前列地尔联合甲钴胺和长春西汀治疗急性耳鸣的疗效观察

Clinical observation of alprostadil combined with mecobalamin and vinpocetine in treatment of acute tinnitus

目的探讨前列地尔注射液联合甲钴胺片和长春西汀片治疗急性耳鸣的临床疗效。方法选取2015年6月—2016年9月在天津中医药大学第一附属医院耳鼻喉科治疗的耳鸣患者87例,随机分为对照组(44例)和治疗组(43例)。对照组口服甲钴胺片,0.5 mg/次,3次/d;且口服长春西汀片,5 mg/次,3次/d。治疗组在对照组基础上静脉注射前列地尔注射液,10μg加入到生理盐水10 mL中,1次/d。两组均治疗2周。观察两组临床疗效,比较两组耳鸣临床症状评分和严重程度积分变化。结果治疗后,对照组和治疗组的总有效率分别为61.36%、86.05%,两组比较差异有统计学意义(P<0.05)。治疗后,两组耳鸣发生环境、睡眠影响、持续时间、生活工作影响、情绪影响和主观感觉评分均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的下降程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组耳鸣严重程度积分均显著下降,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组耳鸣严重程度积分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论前列地尔注射液联合甲钴胺片和长春西汀片治疗急性耳鸣具有较好的临床疗效,可改善临床症状,具有一定的临床推广应用。

Objective To explore the clinical effect of Alprostadil Injection combined with Mecobalamin Tablets and Vinpocetine Tablets in treatment of acute tinnitus. Methods Patients （87 cases） with acute tinnitus in the First Teaching Hospital of Tianjin University of TCM from June 2015 to September 2016 were randomly divided into control group （44 cases） and treatment group （43 cases）. Patients in the control group were po administered with Mecobalamin Tablets, 0.5 mg/time, three times daily. And patients in the control group were also po administered with Vinpocetine Tablets, 0.5 mg/time, three times daily. Patients in the treatment group were iv administered with Alprostadil Injection on the basis of the control group, 10 μg added into normal saline 10 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and tinnitus symptoms scores and tinnitus severity scores in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 61.36% and 86.05%, respectively, and there was difference between two groups （P 〈 0.05）. After treatment, the scores of occurrence environment, sleep effect, duration, life influence, emotional impact, and subjective feeling of tinnitus in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, the tinnitus severity scores in two groups were significantly decreased, and the difference was statistically significant in the same group （P 〈 0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups （P 〈 0.05）. Conclusion Alprostadil Injection combined with Mecobalamin Tablets and Vinpocetine Tablets has clinical curative effect in treatment of acute tinnitus, can improve clinical symptoms, which has a certain clinical application value.