基于临床证据及专家意见的针灸干预突发性耳聋临床决策研究

Clinical Decisions for Acupuncture Treatment in Sudden Hearing Loss Based on Clinical Evidences and Experts Opinions

目的基于临床证据和专家意见,探讨针灸干预突发性耳聋(SHL)的疗效结局及干预层次的临床决策。方法全面收集针灸治疗SHL临床证据,采用RevMan 5.1软件进行数据统计分析,获得证据决策。在全国具有针灸专业背景的高级职称临床医师中,通过自填式问卷,实施具有描述性的学术专业横剖的大样本抽样调查。对专家的意见采用模糊综合评判技术进行统计分析,获得专家决策。结果 3组共25项研究显示针灸干预SHL或配合常规西药或配合常规综合疗法在治愈率、总有效率上优于对照组,针灸配合常规西药或综合疗法在改善显效率方面优于单用针灸干预及对照组;获得国内537名针灸专家意见,模糊综合评判结果为针灸干预SHL可获得整体好转的疗效,干预措施以针灸为主。结论针灸干预SHL可获得整体好转的疗效,干预可以针灸治疗为主,配合常规西药或综合疗法,可显著提高平均听力30dB以上。

OBJECTIVE To summarize clinical evidences and experts opinions of acupuncture for sudden hearing loss and to explore clinical decisions.METHODS The clinical study was comprehensively retrieved and RevMan 5.1 was used to analyze the final indicators.The descriptive cross sectional surveys were carried out among the outstanding clinical physicians in acu puncture and moxibstion with survey samplings.The fuzzy comprehensive evaluation techniques were applied to evaluate the opinions of clinical experts.RESULTS Three group studies including 25 items showed acupuncture or with the assist of western medicine or integrated treatment were superior to the control group in recovery rate and total effective rate.Acupuncture with western medicine or integrated treatment was superior to both the control group and acupuncture group in the improvement.The investigation for 537 experts illustrated acupuncture for SHL may have a good effect in overall improvement and acupuncture in treatments could be used as a major intervention method.CONCLUSION Acupuncture is effective for SHL and acupuncture with the assist of western medicine or integrated treatment can improve over 30dB in hearing on average.