葛根素注射液辅助治疗气滞血瘀型突发性聋患者的疗效观察及对其血液流变学的影响

Efficacy of Puerarin Injection in Auxilary Treatment of Qi Stagnation Blood Stasis Type Sudden Hearing Loss Patients and Its Effect on Hemorheology

目的观察葛根素注射液治疗气滞血瘀型突发性聋(SHL)患者的临床疗效,并分析其对患者血液流变学的影响。方法 90例(90耳)气滞血瘀型SHL患者按随机数字表法分为葛根素组和对照组,其中对照组45例,予以口服或静脉糖皮质激素及常规药物治疗;葛根素组45例,在对照组治疗的基础上,予以葛根素注射液治疗。比较两组患者治疗后1、2、4周纯音听阈改善情况,治疗前后的血液流变学变化情况。结果治疗后1、2周,葛根素组总有效率分别为64.44%(29/45)和73.33%(33/45),对照组分别为56.10%(23/41)和60.98%(25/41),两组同时期比较,差异无统计学意义(P>0.05);治疗后4周,葛根素组和对照组的总有效率分别为82.22%(37/45)、63.41%(26/41),两组差异有统计学意义(χ2=3.87,P<0.05)。葛根素组治疗前后组内比较,血液黏度指标(高切、低切,甘油三酯,血小板聚集率,血液黏度的中切,红细胞聚集指数,红细胞变形指数,红细胞比容,血浆黏度,纤维蛋白原,总胆固醇,低密度脂蛋白)均下降(P<0.05,P<0.01)。对照组治疗前后组内比较,各指标值有所下降,但除红细胞比容外其他指标之间差异均无统计学意义(P>0.05)。治疗后葛根素组血液流变学相关指标(全血黏度低切、中切,血浆黏度,低密度脂蛋白,纤维蛋白原)相比对照组明显下降(P<0.05),部分指标(血小板聚集率,红细胞聚集指数,甘油三酯)显著下降(P<0.01)。结论葛根素注射液辅助治疗可有效提高气滞血瘀型SHL患者的疗效,明显改善其血液流变学状态。

Objective To observe the efficacy of Puerarin Injection（ PI） in treatment of qi stagnation blood stasis type（ QSBST） sudden hearing loss（ SHL） patients,and to analyze its effect on hemorheology. Methods Ninety patients with QSBST SHL（ 90 ears） were assigned to the control group（ 45 cases） and the PI group（ 45 cases）. Patients in the control group took or were intravenously injected steroids,as well as received routine therapy. Those in the PI group additionally received PI therapy. The improvement of pure tone threshold were compared between the two groups after 1,2,and 4 weeks of treatment. The changes of hemorheology were also compared between before and after treatment. Results The total effective rate at post-treatment week 1 and 2 week was respectively 64. 44%（ 29/45） and 73. 33%（ 33/45） in the PI group,and they were 56. 10%（ 23/41） and 60. 98%（ 25/41） respectively in the control group. There were no significant differences between the two groups at the same time point（P〉0. 05）. The total effective rate at post-treatment week 4 was82. 22%（ 37/45） in the PI group and 63. 41%（ 26/41） in the control group,with significant difference between them（ χ^2= 3. 87,P〈0. 05）. The blood viscosity indices（ high and low shear rate,triglyceride,platelet aggregation rate,blood viscosity cut,erythrocyte aggregation index,erythrocyte deformation index,hematocrit,plasma viscosity,fibrinogen,total cholesterol,low density lipoprotein） were significantly decreased after treatment in the PI group after treatment,as compared with before treatment（P〈0. 05,P〈0. 01）. In the control group all aforesaid indices（ except hemocrit value） decreased after treatment,but with no significant difference between pre-and post-treatment（P〉0. 05）. After treated with PI,hemorheological parameters（ blood viscosity at low and middle shear,plasma viscosity,low density lipoprotein,fibrinogen） decreased significantly（P〈0. 05）,partial parameters（ platelet aggregation rate,erythrocyte aggregation index,triglyceride） decreased significantly（P〈0. 01）,as compared with the control group after treatment. Conclusions PI could effectively improve therapeutic effect on QSBST SHL patients,and obviously improve their hemorheological parameters.