耳聋左慈丸合通气散治疗慢性分泌性中耳炎的疗效及对血清水通道蛋白1及4水平的影响

Clinical Efficacy of Erlong Zuoci Wan Combined with Tongqi San in Treatment of Chronic Secretory Otitis Media and Effects on Aquaporin-1 and Aquaporin-4 in Serum

目的:探讨耳聋左慈丸联合通气散加减味治疗慢性分泌性中耳炎(CSOM)肝肾阴虚证的疗效以及对血清水通道蛋白(AQP)^(-1)和AQP-4水平的影响。方法:慢性中耳炎患者共117例,参照数字表法随机分为治疗组58例和对照组59例;对照组给予盐酸头孢美特酯分散片治疗,500 mg/次,2次/d;枸地氯雷他定片,1片/次,1次/d;噻洛唑啉鼻腔滴鼻剂,2滴/次,2次/d。治疗组在对照组治疗的基础上给予耳聋左慈丸联合通气散加减治疗,1剂/d,常规水煎煮,分早晚2次内服;两组患者均给予4周治疗。比较两组中医症状积分和各频率下的骨导阈值;检测两组患者血清AQP^(-1)和AQP-4水平。结果:治疗组治疗后中医临床症状积分均明显低于对照组(P<0.01);治疗组患者临床总有效率为89.61%,对照组为76.92%,治疗组总有效率高于对照组(P<0.05);治疗组治疗后各频率(1,2,4,8 k Hz)骨导阈值均明显低于对照组(P<0.01);治疗后治疗组血清AQP^(-1)和AQP-4水平均明显高于对照组,比较差异均有统计学意义(P<0.01)。结论:耳聋左慈丸联合通气散加减治疗CSOM肝肾阴虚证可明显改善患者临床症状,降低骨导阈值,上调血清AQP^(-1)和AQP-4水平。

Objective： To investigate the clinical efficacy of Erlong Zuoci Wan combined with Tongqi San in treatment of chronic secretory otitis media（ CSOM） with syndrome of deficiency of liver and kidney and observe its effects on aquaporin（ AQP）-1 and AQP-4 levels in serum. Method： One hundred and seventeen patients with chronic secretory otitis media in our hospital were randomly divided into control group（ 59 cases） and treatment group（ 58 cases） by referring to the random number table method. Patients in the control group were treated with cefetamet pivoxil hydrochloride dispersible tablets（ 500 mg / time,bid）,desloratadine citrate disodium tablets（ 1 tablet / time,qd） and xylometazoline nasal drops（ 2 drops / time,bid）. Patients in the treatment group received additional Erlong Zuoci Wan combined with Tongqi San（ 1 dose / d,bid） based on the treatment of control group. The treatment course was 4 weeks for both groups. The traditional Chinese medicine（ TCM） symptom scores and bone conduction threshold under different frequencies were compared between two groups. The AQP-1and AQP-4 levels in serum were detected in two groups. Result： The TCM symptom scores in treatment group were significantly lower than those in the control group after treatment（ P〈0. 01）. The total clinical effective rate was 89. 61% in the treatment group,higher than 76. 92% in the control group（ P〈0. 05）. Bone conduction thresholds under different frequencies（ 1,2,4,8 k Hz） in treatment group were significantly lower than those in control one after treatment（ P〈0. 01）. The AQP-1 and AQP-4 levels in serum of treatment group were significantly higher than those of control group after treatment,with statistically significant differences（ P〈0. 01）.Conclusion： Erlong Zuoci Wan combined with Tongqi San could significantly improve the clinical symptoms of the patients,decrease bone conduction thresholds,and increase the AQP-1 and AQP-4 levels in serum in the treatment of chronic secretory otitis media with syndrome of deficiency of liver and kidney.