针刺"内听宫"穴对突发性耳聋患者脑干听觉诱发电位的影响

目的观察突发性耳聋患者和正常耳针刺内听宫穴脑干听觉诱发电位( ABR)的变化,以确定该穴位治疗耳聋的作用. 方法 19例( 21耳)突聋患者 ,使用丹迪公司 2000型诱发电位仪 ,在铜网屏蔽状态下进行听觉脑干诱发电位检测,针刺内听宫穴 15 min,拔针后休息 5 min,再行 ABR检测,比较针刺前后 ABR的变化. 结果针刺正常耳"内听宫"穴,针刺前后 ABR的Ⅰ ,Ⅴ波潜伏期以及Ⅰ-Ⅴ波间期无显著性变化( P >0.05). 21耳突聋中 15耳针刺内听宫穴耳鸣减轻,甚至消失.耳闷减轻,听力提高.其中 5耳针刺前 ABR波形分化差,Ⅰ波或Ⅲ波消失,重复性差,针刺后其 ABR波形分化明显清晰,Ⅰ,Ⅲ,Ⅴ波均出现,且重复性好. 16耳突聋针刺前 ABR的Ⅰ波潜伏期( 2.00± 0.34) ms,Ⅴ波潜伏期 (6.04± 0.59)ms,ⅠⅤ波间期 (4.04± 0.57)ms,针刺后 ABR的Ⅰ波潜伏期 (1.77± 0.27)ms,Ⅴ波潜伏期 (5.79± 0.63)ms,ⅠⅤ波间期 (3.98± 0.58)ms,Ⅰ ,Ⅴ波潜伏期针刺前后比较差异有显著性意义( t=2.406,2.463,P< 0.05). 结论针刺内听宫穴能提高突聋患者耳蜗听神经以及外侧丘系桥脑的兴奋性和传导性.但对正常耳无影响,针刺该穴位可作为治疗突聋的方法之一.

Effects of acupuncture in" inner Tinggong" acupoint on auditory brainstem response in sudden hearing loss patients

AIM:To observe the changes of auditory brainstem response(ABR) in sudden hearing loss patients and normal ears by acupuncture in " inner Tinggong" acupoint to confirm the effectiveness of the acupuncture in this acupoint in hearing loss. METHODS:The ABR of 19 cases(21 ears) of sudden hearing loss was assayed under copper grid shielding by 2000 model of evoked potential instrument obtained from Dandi Company.ABR was retested after 15-minute acupuncture in inner Tinggong acupoint and 5-minute rest.The results were compared. RESULTS:There was no significant difference in I,V wave latency and I-V interval before and after acupuncture in normal ears(P >0.05).Tinnitus and auditory stuffiness in 15 of 21 ears with sudden hearing loss were relieved or even disappeared after acupuncture with auditory improvement.The ABR waves of 5 ears were poorly differentiated before acupuncture,and I wave or III wave disappeared with poor repetition,while the differentiations of ABR waves were markedly in focus with I wave,III wave and V wave,and moreover with good repetition.I wave latence of ABR in 16 ears with sudden hearing loss was( 2.00± 0.34) ms,V wave latence was(6.04± 0.59) ms, and I-V wave interval was(4.04± 0.57) ms before acupuncture;after acupunture, I wave latence was(1.77± 0.27) ms,V wave latence was(5.79± 0.63) ms and I-V interval was(3.98± 0.58) ms.There were significant differences in I and V latency between before and after acupuncture(t=2.406,2.463,P< 0.05). CONCLUSION:Acupunture in inner Tinggong can increase the excitability and conductibility of cochlea auditory nerve and lateral lemniscus pons to acupuncture inner Tinggong acupoint in sudden hearing loss patients,but with no effects on normal ears,which suggests that it can be one of the therapies for treatment of sudden hearing loss.