宣肺通窍汤联合微波治疗急性分泌性中耳炎的临床对照研究

Clinical Control Trial on Xuanfei Tongqiao Decoction Combined with Microwave in the Treatment of Acute Secretory Otitis Media

目的:探究宣肺通窍汤联合微波对急性分泌性中耳炎(ASOM)患者的临床疗效及对临床症状及炎性因子的影响。方法:选取2015年6月至2017年1月重庆市江津区中心医院收治的ASOM患者102例,将其按照随机数字表法分为对照组和观察组,每组51例。对照组进行常规西医治疗,观察组在对照组的基础上给予中药宣肺通窍汤联合微波治疗,2组均连续治疗2周。统计2组临床疗效;比较2组患者临床症状改善情况;另检测并比较治疗前后2组患者血清及分泌物中炎性因子水平的变化。结果:治疗后对照组无效率为29.41%,显著高于观察组的7.84%,差异有统计学意义(P<0.01);而观察组总有效率为92.16%,显著高于对照组的70.59%,差异有统计学意义(P<0.01);与治疗前比较,治疗后2组患者临床症状积分及平均气导阈值均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.01);而治疗后观察组听力改善水平显著高于对照组,差异有统计学意义(P<0.01);与治疗前比较,治疗后2组分泌物中IL-6、IL-10及TNF-α水平均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.01),而2组治疗前后及组间血清IL-6、IL-10及TNF-α水平无显著性变化,差异无统计学意义(P>0.05)。结论:宣肺通窍汤联合微波治疗ASOM疗效显著,可有效缓解患者临床症状,恢复患耳听力,并有效降低患耳分泌物中炎性因子水平,抑制炎性反应,促进患者转归。

Objective： To explore the clinical efficacy of Xuanfei Tongqiao Decoction combined with microwave in the treatment of acute secretory otitis media（ ASOM） and analyze the effect on the clinical symptoms and inflammatory factors. Methods： A total of 102 ASOM cases in the hospital from Jun. 2016 to Jan. 2017 were selected and divided randomly into control group and treatment group,with 51 cases in each group. Patients in the control group were treated with conventional western medicine,while patients in the treatment group were additionally treated with Xuanfei Tongqiao Decoction combined with microwave. Patients in both the two groups were treated for two weeks continuously. The clinical efficacy and the improvement of clinical symptoms of the two groups were compared. Changes in serum and secretions inflammatory factors levels were detected and compared. Results： The inefficiency of the control group was 29. 41% after the treatment,which was higher than that 7. 84% of treatment group（ P 0. 01）; while the total effective rate treatment group was 92. 16%,which was higher than that 70. 59% of control group（ P 0. 01）. The clinical symptoms integral and average air conduction threshold decreased significantly after the treatment and treatment group was lower（ P 0. 01）,while the improvement in listening of the treatment group was higher than that of control group（ P 0. 01）. The secretions IL-6,IL-10 and TNF-α levels decreased significantly after the treatment; treatment group was lower than control group（ P 0. 01）; the serum IL-6,IL-10 and TNF-α levels between two groups and before and after the treatment showed no significant difference（ P 0. 05）. Conclusion： The clinical efficacy of Xuanfei Tongqiao Decoction combined with microwave in the treatment of ASOM is remarkable,which may relieve the clinical symptoms in some degree,improve listening ability,reduce the secretions inflammatory factor,inhibit inflammatory reaction and promote the patient outcome.