针刺联合糖皮质激素治疗突发性耳聋伴眩晕的疗效及前庭肌源性诱发电位在诊疗中应用的研究

Therapeutic Effect of Acupuncture Combined with Glucocorticoid on Sudden Deafness with Vertigo and Application of Vestibular Myogenic Evoked Potential in Diagnosis and Treatment

目的观察针刺联合糖皮质激素治疗突发性耳聋伴眩晕的疗效及前庭肌源性诱发电位(VEMP)在诊疗中应用的研究。方法选取本院42例突发性耳聋伴眩晕患者作为研究对象,分为观察组与对照组各21例。对照组采用糖皮质激素进行治疗,观察组采用针刺联合糖皮质激素进行治疗,比较两组的疗效、VEMP的变化情况。结果观察组患者总有效率76.2%明显高于对照组57.1%(P<0.05)。治疗前两组眼性前庭诱发肌源性电位(o VEMP)阈值和引出率差异无统计学意义(P>0.05);治疗后两组oVEMP阈值均下降、引出率均增加(P<0.05);治疗后观察组o VEMP阈值低于对照组,引出率高于对照组(P<0.05)。治疗前两组颈性前庭诱发肌源性电位(cVEMP)阈值和引出率差异无统计学意义(P>0.05);治疗后两组阈值下降、引出率增加(P<0.05);治疗后观察组阈值低于对照组,引出率高于对照组(P<0.05)。结论oVEMP和c VEMP联合检测全面客观评价突发性耳聋伴眩晕的前庭传导通路功能;针刺联合糖皮质激素明显改善突发性耳聋伴眩晕的疗效及前庭功能。

Objective To observe the efficacy of acupuncture combined with glucocorticoids in treatment of sudden deafness with vertigo and the application of vestibular myogenic evoked potential(VEMP)in diagnosis and treatment.Methods42 cases of patients with sudden deafness and vertigo were divided into observation group and control group.Control group was treated with glucocorticoids,observation group was treated with acupuncture combined with glucocorticoids.The effects of the two groups and the changes of VEMP were compared.Results The total effective rate of observation group was 76.2%,which was significantly higher than that of control group(57.1%)(P<0.05);there were no significant differences in the threshold and extinction rate of ocular vestibular-evoked myogenic potential(o VEMP)between the two groups before treatment(P>0.05);after treatment,the o VEMP thresholds decreased and the extraction rates increased(P<0.05);the o VEMP threshold of observation group was lower than that of control group,and the extraction rate was higher than that of control group(P<0.05);there was no significant difference in the threshold and extinction rate of cervical vestibular-evoked myogenic potential(c VEMP)between the two groups before treatment(P>0.05);the threshold of the both groups decreased and the extraction rate increased(P<0.05),the threshold of treatment group was lower than that of control group,and the extraction rate was higher than that of controlgroup(P<0.05).Conclusion The combined detection of o VEMP and c VEMP comprehensively and objectively evaluate the vestibular conduction pathway function of sudden deafness with vertigo;acupuncture combined with glucocorticoid significantly improved the efficacy and vestibular function of sudden deafness with vertigo.