耳迷走神经分布区穴位电刺激配合声音掩蔽治疗耳鸣:随机对照研究(英文)

Treatment of tinnitus with electrical stimulation on acupoint in the distribution area of ear vagus nerve combining with sound masking: randomized controlled trial

目的:观察耳迷走神经分布区穴位电刺激配合声音掩蔽治疗耳鸣的疗效。方法:63例耳鸣志愿者根据信封法随机分为治疗组(32人)和对照组(31人),治疗组给予耳迷走神经分布区穴位电刺激配合声音掩蔽治疗,对照组给予口服盐酸氟桂利嗪胶囊和谷维素治疗,两组均治疗8周。治疗前和治疗4周、8周后,根据"耳鸣残疾度量化表"和"耳鸣烦躁级量化表"评估疗效。结果:"耳鸣残疾程度量化表"评估显示,治疗4周后,两组耳鸣残疾程度比较,差异无统计学意义(χ2=1.981,P=0.16);治疗8周后,治疗组耳鸣轻、重度患耳构成比较治疗前有明显改善(χ2=25.01,P<0.001),而对照组治疗前后的差异无统计学意义(χ2=2.986,P=0.084),两组轻度患耳比例差异有统计学意义(χ2=9.315,P=0.002)。"耳鸣致烦躁程度量化表"显示,治疗4周后,治疗组患者烦躁程度明显轻于对照组(χ2=4.661,P=0.03);治疗8周后,两组烦躁轻、重度患者构成比均较治疗前有显著性改善(分别为χ2=25.397,P<0.001和χ2=7.828,P=0.005),治疗组改善程度好于对照组(χ2=5.857,P=0.016)。综合疗效显示,治疗8周后,治疗组和对照组有效率分别为90.63%(29/32)和80.65%(25/31),两组的差异无统计学意义(χ2=0.595,P=0.44)。结论:耳迷走神经分布区穴位电刺激配合声音掩蔽能显著改善耳鸣残疾和耳鸣致烦躁程度,疗效优于西药。

Objective To observe the efficacy of treating tinnitus with electrical stimulation on acupoint in the distribution area of ear vagus nerve by combining with sound masking. Methods Sixty-three volunteers suffering from tinnitus were randomly divided into a treatment group （32 cases） and a control group （31 cases） according to envelope method. The treatment group was given the treatment with electrical stimulation on acupoint in the distribution area of ear vagus nerve by combining with sound masking while the control group was given the treatment by taking flunarizine hydrochloride capsules and oryzanol orally. The treatment for both groups lasted for eight weeks. The efficacy was evaluated before treatment, 4 weeks and 8 weeks following the treatment respectively according to ＂Tinnitus Handicap Inventory＂ and ＂Tinnitus Dysphoria Inventory＂. Results It was revealed from the Tinnitus Handicap Inventory that the differences were not statistically significant by comparing the two groups after treatment for 4 weeks （χ2=1.981, P=0.16）; After 8 weeks of the treatment, patients with mild tinnitus and severe tinnitus were significantly improved in the treatment group compared with those before treatment （χ2=25.01, P〈0.O01） while the difference in the control group was not statistically significant before and after treatment （χ2=2.986, P=0.084）, and the difference of the ratio of patients with mild tinnitus in the two groups was statistically significant （χ2=9.315, P=0.002）. It was revealed from the Tinnitus Dysphoria Inventory that dysphoria of patients in the treatment group was more alleviated than that in the control group after treatment for 4 weeks （χ2=4.661, P=0.03）; After 8 weeks of the treatment, the patients with mild dysphoria and severe dysphoria were significantly improved in the two groups （χ2=25.397, P〈O.001 and χ2=7.828, P=O.O05, respectively）, and the efficacy in the treatment group was improved more significantly than that in the control group （χ2=5.857, P=0.016）. It was shown from the comprehensive efficacy that after 8 weeks of treatment, the effective rates of the two groups were 90.63% （29/32） and 80.65% （25/31） respectively, and the difference between the two groups was not statistically significant （χ2=0.595, P=0.44）. Conclusion Handicap and dysphoria of tinnitus can be improved significantly by treating with electrical stimulation on acupoint in the distribution area of ear vagus nerve and sound masking, and the efficacy was superior to that of western medicines.