参麦注射液联合高压氧治疗突发性聋的临床研究

目的 观察参麦注射液联合高压氧治疗突发性聋（SD）的临床疗效，探讨其治疗机制，为临床治疗提供理论基础。方法 选取2015 年1 月-2016 年3 月于湖北省十堰市太和医院耳鼻喉科收治的206 例SD患者按入院先后顺序随机均分为观察组和参麦组，观察组用地塞米松联合长春西汀等常规治疗，参麦组在该治疗基础上静脉滴注参麦注射液并联合高压氧治疗。记录患者听性脑干反应（ABR）反应阈，并记录80 dBnHL 短声刺激时Ⅰ～Ⅵ波的潜伏期，分析静脉血氧饱和度（SvO2），无创经颅多普勒记录两组患者局部脑血流（RCBF），统计两组患者治疗前后耳鸣和眩晕残存率、愈显率及总有效率。结果 两组ABR Ⅱ波、Ⅲ波潜伏期、Ⅰ～Ⅲ波间期、ABR 反应阈、SvO2 及RCBF 比较有差异（P <0.05），参麦组耳鸣和眩晕残存率降低，愈显率为79.61%、总有效率为98.05%，与观察组比较，差异有统计学意义（P <0.05）。结论 参麦注射液扩管作用可提高耳蜗受损组织血流量，高压氧可提高SvO2，增加外淋巴氧压，促进耳蜗、前庭神经的修复，两者合用提高疗效。

Clinical study of Shenmai injection combined with hyperbaric oxygen in treatment of sudden deafness

Objective To observe the clinical effect of Shenmai injection combined with hyperbaric oxygenin the treatment of sudden deafness (SD), and explore the mechanism of treatment, so as to provide theoreticalbasis for clinical treatment of sudden deafness. Methods A total of 206 SD patients in the OtolaryngologyDepartment of Taihe Hospital between January 2015 and March 2016 were selected. According to the order ofadmission they were randomly divided into observation group and Shenmai group. The patients in the observationgroup were given conventional treatment with Dexamethasone and Vinpocetine. The patients in the Shenmaigroup were treated with intravenous infusion of Shenmai injection combined with hyperbaric oxygen in addition toconventional treatment. The auditory brainstem response (ABR) threshold was recorded, and the latency of waveI-VI was recorded during 80 dB nHL short wave stimulation. Venous oxygen saturation (SvO2) was analyzed. Noninvasivetranscranial Doppler was used to record regional cerebral blood flow (RCBF). The residual rate, healingrate and total effective rate of tinnitus and vertigo before and after treatment in the two groups were statistacallyanalyzed. Results Compared to the observation group, the latency of ABR wave II and III, wave I-III interval,and ABR threshold significantly decreased in the Shenmai group (P < 0.05), while SvO2 and RCBF increased inthe Shenmai group (P < 0.05). The residual rate of tinnitus and vertigo decreased markedly, the healing rate was 79.61%, the total effective rate was 98.05%, compared with the observation group, the differences were statistically significance (P < 0.05). Conclusions Shenmai injection can improve the blood flow of the damaged cochlea tissue. Hyperbaric oxygen can increase SvO2 and the perilymphatic oxygen pressure, and promote the repair of cochlea and vestibular nerve. Combination of Shenmai injection with hyperbaric oxygen can obviously improve the curative effect of SD.