针刺对儿童药物中毒性听力语言障碍脑干听觉诱发电位的影响

Effect of Acupuncture on Brainstem Auditory Evoked Potential in Children with Hearing and Language Disorders

目的：探索针刺治疗儿童听力语言障碍的作用机理。方法：对53例药物中毒所致听力语言障碍儿童进行脑干听觉诱发电位测试。采用随机数字表法将患者分为针刺组31例（62耳），药物对照组22例（44耳）。针刺组主要取四神针、颞三针、耳三针、舌三针、风池、哑门、合谷、中渚、足临泣为治疗穴位，每日1次，每次30min；对照组口服盐酸葡桂利嗪胶囊、三磷酸腺苷、VitB1、VitB6。均为每月1疗程，连续治疗4个疗程。以脑干听觉诱发电位Ⅰ、Ⅲ、Ⅴ波的峰潜伏期，Ⅰ～Ⅲ、Ⅲ～Ⅴ峰间期为主要观察指标。结果：针刺组各波峰潜伏期治疗前后自身比较，Ⅰ、Ⅴ波潜伏期明显缩短，具有显著性差异（P〈0．05），而Ⅲ波变化不显著（P〉0．05）；治疗后组间比较，Ⅰ、Ⅴ波潜伏期有显著性差异（P〈0．05），Ⅲ波潜伏期无显著性差异（P〉0．05）。针刺组各波峰间期治疗前后自身比较，Ⅰ～Ⅲ、Ⅲ～Ⅴ波间期明显缩短（P〈0．05），Ⅰ～Ⅴ波间期变化不显著（P〉0．05）；治疗后组间比较，Ⅰ～Ⅲ、Ⅲ～Ⅴ波间期有显著性差异（P〈0．05），而Ⅰ～Ⅴ波间期差异无显著性（P〉0．05）。结论：针刺有效穴位能够明显缩短Ⅰ、Ⅴ波潜伏期和Ⅰ～Ⅲ、Ⅲ～Ⅴ波间期，促进听力语言障碍患儿的听觉和语言的发育，改善患儿的预后。

Objective： To explore the mechanism of acupuncture therapy in improving infant dysaudia and aphasis. Methods, Fifty-three children with dyseudia and aphasis caused by medicines were randomly divided into acupuncture group （31 cases） and control group （22 cases）. Sishenzhen [4 points 1.5 cun left, right, superior and inferior respectively to Baihui （GV 20）1, Niesenzhen （point 1; 2 cun straight superior to the ear-tip; point 2 and 3：1 cun lateral to point 1）, Ersanzhen [Tinggong （SI 19）, Tinghui （GB 2） and Wangu （GB 12） ], Fengchi （GB 20）, Yamen （GV 15）, Hegu （LI 4）, etc were punctured, once daily, 6 times a week. Infant patients in control group were ordered to take Flunarizine Hydrochloride （5 mg/time/d）, ATP （20 mg/ time, t. i. d. ）, Vit B1（20 mg/time, t. i. d. ） and Vit B6（20 mg/time, t. i. d. ）. Both groups were treated for 4 months. Brainstem auditory evoked potentials （BAEP） induced by a brief click stimulus （110- 125 dB, 9 Hz） to one ear was recorded by using surface electrodes typically placed at the vertex of the scalp and ear lobes and Kepotin EP/EMG Instrument before and after the treatment. The waveform peaks were labeled as Ⅰ -Ⅴ. Results： Compared with pre-treatrnent, the latency values of peak Ⅰ and Ⅴ of acupuncture group decreased significantly （P〈 0.05）; while comparison between two groups after the treatment showed that the latency values of peak Ⅰ and Ⅴ of acupuncture group were significantly lower than those of control group （P 〈 0.05）. The interphases of peak Ⅰ - Ⅲ and peak Ⅲ -Ⅴ presented a similar tendency to those of peak latency, suggesting that the effect of acupuncture in improving auditory disorder is significantly better than that of medication. No significant differences were found between two groups in peak Ⅲ latency and interphase Ⅰ - Ⅴ （P〉0.05）. Concision; Acupuncture has a good effect in lessening the latency and interphase of BAEP, which may be.responsible for its effect in improving hearing and language disorders in children with dysaudia and aphasis.