电针及参麦注射液结合西医常规疗法治疗突发性耳聋临床研究

Clinical study of electroacupuncture and Shenmai injection combined with conventional western therapy as treatments for the sudden deafness

目的 评价电针及参麦注射液结合西医常规疗法治疗突发性耳聋（sudden deafness,SD）的疗效.方法 将符合入选标准的186例SD患者按病历尾号随机分为2组,每组93例.对照组采用抗炎、扩张血管等西医常规疗法治疗,治疗组在对照组基础上配合电针及静脉注射参麦注射液.2组均治疗11 d.采用无创经颅多普勒超声监测局部脑血流（regional cerebral blood flow,rCBF）,采用丹麦MADSEN听觉诱发电位仪监测眼肌前庭诱发肌源性电位（ocular vestibular evoked myogenic potential,oVEMP）,记录其主要参数N1和Pl潜伏期、N1和Pl振幅、N1～Pl波间期及oVEMP引出率,评价临床疗效.结果 治疗组愈显率为88.6%（75/93）、总有效率为97.8%（91/93）,对照组分别为63.4%（59/93）、90.3%（84/93）,2组愈显率及总有效率比较,差异均有统计学意义（χ2值分别为5.920、7.021,P值分别为0.029、0.012）.治疗后,治疗组耳鸣[17.2%（16/93）比30.1%（28/93）,χ2=7.152]与眩晕[15.1%（14/93）比21.5%（20/93）,χ2=6.023]残存率低于对照组（P〈0.05）;治疗组听阈[（39.59±5.36）dBHL比（45.85±5.08）dBHL,t=2.903]低于对照组（P=0.034）;治疗组N1[（10.62±0.84）μV比（7.14±0.59）μV;t=3.259,P=0.017]、Pl[（11.79±0.91）μV比（9.90±0.82）μV;t=2.871,P=0.037]振幅及oVEMP引出率[95.7%（89/93）比81.7%（76/93）;χ2=7.963,P=0.012]高于对照组,N1[（7.86±0.82）ms比（9.78±1.24）ms;t=3.167,P=0.031]和Pl[（6.57±0.77）ms比（9.39±1.15）ms;t=3.729,P=0.009]潜伏期低于对照组.结论 电针及参麦注射液结合西医常规疗法可增加SD患者耳蜗受损组织血流量,促进耳蜗毛细胞和前庭神经功能的再生与修复.

Objective To observe the clinical effect of electroacupuncture and Shenmai injection combined with conventional western therapy as treatments for the sudden deafness.Methods A total of 186 patients with sudden deafness were randomly divided into two groups. Each group included 93 patients. The control group was treated with the pipe-expanding and anti-inflammatory, but the treatment group was treated with electroacupuncture and Shenmai injection based on the control group. Both groups were treated for 11 days.Before and after treatments, the regional cerebral blood flow （rCBF） was detected. The MADSEN was used to detect ocular vestibular evoked myogenic potential （oVEMP）, including N1-Pl amplitude, N 1-Pl incubation period, N1-Pl wave duration and extraction rate of oVEMP.Results The recovery rate of control group was 63.4% （59/93） and total effective rate was 90.3% （84/93）, which was 88.6% （75/93） and 97.8% （91/93） in combined treatment group, and there was significant difference between the 2 groups （χ2=5.923,P〈0.05）. After 11 days of treatment, the Tinnitus （17.2%vs. 30.1%,χ2=7.152）, vertigo and survival rate （15.1%vs. 21.5%,χ2=6.023） in combined treatment group showed significantly lower than those in the control group （P〈0.05）. The threshold （39.59 ± 5.36 dBHLvs. 45.85 ± 5.08 dBHL,t=2.903） in combined treatment group showed significantly lower than those in the control group （P=0.034）. The N1 amplitude （10.62 ± 0.84μVvs. 7.14 ± 0.59μV;t=3.259,P=0.017）, P1 amplitude （11.79 ± 0.91μVvs. 9.90 ± 0.82μV;t=2.871,P=0.037）, extraction rate of oVEMP （95.7%vs. 81.7%;χ2=7.963,P=0.012） in combined treatment group showed significantly higher than those in the control group. The N1 incubation period （7.86 ± 0.82 msvs. 9.78 ± 1.24 ms;t=3.729,P=0.009） and Pl incubation period （6.57 ± 0.77 msvs. 9.39 ± 1.15 ms;t=3.064,P=0.025） in combined treatment group showed significantly lower than those in the control group.Conclusions The Electroacupuncture and Shenmai injection combined with conventional western therapy could improve blood circulation produce a synergistic therapeutic effect on damaged tissue, improve cochlear hair cells and vestibular nerve regeneration, and repaire the functions.