益气活血法对体内自由基的影响及其治疗突发性聋的疗效机理

Investigation on the effect of Qi-boosting blood-quickening method on free radicals and its mechanism underlying the therapeutic effect on sudden hearing loss

目的从自由基清除角度探讨益气活血法治疗突发性聋的机理。方法60例突发性聋患者(65耳),随机分为治疗组30例(33耳)和对照组30例(32耳)。对照组应用高压氧联合药物(尼群地平等)疗法,治疗组在此基础上加用益气活血汤进行治疗,疗程持续20天。另取健康志愿者30名作为正常对照组。采用硫代巴比妥酸法检测MDA,放射免疫法检测SOD,分别比较两组患者治疗前后的相关检测指标及听力变化。同时应用邻三苯酚法检测实验小鼠的自由基变化,观察益气活血汤的抗自由基效用。结果治疗组痊愈6耳,显效13耳,有效10耳,总有效率87.88%;对照组痊愈6耳,显效6耳,有效9耳,总有效率65.63%。两组疗效比较差异有统计学意义(χ2=4.54,P<0.05)。比较SOD和MDA检测结果,治疗组治疗前后的差异有统计学意义。不同组别的实验动物也显示了相似的变化趋势。结论益气活血汤所用中药可能通过有效清除体内自由基而对突发性聋发挥更好的治疗效用。

Objective To investigate the effect of Qi-boosting blood-quickening method on free radicals and its mechanism underlying the therapeutic effect on sudden hearing loss based on both of clinical and experimental studies. Methods Included in this Part of clinical study were 60 cases（65 ears）with sudden hearing loss randomly divided into two groups, with 30 ones （33 ears） in treating group （TG） treated by a combined medicine therapy integrating routinely used drugs like nimodipine etc. with hyperbaric oxygen therapy and 30（32 ears）in controlling one （CG） treated by such a combined medicine therapy with Qi-boosting blood-quickening decoction （QBBQD） orally taken.The therapy was lasted for 20 days for all the cases in the two groups.Thirty healthy volunteers were taken as the normal controlling group （NCG）. Their auditory acuity was assayed routinely and blood samples were taken to determine the levels of malonylialdehyde （MDA） and superoxide dismutase （SOD） by the Procedures of thiobarbituric acid and radioimmunoassay before and after the treatment respectively, with a comparative analysis made to see their changes in auditory threshold and in these laboratory indicators following the therapy.In addition, an experimental study was carried out among mice to investigate the clearing effect of QBBQD on free radicals, with the levels of free radicals determined by Pyrogallol auto-oxidation Procedures. Results The cages of TG were shown cured in 6 ears, significantly effective in 13 ears and effective in 10 ears, with a total effective rate of 87.88%, while the ones of CG were shown cured, significantly effective and effective only in 6,6 and 9 ears respectively, with a total effective rate of 65.63%. There was a very significant difference in the therapeutic effect between the two groups as shown （x^2=4.54, P〈0. 05）. Furthermore, a significant difference was also found between the data in the values of SOD and MDA before and after treatment in TG,with a basically similar tendency, in these indicators as determined in animal experiments as well. Conclusions The therapeutic effects of QBBQD on sudden hearing loss may be brought about through its Pharmacological effects on free radicals to make them cleared away effectively.