基于耳鸣匹配法观察针刺治疗肾精亏损型耳鸣的临床研究

Tinnitus Matching-based Clinical Study on Acupuncture Treatment for Tinnitus of Kidney Essence Deficiency Type

目的基于耳鸣匹配法观察针刺治疗肾精亏损型耳鸣的临床疗效。方法将60例肾精亏损型耳鸣患者随机分为A组和B组,每组30例。A组基于辨证取穴进行针刺治疗,B组基于辨病取穴进行针刺治疗。两组治疗前后分别通过纯音听阈测试及耳鸣匹配法(测试耳鸣频率和响度的匹配)来评价患者的听力情况。结果两组治疗后纯音听阈测试各项指标与同组治疗前比较,差异均具有统计学意义(P<0.01)。A组治疗后纯音听阈测试部分指标(500、750、1000、2000 Hz)与B组比较,差异均具有统计学意义(P<0.05)。两组治疗后耳鸣匹配法组内及组间比较,差异均无统计学意义(P>0.05)。两组治疗后耳鸣响度匹配与同组治疗前比较,差异均具有统计学意义(P<0.01)。A组治疗后耳鸣响度匹配与B组比较,差异具有统计学意义(P<0.05)。结论针刺是一种治疗肾精亏损型耳鸣的有效方法,辨证辨病取穴的治疗效果优于单纯辨病取穴。

Objective To make a tinnitus matching-based observation of the clinical therapeutic effect of acupuncture on tinnitus of kidney essence deficiency type. Methods Sixty patients with tinnitus of kidney essence deficiency type were randomized to groups A and B, 30 cases each. Group A received acupuncture based on syndrome differentiation- based point selection and group B, acupuncture based on disease differentiation-based point selection. Hearing condition was assessed by pure tone hearing threshold and tinnitus matching （tinnitus frequency and loudness matching test） in the two groups of patients before and after treatment. Results There were statistically significant pre-/post- treatment differences in various thresholds in pure tone audiometry in the two groups （P〈0.05）. There were statistically significant post-treatment differences in partial thresholds in pure tone audiometry （500 Hz, 750 Hz, 1000 Hz and 2000 Hz） between Group A and group B （P〈0.05）. Tinnitus matching had no statistically significant pre-/post-treatment difference within the two groups and no statistically significant post-treatment difference between the two groups （P〉0.05）. There was a statistically significant pre-/post-treatment difference in tinnitus loudness matching in the two groups （P〈0.01）. There was a statistically significant post-treatment difference in tinnitus loudness matching between Group A and group B （P〈0.05）. Conclusions Acupuncture is an effective way to treat tinnitus of kidney essence deficiency type. The therapeutic effect of syndrome differentiation-based acupoint selection is better than that of disease differentiation-based acupoint selection.