益气聪明汤合通气散加减联合氯硝西泮治疗特发性耳鸣伴失眠的疗效分析

Effect of Yiqi Congming Decoction(益气聪明汤)and Tongqi Powder(通气散)Combined with Clonazepam on Idiopathic Tinnitus with Insomnia

目的观察用益气聪明汤合通气散加减联合氯硝西泮治疗特发性耳鸣伴失眠的临床疗效。方法选择2017年1月—2019年8月于医院就诊的特发性耳鸣伴失眠患者80例为研究对象,将患者按照随机数字表法分为对照组和治疗组各40例。对照组患者给予甲钴胺联合氯硝西泮常规西药治疗;治疗组患者给予益气聪明汤合通气散加减而成的中药内服联合氯硝西泮治疗,连续治疗2周为疗程。比较两组患者治疗耳鸣、失眠的疗效、耳鸣响度、耳鸣残疾量表(THI)、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、心理状态评分。结果在对耳鸣的治疗方面,对照组、观察组的有效率为72.50%、92.50%,以观察组疗效更好(χ^(2) =5.817,P<0.05);在对失眠的治疗方面,对照组、观察组的有效率为77.50%、95.00%,以观察组疗效更好(χ^(2)=5.165,P<0.05);治疗1周、2周后,观察组患者的耳鸣响度评分均显著低于对照组(t=10.695,20.623,P<0.05);治疗后,观察组的耳鸣THI评分、睡眠PSQI评分与对照组相比下降更明显(P<0.05);观察组患者治疗后的心理状态更好,SAS、SDS评分显著低于治对照组(P<0.05)。结论益气聪明汤合通气散加减联合氯硝西泮治疗特发性耳鸣伴失眠有确切疗效,能有效降低耳鸣响度,改善耳鸣残疾程度,提高睡眠质量,减轻焦虑、抑郁状态,值得临床推广。

Objective To observe the clinical effect of Yiqi Congming Decoction(益气聪明汤)and Tongqi Powder(通气散)combined with clonazepam in the treatment of idiopathic tinnitus with insomnia.Methods A total of 80 patients with idiopathic tinnitus and insomnia admitted to our hospital from January 2017 to August 2019 were selected as the study subjects,and the patients were divided into the control group and the treatment group according to the random number table method,with 40 patients in each.The control group was treated with mecobalamin combined with clonazepam.The patients in the treatment group were given Yiqi Congming Decoction and Tongqi Powder combined with clonazepam,and the treatment lasted for 2 weeks.The therapeutic effect of tinnitus and insomnia,tinnitus loudness,Tinnitus disability Scale(THI),Pittsburgh Sleep Quality Index(PSQI)and psychological status score were compared between the two groups.Results In the treatment of tinnitus,the effective rates of the control group and the observation group were 72.50%and 92.50%,respectively,with better efficacy in the observation group(χ^(2)=5.817,P<0.05).In the treatment of insomnia,the effective rates of the control group and the observation group were 77.50%and 95.00%,,respectively,with the observation group having better efficacy(χ^(2)=5.165,P<0.05).After 1 and 2 weeks of treatment,the tinnitus loudness score of the observation group was significantly lower than that of the control group(t=10.695,20.623,P<0.05).After treatment,tinnitus THI score and sleep PSQI score in the observation group were decreased more significantly than those in the control group(P<0.05).Patients in the observation group had better psychological state after treatment,and SAS and SDS scores were significantly lower than those in the control group(P<0.05).Conclusion Yiqi Congming Decoction and Tongqi Powder combined with clonazepam in the treatment of idiopathic tinnitus with insomnia has an exact effect.It can effectively reduce tinnitus loudness,improve tinnitus disability,improve sleep quality,reduce anxiety and depression,and is worthy of clinical promotion.