耳周三穴深刺与浅刺治疗主观性耳鸣:随机对照研究

Deep needling and shallow needling at three acupoints around ear for subjective tinnitus:a randomized controlled trial

目的：对比耳周三穴深刺与浅刺治疗主观性耳鸣的疗效差异。方法：将50例主观性耳鸣患者随机分为深刺组和浅刺组,每组25例,最后深刺组22例、浅刺组20例纳入统计。两组治疗均选取耳周三穴和远端取穴相结合的方法,取患侧翳风、听会、耳门、支沟、中渚、合谷等穴,深刺组深刺翳风、听会、耳门耳周三穴,深度为30~38mm,其余穴位均常规针刺;浅刺组则浅刺上述耳周三穴,深度15~20mm,其余穴位常规针刺。两组留针时间均为30min,每日1次,每周治疗5次,连续治疗4周。观察治疗前后患者耳鸣残疾评估量表（THI）评分、耳鸣程度分级、耳鸣声响程度视觉模拟评分（VAS）的变化情况,并比较两组疗效。结果：深刺组的总有效率为59.1%（13/22）,优于浅刺组的20.0%（4/20,P〈0.05）。深刺组THI评分、耳鸣程度分级、耳鸣声响程度VAS评分均较治疗前改善（均P〈0.05）;浅刺组THI评分、耳鸣程度分级、耳鸣声响程度VAS评分治疗前后比较,差异均无统计学意义（均P〉0.05）,且治疗后以上观察指标深刺组均优于浅刺组（均P〈0.05）。结论：深刺耳周三穴治疗主观性耳鸣可以明显改善耳鸣症状,降低耳鸣声响程度,疗效优于耳周三穴浅刺。

Objective To compare the effective differences between deep needling and shallow needling at three acupoints around ear for subjective tinnitus.Methods Fifty patients with subjective tinnitus were randomized divided into a deep needling group and a shallow needling group,25 cases in each group.Twenty-two patients in the deep needling group and 20 patients in the shallow needling group were brought into statistic in the end.In the two groups,the three acupoints around ear and distal acupoints were both selected.The acupoints of the affected side such as Yifeng（TE 17）,Tinghui（GB 2）,Ermen（TE 21）,Zhigou（TE 6）,Zhongzhu（TE 3）and Hegu（LI 4）were adopted.Yifeng（TE 17）,Tinghui（GB 2）and Ermen（TE 21）were acupunctured 30-38 mm in the deep needling group and 15-20 mm in the shallow needling group.The other acupoints were conventionally acupunctured in the two groups.The needles were retained for 30 min,once a day and five times a week for all patients.The treatment was continuously for 4weeks in the two groups.Tinnitus handicap inventory（THI）scores,tinnitus grades and visual analogue scale（VAS）for tinnitus sound levels were observed before and after treatment,and the effects of the two groups were compared.Results The total effective rate in the deep needling group was 59.1%（13/22）,and it was better than 20.0%（4/20）in the shallow needling group（P〈0.05）.In the deep needling group,the THI score,tinnitus grade and the VAS score were improved than those before treatment（all P〈0.05）.In the shallow needling group,the three above indices before and after treatment were not different in statistical significance（all P〉0.05）.After treatment,all the three indices in the deep needling group were superior to those in the shallow needling group（all P〈0.05）.Conclusion Acupuncture at the three acupoints around ear deeply could apparently improve tinnitus,and reduce tinnitus sound levels for subjective tinnitus.The effect is better than that by shallow needling at the three acupoints.