红光与常规治疗对成人急性化脓性中耳炎的协调作用

Synergistic Effect of Red Light on Adult Acute Suppurative Otitis Media

目的观察在常规治疗基础上联合红光照射对成人急性化脓性中耳炎(acute suppurative otitis media,ASOM)临床疗效的影响。方法确诊为急性化脓性中耳炎的患者62例68耳,随机分为对照组31例33耳,使用抗生素滴耳、口服黏液促排剂;试验组31例35耳,在此基础上联合红光照射治疗。治疗后7和14 d比较两组患者临床症状改善情况、听力恢复情况;记录外周血的TNF-α、IL-2、IL-6、IL-10、IL-1β;以及耳道内致病菌株数。结果治疗后7和14 d,试验组临床症状改善情况和听力恢复情况(气导听阈均值、气-骨导听阈差均值)分别优于相同治疗时间点的对照组(P<0.05);治疗第7天,对照组外周血的TNF-α和IL-6较治疗前有显著下降(P<0.05),试验组外周血的TNF-α、IL-2、IL-6、IL-10、IL-1β均较治疗前有显著下降(P<0.05)。试验组与对照组相比,除IL-10外,其余炎性因子下降幅度均低于对照组(P<0.05);治疗第14天,两组耳道内致病菌株数显著降低(P<0.05),且试验组显著低于对照组(P<0.05)。结论对于ASOM患者,在常规抗生素联合黏液促排剂治疗的基础上联合红光治疗,可加速鼓室黏膜恢复正常、提高听力改善速度和程度,其机制可能与红光协同消除病原菌、加速降低多项炎性因子水平有关。联合红光治疗对于抗生素疗效不佳而导致病情恢复较慢的患者是很好的选择。

ObjectiveTo observe the clinical effect of red light on adult acute suppurative otitis media(ASOM)based on regular treatment.MethodsTotally 62 adult patients with 68 ears diagnosed as ASOM were randomly divided into two groups:the control group(33ears)and experimental group(35 ears).The ears in the control group were treated with antibiotic ear drops and oral mucus drainageenhancers,the ears in the experimental group were given red light irradiation in addition.The curative effects of the two groups atdifferent points of time were compared respectively.ResultsOn the 7 th and 14 th day after the treatment,the improvement of clinical symptoms and hearing(mean value of airconduction threshold and mean value of air-bone conduction threshold difference)in the experimental group were better than those inthe control group(P<0.05).On the 7 th day after the treatment,the TNF-αand IL-6 in peripheral plasma of the control groups werelower than those before the treatment(P<0.05),and the TNF-α,IL-2,IL-6,IL-10 and IL-1βof the experimental group were alllower than those before the treatment.Except of the difference in the level of IL-10,the differences between the two groups in thelevels of all the inflammatory factors were statistically significant(P<0.05).On the 14 th day,the amount of the pathogenic bacteriain the ear canal of the two groups decreased significantly(P<0.05),and the amount of the experimental group was much lower thanthat of the control group(P<0.05).ConclusionsFor ASOM cases,adding red light therapy on the basis of conventional treatment will accelerate the recovery oftympanic mucosa and improve the speed and degree of hearing improvement.The mechanism may be related to red light synergisticelimination of pathogenic bacteria and reduction of multiple cytokines.Red light therapy is a good choice for ASOM with poorantibiotic efficacy and slow recovery.