针刺听宫穴治疗耳鸣疗效观察及影响因素分析

Curative effect and influence factors of electroacupuncture in Tinggong(SI19) on tinnitus

目的通过电针刺激听宫穴治疗耳鸣观察其临床疗效,同时分析可能影响疗效的主要因素。方法纳入门诊主观性耳鸣患者120例,取患侧听宫穴垂直进针1.2～1.3寸,手法平补平泻,不提插捻转,至针感向耳内放散、局部酸麻胀痛感为度。针尾接G68050-2A脉冲治疗仪,通连续波刺激,重复频率30 Hz,每次留针15 min,每日1次,20次为1个疗程。疗程结束后根据疗效评定标准评价疗效,并用多元线性回归法分析耳鸣治疗中的影响因素。结果①耳鸣患者年龄主要集中在30～65岁,男女比例为1∶1.3,病程最短者7 d,最长10年。②耳鸣消失10例,显效41例,有效43例,无效26例,总有效率78.4%,疗效确切。③由回归方程可知:疗效与患者年龄及耳鸣持续时间呈负相关,与耳鸣严重程度呈正相关(P=0.000),而性别、耳鸣响度、原发基础病及听力情况与疗效之间无统计学相关性。结论电针刺激听宫穴治疗神经性耳鸣效果肯定,在不考虑耳鸣病因的条件下,年龄较小、耳鸣严重程度重、病程时间短的患者,预期的结局越好。

Objective To observe the curative effect of electroacupuncture in Tinggong （SI19） on tinnitus, and analyse the influence factors on the curative effect. Methods The patients with subjective tinnitus （n = 120） were selected from clinic. The patients were given acupuncture vertically in Tinggong （SI19） of tinnitus side for 1.2 - 1.3 tun until they had local aching, tingling and distending pain. Then the end of needle was connected with pulse therapeutic device G68050-2A with stimulation of continuous wave at repetition frequency of 30 Hz for 15 minutes. The treatment was given to the patients once a day and one therapeutic course included 20 times. The curative effect and influence factors were reviewed and analysed according to the evaluation standard and the method of multiple linear regression. Results （1）The patients with tinnitus were aged mainly from 30 years old to 65 years old, and the proportion of male to female was 1 to 1.3. The shortest disease course was 7 days and the longest was 10 years. （2）There were 10 eases cured, 41 with obvious effect, 43 with effect and 26 without any curative effect. The total effective rate was 78.4%. The curative effect was definite. （3）The results of regression showed that the curative effect was negatively correlated to the age and duration of tinnitus, and correlated to tinnitus severity （P = 0. 000）. There was no statistical correlation between the curative effect and sex,tinnitus loudness, primary basic diseases and hearing. Conclusion The stimulation of electroacupuncture in Tinggong （SI19） had a reliable curative effect. The younger patients with more severe tinnitus and shorter disease course have better prognosis without considering tinnitus cause.