“平衡复位正骨推拿法”对兔颈源性突发性耳聋模型血流速度及听性脑干反应的影响

Effect of Bone-Setting manipulation on Blood Flow Velocity and Auditory Brainstem Responses of Cervicogenic Sudden Hearing Loss Model Rabbits

目的观察"平衡复位正骨推拿法"对兔颈源性突发性耳聋模型血流速度及听性脑干反应(ABR)的影响,探讨其治疗颈源性突发性耳聋的可能作用机制。方法将40只大耳兔随机分为空白对照组、模型组、普通手法组和正骨手法组,各10只。采用硬化剂注射法进行造模,造成颈源性突发性耳聋模型。空白对照组和模型组不予治疗,普通手法组与正骨手法组均予地塞米松0.47 mg/kg静滴,每日1次,3 d后减至0.23 mg/kg,再使用3 d停药,维生素B_1 4.67 mg/kg、维生素B_(12)0.02 mg/kg肌注,每日1次,在此基础上普通手法组予常规手法治疗,正骨手法组予"平衡复位正骨推拿法"治疗,每日1次,连续干预14 d。结果与空白对照组比较,模型组BA、LVA、RVA、LPICA、RPICA的平均血流速度(Vm)均下降,Ⅲ、Ⅳ波PL及Ⅰ~Ⅲ波IPL均延长(P<0.05);与模型组比较,普通手法组及正骨手法组的BA、LVA、RVA、LPICA、RPICA的Vm均升高,Ⅲ波峰潜伏期(PL)及Ⅰ~Ⅲ波的峰间值(IPL)均缩短(P<0.05),正骨手法组的改善优于普通手法组(P<0.05)。结论 "平衡复位正骨推拿法"能对抗血管痉挛,改善微循环及脑干听觉通路传导,促进听力恢复。

Objective： To observe the effect of bone-setting manipulation on blood flow velocity and auditory brainstem responses of cervicogenic sudden hearing loss model rabbits and explore its possible mechanism. Methods： 40 big ear rabbits were randomly and equally divided into the control group,the model group, common massage group, bone-setting manipulation group,with ten rabbits in each. Cervicogenic sudden hearing loss model was duplicated by injecting sclerosing agent. Rabbits in the control group and the model group received no treatment, while rabbits in common massage group and bone-setting manipulation group were treated with dexamethasone intravenous drip of 0.47mg/kg once a day,3 days later,decreased to 0.23 mg/kg once a day,3 days again,and with vitamin B1 and vitamin B12 intramuscular injection of 4.67 mg/kg and 0.02 mg/kg once a day,based on which, the common massage group was treated with conventional massage and the bone-setting manipulation group was treated with bone-setting manipulation continuously for 14 days. The mean blood flow velocity（Vm） of bilateral vertebral artery,basilar artery,and bilateral posterior inferior cerebellar artery were detected by transcranial Doppler（TCD）. The peak latency（PL） of Ⅰ , and Ⅳ wave and the interpeak latency （IPL） of Ⅰ～ Ⅲ, Ⅲ～Ⅳ, Ⅰ -Ⅳ wave on the left were detected at 50 Hz high stimulation. Results： Compared with the control group,the mean blood flow velocity （Vm） of BA,LVA,RVA,LPICA and RPICA in the model group was decreased significantly ;the peak latency of Ⅲ,Ⅳ wave and the interpeak latency of Ⅰ～ Ⅲ wave in the model group were extended significantly （P〈 0.05）;compared with the model group,the mean blood flow velocity （Vm） of BA, LVA, RVA, LPICA and RPICA in the common massage group and bone-setting manipulation increased significantly;the peak latency of Ⅲ, Ⅳ wave and the interpeak latency Ⅰ～Ⅲ wave in the model group were shortened significantly（P〈 0.05）. Conclusion： The bone-setting manipulation can resist vascular spasm and improve microcirculation and the conduction of the brainstem cochlear path,which is order to promote hearing recovery.