4 k Hz)听阈值明显低于对照组,耳鸣响度和程度评分明显低于对照组(P0.01)。治疗组有效率为92.54%,显著高于对照组的78.46%(P0.05)。治疗后15 d和30 d,治疗组血清中5-HT水平明显低于对照组同期(P0.01)。结论:腹针联合补肾开窍方治疗感音神经性耳鸣肾精亏损证疗效明显,下调血清中5-HT水平可能与其治疗效果有关。

Clinical Research of Acupuncture Combined with Medicine in Treating for Sensorineural Tinnitus

Objective:To investigate efficacy of abdominal acupuncture combined with Bushen Kaiqiao Decoction in treating sensorineural tinnitus with Kidney Essence Deficiency Syndrome,and the influence on serum levels of 5-hydroxytryptamine(5-HT).Method:108 sensorineural tinnitus cases with were randomly divided into control group(54 cases) and treatment group (54 cases).Cases of control group were orally treated with flunarizine hydrochloride capsules(qd and 10 mg/time) and oryzanol(20 mg/ time and tid),treatment group was given abdominal acupuncture combined with Bushen Kaiqiao decoction in addition of control group,treating for l month in both groups.Hearing threshold,tinnitus loudness,tinnitus score,and efficacy were compared between two groups.Serum levels of 5-HT was detected in two groups.Results:After treatment,hearing threshold of different frequencies (1,2,4 kHz),tinnitus loudness and tinnitus score were obviously lower than control group (P ＜ 0.01).Total efficacy of treatment group was 92.54％,which was remarkably higher than control group 78.46％ (P ＜ 0.05).Serum levels of 5-HT of treatment group was obviously lower than control group after treatment (P ＜ 0.01).Conclusion:Efficacy of abdominal acupuncture combined with Bushen Kaiqiao Decoction in treating for sensorineural tinnitus of Kidney Essence Deficiency Syndrome is significant,which may be related to the down-regulation of serum levels of 5-HT.