温针灸联合卡马西平治疗肝肾不足型主观性耳鸣的随机对照研究

Warming Needle Moxibustion Combined with Carbamazepine in the Treatment of Subjective Tinnitus of Liver-kidneyDeficiency: ARandomized Controlled Study

目的:观察温针灸联合卡马西平治疗肝肾不足型主观性耳鸣的临床疗效。方法:选取2015年1月至2016年10月北京市和平里医院针灸科门诊及耳鼻喉科门诊,北京市鼓楼中医医院针灸科门诊就诊的中医辨证属肝肾不足型主观性耳鸣患者76例作为研究对象,采用随机对照试验的方法,随机分为观察组和对照组,每组38例。观察组采用耳鸣侧耳周穴位(耳门、听宫、听会等)及远端穴位(太冲、太溪等)常规针刺,予听宫穴行温针灸,5次/周,休息2 d/周;配合口服卡马西平200 mg,3次/d。对照组仅口服卡马西平200 mg,3次/d。2组均治疗2周。采用耳鸣严重程度评分量表(TEQ)、耳鸣匹配检测评价患者治疗前后耳鸣情况,比较2组临床有效率。结果:1)治疗前2组患者耳鸣严重程度比较,差异无统计学意义(P>0.05),治疗后2组患者耳鸣严重程度均有好转(P<0.01),且观察组好转程度大于对照组(P<0.05);2)治疗后2组患者耳鸣响度均有下降(P<0.05),且观察组疗效优于对照组(P<0.05);3)观察组总有效率为94.44%,对照组为86.11%,2组比较差异有统计学意义(P<0.05)。结论:温针灸联合卡马西平对于肝肾不足型主观性耳鸣的疗效优于单纯卡马西平治疗。

Objective:To compare the difference of the clinical efficacy in subjective tinnitus of liver-kidney deficiencybetween warming needle moxibustion combined with carbamazepine and oral carbamazepine.Methods:According to the randomized controlled trial(RCT),76 patients with subjective tinnitus admitted inBeijing Hepingli HospitalfromJanuary 2015 toOctober2016 were selected as research subjects,and they were randomly divided into an observation group(38 cases)and a control group(38 cases).The observation group was treated with carbamazepine(200 mgpo tid)combined with warming needle moxibustion at Tinggong(SI 19),androutine adcupunture atacupoints near affected earsincluding Ermen(TE 21),Tinghui(GB 2),Tinggong(SI 19),etcand the distal acupointslike Taichong(LV 3)and Taixi(KI 3);the control group was treated with carbamazepine(200 mg po tid).The warming needle moxibustion was given 5 times per week with2 days per weekoff,and the treatment lasted for 2 weeks.The Tinnitus Effect Questionnaire(TEQ)and tinnitus loudness were applied to assess the severity of tinnitus before and after the treatment.Also the effective rate of the 2 groups was compared.Results:(1)Before the treatment,there was no significant differencebetweenthe severity of tinnitus in the 2 groups(P>0.05).After the treatment,the severity of tinnitus were both improved in the 2 groups(P<0.01),which was more significant in the observation groupcompared with that in thecontrolgroup(P<0.05);(2)The tinnitus loudness of both groups wasdecreased after the treatment(P<0.05),which was more significant in the observation group compared with that in the control group(P<0.05);(3)The total effectiverate was 94.44%in the observation group,which was superior to 86.11%in the control group,with statistically significantdifference(P<0.05).Conclusion:The efficacy of the warming needle moxibustion combined with carbamazepine was superior to that of the simple carbamazepine insubjective tinnitusof liver-kidney deficiency.