针刺配合清肝聪耳合剂治疗特发性耳鸣的疗效观察

Observations on the Efficacy of Acupuncture plus Qinggan Conger Mixture for Idiopathic Tinnitus

目的观察针刺配合清肝聪耳合剂治疗特发性耳鸣的临床疗效及对心理声学特征的影响。方法将86例肝火上扰型特发性耳鸣患者,随机分为针药组和对照组,每组43例。针药组采用针刺配合清肝聪耳合剂口服治疗,对照组采用银杏叶提取物滴剂、甲钴胺片、盐酸氟桂利嗪胶囊口服。观察治疗前后耳鸣评价量表(TEQ)评分变化。进行纯音测听和心理声学检测[音调匹配(PM)、响度匹配(LM)、最小掩蔽级测试(MMLs)、(Feldman曲线)]。比较两组临床疗效及病程、严重程度、耳鸣匹配频率对临床疗效的影响。结果针药组总有效率显著优于对照组(P<0.05)。两组耳鸣严重程度评分均较治疗前降低(P<0.05),针药组评分明显低于对照组(P<0.05);针药组不同病程、不同耳鸣匹配频率、不同耳鸣严重程度的临床疗效比较,差异有统计学意义(P<0.05)。针药组治疗后音调匹配频率(PMl)和音调匹配类型(PM2)无明显变化(P>0.05);治疗前后响度匹配感觉级(LMSL)、MMLs、MMLs差值、Feldman曲线比较,差异有统计学意义(P<0.05)。结论针刺配合清肝聪耳合剂治疗肝火上扰型特发性耳鸣疗效显著,对耳鸣及其产生的不良心理反应有很好的治疗作用。

Objective To observe the clinical efficacy of acupuncture plus Qinggan Conger mixture for idiopathic tinnitus and its effect on psychoacoustic characteristics.Method Eighty-six patients with idiopathic tinnitus of liver-fire disturbing upward type were randomized to acupuncture plus medicine and control groups,with 43 cases in each group.The acupuncture plus medicine group received acupuncture plus oral administration of Qinggan Conger mixture and the control group,oral administration of Ginkgo biloba leaf extract drops,MeCobalamin Tablets and Flunarizine Hydrochloride Capsules.The Tinnitus Evaluation Questionnaire(TEQ)score was recorded before and after treatment.Pure tone audiometry and psychoacoustic testing[pitch matching(PM),loudness matching(LM),minimum masking levels(MMLs),Feldman curve and residual inhibition(RI)]were performed.The clinical therapeutic effects,durations of disease,severities and the effects of tinnitus frequency matching on clinical efficacy were compared between the two groups.Result The total efficacy rate was higher in the acupuncture plus medicine group than in the control group(P<0.05).After intervention,the tinnitus severity score decreased in the two groups compared with before(P<0.05)and was significantly lower in the acupuncture plus medicine group than in the control group(P<0.05).In the acupuncture plus medicine group,there was a statistically significant difference in the clinical therapeutic effect of different durations of disease,tinnitus frequency matchings and tinnitus severities(P<0.05).In the acupuncture plus medicine group,pitch matching frequency(PM1)and pitch matching type(PM2)did not change significantly after treatment and loudness matching sensation level(LMSL),MMLs,MMLs difference value and Feldman curve had statistically significant pre-/post-treatment differences(P<0.05).Conclusion Acupuncture plus Qinggan Conger mixture has marked efficacy in treating idiopathic tinnitus.It produces a good therapeutic effect on tinnitus and its adverse psychological reactions.