针刺捻转补法治疗中风合并耳鸣耳聋临床研究

Acupuncture for the stroke patients with tinnitus, hearing loss by using the twirling ;reinforcing method

目的：评价针刺捻转补法治疗中风合并耳鸣耳聋的疗效。方法将符合入选标准的中风合并耳鸣耳聋患者92例，采用随机数字表法分为观察组47例和对照组45例。观察组取患侧听宫、听会、翳风穴和双侧中渚、外关、太冲、三阴交、太溪穴，太溪、三阴交穴施以捻转补法；对照组选取与治疗组相同穴位，采用留针法。2组均配合半导体激光和五官超短波治疗，均治疗20 d。采用耳鸣严重程度量表评估患者耳鸣情况，评价临床疗效。结果治疗后，观察组耳鸣严重程度评分[（5.04±3.24）分比（5.67±3.55）分,t＝-0.880]低于对照组，但差异无统计学意义（P＞0.05）。观察组耳鸣显效率为38.3%（18/47）、对照组为17.8%（8/45），2组比较差异有统计学意义（χ2＝17.391， P＝0.000）。观察组耳聋显效率为38.3%（18/47）、对照组为31.1%（14/45），2组比较差异有统计学意义（χ2＝8.522，P＝0.004）。结论捻转补法针刺治疗中风合并耳鸣耳聋优于常规针刺留针手法的疗效。

Objective To evaluate the effect of acupuncture for the stroke patients with tinnitus, hearing loss by using the twirling reinforcing method. Methods A total of 92 tinnitus, hearing loss patients with stroke were included and divided into the observation group and control group by random number table method, 47 in the observation group and 45 in the control group. Patients in both groups were needled at Tinggong, Tinghui, Yifeng in the affected side, and Zhongzhu, Waiguan, Sanyinjiao, Taichong and Taixi in both sides. Patients in the observation group were needled at Taixi and Sanyinjiao using the twirling reinforcing method, but those in the control group needled at Taixi and Sanyinjiao using the needle retention method. Patients in both groups were also treated with semiconductor laser therapy and ultrashort wave therapy. All patients were treated for 20 days. The Tinnitus Severity Scale and the clinical effect were evaluated. Results After the treatment, the Tinnitus Severity Scale scores in the observation group were significantly lower than that in the control group （5.04 ± 3.24 vs. 5.67 ± 3.55; t=-0.880, P〉0.05）. The improvement rate in tinnitus in the observation group was significantly higher than that in the control group （38.3%vs.17.8%;χ2=17.391, P=0.000）. The improvement rate in hearing loss showed no significant difference between two groups （38.3%vs. 31.1%;χ2=8.522, P=0.004）. Conclusions Acupuncture using the twirling reinforcing method may relieve tinnitus of the stroke patients with tinnitus, hearing loss.