阶梯性治疗与Valsava法治疗成人分泌性中耳炎临床疗效和安全性比较

The clinical efficacy and safety of escalation therapy and Valsava method on adult secretory otitis media

目的比较阶梯性治疗与Valsava法治疗成人分泌性中耳炎临床疗效和安全性。方法选择128例(146耳)患者,随机分为阶梯性治疗组(观察组)和Valsava法治疗组(对照组),每组64例。治疗后观察两组患者的疗效,比较两组患者的不良反应发生率,随访半年评价其生活质量。结果观察组患者的有效率93.75%,优于对照组的60.93%,差异有显著统计学意义(P<0.01)。治疗前,两组患者的纯音气导听阈、气骨导差比较,差异均无统计学意义(P>0.05);治疗后,与对照组比较,观察组患者的纯音气导听阈、气骨导差均降低明显,差异有统计学意义(P<0.05)。观察组患者出现不良反应发生率3.13%,低于对照组的10.94%,差异有统计学意义(P<0.05)。治疗前,两组患者的汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分总分、精神性因子以及躯体性因子分比较,差异无统计学意义(P>0.05)。治疗后,与对照组比较,观察组患者的HAMD、HAMA评分总分及各因子分均降低明显,差异具有统计学意义(P<0.05)。随访期间两组患者均无失访现象,与对照组比较,观察组患者随访3个月、6个月的生活质量指标PF、RP、RE得分均升高明显,差异具有统计学意义(P<0.05)。结论阶梯性治疗方案可有效提高成人分泌性中耳炎的疗效及生活质量,改善患者的听力指标,降低不良反应发生率,改善患者的不良情绪,是一种安全有效的治疗措施。

Objective To observe the clinical efficacy of escalation therapy and Valsava method on adult secretory otitis media, and explore its safely. Methods A total of 128 cases of adult secretory otitis media patients were enrolled in the study and randomly divided into two groups. The observation group took escalation therapy and the control group adopted Valsava method, then to compare the effect of two groups and the incidence of complications and living quality. Results The total effective rate of the observation group was 93.75 % and significantly higher than that of the control group 60.93 % （ P 〈 0.05 ）. Before the treatment, two groups of patients with pure tone air conduction audibility thresh-old, poor bones guide, differences did not have statistical significance （ P 〉 0.05 ）. After treatment, pure tone air conduction audibility thresh- old, bones are reduced obviously compared with the control group and observation group of patients with statistically significant difference （ P 〈 0. 05 ）. The adverse reactions rate of the observation group was 3.13% and significantly lower than that of the control group 10.94% （ P 〈0.05 ）. Before the treatment, two groups of patients with HAMD, HAMA score, mental factor and physical factor comparison, there was no statistically sig- nificant difference （ P 〉0. 05 ）. After treatment, HAMA scale total score and each factor points are reduced obviously compared with the control group and observation group of patients with HAMD with statistically significant difference （ P 〈 0.05 ）. During the follow - up of the patients, the observation group patients were followed up for 3 months, 6 months the quality of life index score of PF, RP and RE are increased obviously com- pared with control group, with statistically significant difference （ P 〈 0.05 ）. Conclusion The clinical efficacy of escalation therapy on adult se- cretory otitis media was better and safety, It can improve the index of heating and unhealthy feelings of the patient , reduce the incidence of adverse reactions.