针刀联合星状神经节阻滞术治疗颈源性耳鸣的临床研究

Clinical research of needle-knife combined with stellate ganglion block in the treatment of cervicogenic tinnitus

目的初步观察针刀联合星状神经节阻滞术对颈源性耳鸣的影响,为治疗耳鸣提供新思路。方法研究对象为中日友好医院针灸科门诊自2014年7月~2016年2月接诊的第一主诉为耳鸣的患者。将符合标准的94例颈源性耳鸣患者随机分为针刀联合治疗组(52例)和对照组(42例)。针刀联合治疗组采用针刀治疗(每周1次,共4次),同时行星状神经节阻滞术(每周3次,共12次),对照组仅行星状神经节阻滞术(每周3次,共12次)。观察两组治疗前后耳鸣评分、耳鸣分级以及椎-基底动脉血流速度的变化。结果针刀联合治疗组总有效率为53.85%,明显高于对照组(21.43%),差异有统计学意义(χ~2=10.2298,P<0.05)。两组患者治疗前后椎-基底动脉血流速度比较,差异无统计学意义(P>0.05)。结论针刀联合星状神经节阻滞术治疗耳鸣效果显著,耳鸣的改善与椎-基底动脉血流速度之间的相关关系未得到确认。

Objective To observe the effect of needle-knife combined with stellate ganglion block for cervicogenic tinnitus preliminary, and to provide new idea for the treatment of tinnitus. Methods The research objects were the patients with the first chief complaint as tinnitus treated in Outpatient Department of Acupuncture and Moxibustion, Chi-na-Japan Friendship Hospital from July 2014 to February 2016. 94 patients with cervicogenic tinnitus met with criteria were randomly divided into needle-knife combined treatment group（52 cases） and control group（42 cases）. The needle-knife combined treatment group was taken needle-knife therapy（once a week, total 4 times） combined with stellate ganglion block（3 times per week, total 12 times） at the same time. The control group was only taken stellate ganglion block（3 times per week, total 12 times）. The tinnitus scores, tinnitus classification, and the changes of vertebral-basilar artery blood flow velocity before and after treatment in the two groups were observed. Results The total effective rate of needle-knife combined treatment group was 53.85%, which was higher than that of control group（21.43%）, the difference was statistically significant（χ~2=10.2298, P〈0.05）. There were no significant differences of the vertebral-basilar artery blood flow velocity before and after treatment within the two groups（P〈0.05）. Conclusion The curative effect of needle-knife combined with stellate ganglion block in the treatment of tinnitus is remarkable. However, the correlation between improvement of tinnitus and vertebral-basilar artery blood flow velocity is not confirmed.