针刺与中医药物结合辨证治疗特发性主观性耳鸣的疗效

 目的 观察针刺与中医药物结合辨证治疗特发性主观性耳鸣的疗效。方法 选择2018-01至2021-09于解放军总医院第八医学中心中医科就诊的特发性主观性耳鸣患者106例,依据患者治疗意愿分为针药结合组和单纯针刺组两组。单纯针刺组予针刺治疗,针药结合组在针刺治疗的基础上联合中药治疗。两组治疗周期4周。于治疗前、治疗4周后、治疗结束后3个月填写耳鸣严重程度评估量表(TEQ)进行评分,判定疗效和复发,比较2组疗效和复发率差异。结果 (1)针药结合组纳入可分析病例55例,单纯针刺组纳入43例。两组在性别、年龄、病程3个方面差异具均有统计学意义(P＜0.05)。进行倾向性评分匹配法后,两组各有38例达到了所设置的匹配容差,保证了两组基线的可比性。(2)治疗4周后,针药结合组TEQ评分较单纯针刺组明显降低,差异有统计学意义(P＜0.05),针药结合组总有效率89.47%,优于于单纯针刺组71.05%(P＜0.05)。(3)治疗结束3个月后随访,针药结合组复发率(5.88%)低于单纯针刺组(18.52%),差异有统计学意义(P＜0.05)。结论 针刺与中医药物辨证治疗特发性主观性耳鸣疗效优于单纯针刺治疗。

Study on treatment of primary subjective tinnitus with acupuncture combined with traditional Chinese medicine based on syndrome differentiation

Objective To observe the clinical efficacy of acupuncture combined with traditional Chinese medicine (TCM) based on syndrome differentiation on patients with primary subjective tinnitus. Methods A non-randomized controlled trial design was performed. Patients with primary subjective tinnitus who met the criteria were included and divided into the acupuncture combined with TCM group and the acupuncture alone group according to their intervention. The acupuncture alone group was treated with acupuncture alone, and the acupuncture combined with TCM group was treated with TCM based on syndrome differentiation on the basis of the above acupuncture treatment. Treatment lasted for 4 weeks. Tinnitus Evaluation Questionnaire (TEQ) was completed before treatment, 4 weeks after treatment and 3 months after the end of treatment to score efficacy and recurrence, and the difference in efficacy and recurrence rate between the two groups was compared. Results There were 55 analyzable cases in the acupuncture combined with TCM group and 43 cases in the acupuncture alone group. There were significant differences in gender, age and course of disease between two groups (P<0.05). After the propensity score matching method, 38 patients in each group reached to the matching tolerance, thus ensuring the comparability of baseline between two groups. After 4 weeks of treatment, the TEQ score of acupuncture combined with TCM group was significantly lower than that of acupuncture alone group (P<0.05), and the total effective rate of acupuncture combined with TCM group was 89.47%, which significantly higher than that of acupuncture alone group (71.05%) (P<0.05). At the three months’ follow-up after the end of treatment, the recurrence rate of acupuncture combined with TCM group (5.88%) was significantly lower than that of acupuncture alone (18.52%) (P<0.05). Conclusions The efficacy of acupuncture combined with TCM group based on syndrome differentiation on primary subjective tinnitus is better than that of acupuncture alone.