注射用七叶皂苷钠治疗突发性聋伴主观性耳鸣的临床观察

目的评估注射用七叶皂苷钠治疗突发性聋伴主观性耳鸣的临床应用价值。方法选取2010年8月至2011年10月在我科治疗的伴主观性耳鸣的突发性聋患者(听力曲线为上升型)79例,分为七叶皂苷钠组(37例)和银杏叶提取物组(42例),从耳鸣疗效、听力疗效及综合疗效3方面评价。结果 七叶皂苷钠组耳鸣改善有效率(95%),听力改善有效率(89%),综合有效率(87%),高于银杏叶提取物组,差异具有统计学意义(P<0.05)。结论七叶皂苷钠治疗突聋伴主观性耳鸣患者疗效优于银杏叶提取物。     

银杏叶片联合地塞米松治疗神经性耳鸣的临床疗效研究

目的 探究银杏叶片联合地塞米松治疗神经性耳鸣的临床疗效。方法 70例神经性耳鸣患者,按照随机数字表法分为对照组和观察组,各35例。对照组采取地塞米松治疗,观察组采取银杏叶片联合地塞米松治疗。比较两组患者临床疗效、不良反应发生率及治疗前后耳鸣情况(耳鸣致残量表评分、响度评分)、中枢神经递质[血清5-羟色胺(5-HT)和γ-氨基丁酸(GABA)]水平。结果 观察组的治疗总有效率91.43%高于对照组的71.43%,差异有统计学意义(P<0.05)。治疗前,两组患者的耳鸣致残量表评分和响度评分比较,差异无统计学意义(P>0.05);治疗后,两组患者的耳鸣致残量表评分和响度评分均低于本组治疗前,且观察组患者的耳鸣致残量表评分(26.38±3.41)分和响度评分(5.24±1.26)分均低于对照组的(32.54±4.19)、(7.07±1.42)分,差异有统计学意义(P<0.05)。治疗前,两组患者的血清5-HT和GABA水平比较,差异无统计学意义(P>0.05);治疗后,两组患者的血清5-HT水平低于本组治疗前, GABA水平高于本组治疗前,且观察组患者的血清5-HT(...     

银杏叶片联合地塞米松治疗神经性耳鸣的临床研究

目的 评估银杏叶片联合地塞米松治疗神经性耳鸣患者的临床疗效。方法 选取2019年6月—2020年6月在遂宁市中心医院耳鼻咽喉科住院的120例神经性耳鸣患者，随机分为对照组和治疗组，每组各60例。对照组鼓室内灌注地塞米松磷酸钠注射液，0.6 mL/次，首周治疗2次，然后1次/周。治疗组在对照组基础上口服银杏叶片，2片/次，3次/d。两组均持续治疗4周。观察两组患者临床疗效，比较治疗前后两组患者耳鸣致残量表（THI）评分、耳鸣响度和中枢神经递质水平。结果 治疗后，治疗组神经性耳鸣的临床症状改善的有效率（93.33%）显著高于对照组（68.33%）（P＜0.05）。治疗后，两组患者THI评分、耳鸣响度评分均较治疗前显著降低（P＜0.05），治疗后治疗组THI评分、耳鸣响度评分低于对照组（P＜0.05）。治疗后，两组患者血清5-羟色胺（5-HT）的水平显著降低，γ-氨基丁酸（GABA）的含量显著升高（P＜0.05）；且治疗组5-HT和GABA的变化比对照组更明显（P＜0.05）。结论 银杏叶片联合地塞米松治疗可显著改善神经性耳鸣患者的临床症状，降低患者的耳鸣响度，调节中枢神经递质的水平。     

健脾益气止鸣汤联合西药治疗神经性耳鸣40例疗效观察

目的 探讨健脾益气止鸣汤联合西药治疗神经性耳鸣的临床疗效。方法 80例神经性耳鸣患者,按照入院治疗先后顺序分为对照组和观察组,各40例。其中对照组选择西药治疗方案,观察组在对照组基础上联合健脾益气止鸣汤行中医辨证治疗。比较两组治疗效果;中医证候积分;最大及最小耳鸣响度;治疗前后耳鸣严重程度评分;耳鸣残疾评分;左耳和右耳听阈值和生活质量评分。结果 观察组治疗总有效率为97.5%,显著高于对照组的77.5%,差异具有统计学意义(P<0.05)。观察组中医症候积分、最大耳鸣响度、最小耳鸣响度分别为(11.29±4.12)分、(23.00±2.80)dB、(0.04±0.01)dB,均显著低于对照组的(16.33±3.27)分、(65.10±6.10)dB、(13.40±1.80)dB,差异均有统计学意义(P<0.05)。治疗后,观察组耳鸣严重程度评分、耳鸣残疾评分、左耳和右耳听阈值分别为(4.34±1.56)分、(37.47±9.45)分、(27.93±4.24)dB,均显著低于对照组的(8.13±1.52)分、(44.28±8.37)分、(29.41±1.84)dB,生活质量评分(60.56±10.63)分高于对照组的(51.34±10.11)分,差异均有统计学意义(P<0.05)。结论 健脾益气止鸣汤联合西药治疗方案应用于神经性耳鸣患者中临床疗效更理想,可改善患者的疗效,并降低最大耳鸣响度、最小耳鸣响度,是一种值得推荐的中西医治疗方案。     

卡马西平联合鼠神经生长因子治疗耳鸣的疗效观察

目的探讨卡马西平片联合注射用鼠神经生长因子治疗耳鸣的临床疗效。方法选取2014年7月—2016年7月中国人民解放军第三七一医院耳鼻喉科收治的耳鸣患者97例为研究对象,所有患者在随机分组的原则下分为对照组(48例)和治疗组(49例)。对照组肌肉注射注射用鼠神经生长因子,30μg与2 m L氯化钠注射液进行混合,1次/d。治疗组在对照组基础上口服卡马西平片,1片/次,2次/d。两组患者均连续治疗3周。观察两组的临床疗效,比较两组的耳鸣致残量表(THI)评分、耳鸣响度和耳鸣残疾程度。结果治疗后,对照组和治疗组的总有效率分别为81.25%、97.96%,两组比较差异有统计学意义(P0.05)。治疗后,两组THI评分和耳鸣响度均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组无残疾人数均显著增多,中度残疾人数均显著减少,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论卡马西平片联合注射用鼠神经生长因子治疗耳鸣具有较好的临床疗效,可降低耳鸣响度,改善耳鸣残疾程度,安全性较好,具有一定的临床推广应用价值。     

天麻素联合利多卡因耳迷根穴位注射治疗特发性耳鸣的疗效分析

目的 探讨天麻素联合利多卡因耳迷根穴位注射治疗特发性耳鸣的疗效.方法 选取该院2012年5月-2015年12月收治的特发性耳鸣患者130例为研究对象,根据随机数字表法将其分为观察组(n=70)和对照组(n=60),其中对照组在基础治疗的基础上口服银杏叶制剂和金纳多口服片剂,观察组在对照组的基础上于耳迷根穴位注射利多卡因和天麻素.比较两组患者治疗前和治疗后耳鸣残疾量表(THI)评分、视觉模拟量表(VAS)评分、耳鸣响度、睡眠量表(SPIEGEL)评分、焦虑量表评分、抑郁量表评分和耳鸣分级的变化,评价两组的临床疗效.结果 治疗后,两组患者的THI评分、VAS评分、耳鸣响度、SPIEGEL评分、焦虑量表评分、抑郁量表评分和耳鸣分级较治疗前均明显降低,且治疗后观察组THI评分、VAS评分、耳鸣响度、SPIEGEL评分、焦虑量表评分、抑郁量表评分和耳鸣分级均低于对照组,两组比较均差异有统计学意义(P<0.05).对照组治疗的总有效率为58.3%,观察组治疗的总有效率为91.4%,两组总有效率比较差异有统计学意义(χ2=19.486,P<0.001).结论 耳迷根穴位注射天麻素和利多卡因可明显改善特发性耳鸣患者的生活质量,提高治疗特发性耳鸣患者的临床有效率.     

耳鸣掩蔽和习服治疗在主观性耳鸣治疗中的效果分析

目的分析耳鸣掩蔽和习服治疗在主观性耳鸣治疗中的效果。方法本研究所选研究对象为我院2014年3月至2016年2月收治的80例主观性耳鸣患者,其中65例患者的掩蔽试验结果为阳性,15例患者的掩蔽试验结果为阴性;将65例掩蔽试验结果为阳性患者中的35例作为对照组,其他45例患者则为实验组,两组患者分别给予耳鸣掩蔽治疗和习服治疗。结果在临床治疗总有效率以及耳鸣残疾评估量表评分方面,实验组均显著优于对照组(P<0.05)。结论习服治疗主观性耳鸣患者的临床效果显著,具有临床应用价值。     

复方樟柳碱治疗主观性耳鸣的疗效观察

目的观察复方樟柳碱注射液治疗主观性耳鸣的临床效果。方法将主观性耳鸣患者随机分为治疗组60例和对照组60例,治疗组采用复方樟柳碱注射液于颞浅动脉旁皮下注射,1次/d;对照组用谷维素20mg口服,3次/d,2%利多卡因静脉滴注,1次/d,疗程均为14d。耳鸣消失为显效,耳鸣改善为有效,耳鸣不改善为无效。结果治疗组显效31例,有效22例,无效7例,总有效率为88.3%;对照组显效15例,有效23例,无效22例,总有效率为63.3%,治疗组的疗效明显优于对照组(P<0.05)。结论复方樟柳碱注射液治疗主观性耳鸣安全、有效。     

耳鸣习服疗法治疗耳鸣患者50例临床观察

目的观察耳鸣习服疗法(TRT)治疗耳鸣的临床效果。方法对50例慢性耳鸣患者采用TRT治疗,分别于治疗第1,3,6个月时采用耳鸣残疾度量化表(THI)评定疗效,并比较治疗前后耳鸣烦躁程度。结果治疗后第1个月THI评分(39.2±8.4)分与治疗前(47.8±9.6)分比较差异无统计学意义(P>0.05),治疗后第3个月THI评分(28.5±7.3)分较治疗前(47.8±9.6)分明显下降,治疗后第6个月THI评分(16.8±5.6)分较治疗第3个月明显降低,差异均有统计学意义(P<0.01)。治疗后,患者耳鸣烦躁程度优于治疗前,差异有统计学意义(P<0.01)。结论 TRT是临床治疗慢性耳鸣的有效方法。     

甲钴胺与银杏叶注射液联合治疗2型糖尿病耳聋耳鸣疗效观察

目的 观察甲钴胺与银杏叶注射液联合治疗2型糖尿病耳聋耳鸣的疗效.方法 46例糖尿病耳聋耳鸣患者按就诊月份分为观察组26例与对照组20例.观察组应用甲钴胺、银杏叶注射液联合治疗,对照组应用银杏叶注射液静脉滴注治疗,通过纯音测听、耳鸣匹配、声导抗检查,观察并比较2组疗效.结果 观察组耳聋有效率76.9%,耳鸣有效率88.5%.对照组耳聋有效率50.0%,耳鸣有效率60.0%.2组耳鸣、耳聋的有效率差异均有统计学意义(P<0.05)结论 甲钴胺与对银杏叶注射液治疗2型糖尿病耳聋耳鸣都有明显疗效,二药联合应用疗效好于单用银杏叶.     

Emerging pharmacotherapy of tinnitus

Tinnitus, the perception of sound in the absence of an auditory stimulus, is perceived by about 1 in 10 adults, and for at least 1 in 100, tinnitus severely affects their quality of life. Because tinnitus is frequently associated with irritability, agitation, stress, insomnia, anxiety and depression, the social and economic burdens of tinnitus can be enormous. No curative treatments are available. However, tinnitus symptoms can be alleviated to some extent. The most widespread management therapies consist of auditory stimulation and cognitive behavioral treatment, aiming at improving habituation and coping strategies. Available clinical trials vary in methodological rigor and have been performed for a considerable number of different drugs. None of the investigated drugs have demonstrated providing replicable long-term reduction of tinnitus impact in the majority of patients in excess of placebo effects. Accordingly, there are no FDA or European Medicines Agency approved drugs for the treatment of tinnitus. However, in spite of the lack of evidence, a large variety of different compounds are prescribed off-label. Therefore, more effective pharmacotherapies for this huge and still growing market are desperately needed and even a drug that produces only a small but significant effect would have an enormous therapeutic impact. This review describes current and emerging pharmacotherapies with current difficulties and limitations. In addition, it provides an estimate of the tinnitus market. Finally, it describes recent advances in the tinnitus field which may help overcome obstacles faced in the pharmacological treatment of tinnitus. These include incomplete knowledge of tinnitus pathophysiology, lack of well-established animal models, heterogeneity of different forms of tinnitus, difficulties in tinnitus assessment and outcome measurement and variability in clinical trial methodology.     

Emerging pharmacotherapy of tinnitus

One in ten adults has clinically significant subjective tinnitus, and for one in hundred, tinnitus severely affects their quality of life. Despite the significant unmet clinical need for a safe and effective drug targeting tinnitus relief, there is currently not a single FDA-approved drug on the market. Even a drug that produces a small but significant effect would have a huge therapeutic impact. In the last few years, there have been significant advances in i) the understanding of the pathophysiology of the different forms of tinnitus, ii) the establishment of valid animal models and iii) the development of clinical trial methodology. A glimpse of hope is appearing in the horizon as an increasing number of pharmaceutical industries now have compounds targeting tinnitus in their pipeline.     

耳鸣习服治疗耳鸣84例临床分析

目的探讨耳鸣习服疗法（TRT）治疗耳鸣的临床疗效。方法将84例以耳鸣为第一主诉的长期严重主观耳鸣患者采用习服疗法进行治疗。在治疗开始后2周、1个月和2个月时进行疗效评定。结果 2周时总有效率为71.43%,1个月为78.57%,2个月为82.14%。结论 TRT是临床治疗耳鸣的一种较理想的方法。     

耳鸣习服治疗耳鸣84例临床分析

目的 探讨耳鸣习服疗法(TRT)治疗耳鸣的临床疗效.方法 将84例以耳鸣为第一主诉的长期严重主观耳鸣患者采用习服疗法进行治疗.在治疗开始后2周、1个月和2个月时进行疗效评定.结果 2周时总有效率为71.43%,1个月为78.57%,2个月为82.14%.结论 TRT是临床治疗耳鸣的一种较理想的方法.     

Current pharmacological treatments for tinnitus

Introduction: Tinnitus, the phantom perception of sound, is a highly prevalent disorder and treatment is elusive.

Areas covered: This review focuses on clinical research regarding pharmacological treatments for tinnitus. The authors searched PubMed databases for English language articles related to pharmacological treatment of tinnitus, published through August 2012. The keywords "tinnitus AND pharmacological treatment” and “tinnitus AND drugs” were used. The search focused on clinical trials, but was complemented by other articles and information from clinical trial registries.

Expert opinion: Despite the significant unmet clinical need for a safe and effective drug for tinnitus relief, there is currently no EMA- or FDA-approved drug on the market. Even a drug that produces a small but significant effect would have a huge therapeutic impact. At present, evidence-based pharmacological approaches are limited to the treatment of comorbidities such as depression, anxiety, or insomnia. In the last few years there have been significant advances in the understanding of the pathophysiology of the different forms of tinnitus, the establishment of valid animal models, and the development of clinical trial methodology. A glimpse of hope is appearing in the horizon as an increasing number of pharmaceutical industries now have compounds targeting tinnitus in their pipeline.     

An evaluation of tinnitus treatment

Tinnitus is a significant problem for otolaryngologists and one of the greatest problems facing a patient, precisely for its subjective aspects,is the lack of understanding and the uncertainty created by often erratic rationale and dubious medical approache. It affects 10 - 20% of the general population and may be a significant problem for about 4% of sufferers. For years countless approaches to tinnitus have been proposed. During the last few years rapid progress has been made in the tinnitus field, providing better insight into the potential mechanisms of tinnitus generation, perception and ways of treatment.     

耳鸣诊断方法 的新进展

尽管耳鸣并非全由器质性病变引起，但其对生活质量产生的不良影响及近年不断增高的发病率使其愈加受到重视。由于耳鸣是患者的主观感受，很难将其客观化。所以其发病机制的研究、病因的确定、诊断及治疗均是医学界的难题。经过几十年的深入研究．耳鸣的发病机制、诊断等各方面均已取得进展。笔者通过对近十年国内外文献报道的研究，总结耳鸣常规诊断方法 、影像学、量化、严重程度评估及听尼特删诊疗技术等的最新进展。     

Role of acamprosate in sensorineural tinnitus

Acamprosate with dual mechanism of action as glutamate antagonist and GABA agonist can be a potential target to decrease the severity of sensorineural tinnitus.

Objective:

(1)To study the effectiveness of acamprosate in providing subjective relief and objective improvement in patients having tinnitus of sensorineural origin. (2) To evaluate the adverse events related to the use of acamprosate and also determine the change in quality of life (QOL) parameters.

Materials and Methods:

The study was randomized double-blind, placebo controlled, crossover. Forty adult subjects (>18 years of age), of either sex with tinnitus of sensorineural origin, were administered either acamprosate 333 mg TDS or matched placebo for a period of six weeks followed by a washout period of one week. Drug therapy was switched for another six weeks in consonance with the crossover design. The effect of acamprosate and placebo on subjective relief and objective improvement was evaluated by using modified tinnitus severity, QOL scores and audiometry with tinnitus matching in frequency and loudness.

Results:

At the end of the study, the drug had shown a statistically significant improvement in reducing the tinnitus score in 92.5% of the patients and placebo with an improvement in 12.5% of the patients. The drug was well tolerated without any serious drug reactions.

Conclusion:

Acamprosate is an effective drug in treating the severity of sensorineural tinnitus without causing much of the side effects.KEY WORDS: Acamprosate, audiometry, sensorineural tinnitus, tinnitus matching