从“筋”论刺治疗颈源性耳鸣临床观察

Cervical tinnitus treated by acupuncture based on“jin”theory:a clinical observation

目的:比较从"筋"论刺与常规针刺及西药治疗颈源性耳鸣的疗效差异。方法:将95例患者不完全随机分为从筋论刺组(32例)、常规针刺组(31例)及药物组(32例)。从筋论刺组据经筋理论针刺治疗,以患侧经筋"结""聚"点、阳性反应点、风池、天容、天牖、翳明为主穴,耳门、听宫、听会、支沟为配穴,每日1次;常规针刺组主穴取听宫、听会、耳门,根据辨证配穴,采用常规针刺治疗,每日1次;药物组口服甲磺酸倍他司汀片治疗,一天3次。3组均10天为一疗程,2个疗程后根据耳鸣响度评分(采用VAS)、耳鸣残疾度量化表(THI)及耳鸣严重程度评估量表(TSIS)评估治疗前后耳鸣程度,并比较3组患者临床疗效。结果:研究过程中有5例病例脱落。3组治疗后VAS、THI及TSIS评分均较治疗前降低(均P<0.05),治疗后VAS、THI及TSIS评分从筋论刺组较常规针刺组、药物组低(P<0.05,P<0.01);3组总有效率分别为90.0%(27/30)、80.0%(24/30)、63.3%(19/30),从筋论刺组与常规针刺组、药物组比较差异均有统计学意义(P<0.05,P<0.01)。结论:从"筋"论刺治疗颈源性耳鸣疗效优于常规针刺及药物治疗。

Objective To compare the efficacy among acupuncture based on ＂jin＂ theory, regular acupuncture and western medication. Methods A total of 95 cases, by using incomplete randomization method, were divided into a ＂jin＂ theory acupuncture group （32 cases）, a regular acupuncture group （3t cases） and a medication group （32 cases）. Patients in the ＂jin＂ theory acupuncture group were treated with acupuncture based on ＂jin＂ theory, which included the ＂gather＂ and ＂knot＂ points on the affected side： positive reacted points, Fengehi （GB 20）, Tianrong （SI 17）, Tianyou （TEl6） and Yiming （EX-HN14） as the main acupoints, while the Ermen （TE 21）, Tinggong （SI 19） and Tinghui （GB 2） and zhigou （TE 6） as the auxiliary acpoints; the treatment was given once a day. Patients in the regular acupuncture group were treated with regular acupuncture at Tinggong （SI 19）, Tin- ghui （GB 2） and Ermen （TE 21） and other matched acupoints based on syndrome differentiation, once a day. Pa- tients in the medication group were treated with oral administration of betahistine mesylate, three times a day. Ten days of treatment were taken as one session in three groups, and totally 2 sessions were given. Visual analogue scale （VAS）, tinnitus handicap inventory （THI）, and tinnitus severity assessment scale （TSIS） were evaluated before and after treatment; also the clinical efficacy was compared among three groups. Results There are 5 drop-out cases du- ring the study. After the treatment, the VAS, TH｜ and TSIS were improved in three groups （all P〈0, 05） ; the VAS, THI and TSIS in the ＂jin＂ theory acupuncture group were lower than those in the regular acupuncture group and medication group （P〈0.05, P〈0.0l）. The total effective rate was 90.0% （27/30）, 80.0% （24/30） and 63.3 （19,/30）, which was higher in the ＂jin＂ theory acupuncture group （P〈0. 05, P〈0. 01）. Conclusion The acupuncture based on ＂jin＂ theory is superior to regular acupuncture and western medication for cervical tinnitus.