综合方案治疗神经性耳鸣临床疗效分析

Clinical effect of comprehensive treatment on nervous tinnitus

目的神经性耳鸣为临床常见疑难疾病,对患者生活质量产生严重影响,目前尚没有统一、有效的治疗规范。本研究采用包含中药、三氧疗法和西药常规治疗的综合方案治疗神经性耳鸣患者,评价综合治疗方案干预神经性耳鸣患者的临床疗效及对患者生活质量的影响。方法选取2016-01-01-2018-06-30泰安市中医医院脑病科收治的120例神经性耳鸣辨证属"邪郁少阳、痰瘀阻窍"的患者为研究对象,按性别、年龄和病程组间匹配的原则,分为西药常规组、三氧组(三氧疗法+西药常规)、中药组(中药+西药常规)及综合治疗组(中药+三氧+西药常规)4组,各30例。观察患者总有效率、耳鸣响度评分、耳鸣致残量表(tinnitus handicap inventory,THI)评分及健康调查简表(the MOS36item short form health survey,SF-36)评分。结果治疗后西药常规组、三氧组、中药组及综合治疗组总有效率分别为56.7%、70.0%、73.3%和86.7%,综合治疗组疗效最佳,χ^2=6.731,P=0.043;耳鸣响度评分分别为(3.66±1.20)、(3.02±0.90)、(2.91±0.85)和(2.45±0.65)分,较治疗前均有降低,以综合治疗组最优,F=19.378,P=0.041;THI评分分别为(40.25±10.51)、(36.78±8.43)、(35.48±8.26)和(28.67±7.38)分,较治疗前均有降低,以综合治疗组最优,F=23.627,P=0.038;SF-36量表评分分别为(111.93±12.54)、(118.62±13.32)、(119.73±13.82)和(122.18±14.34)分,较治疗前均有提高,以综合治疗组最优,F=22.486,P=0.042。结论综合治疗方案干预神经性耳鸣可明显提高患者的总有效率,减轻耳鸣程度,提高患者生活质量。

OBJECTIVE Neurvous tinnitus is a common difficult disease in clinical practice,which has a serious impact on patients’quality of life.Currently,there is no unified and effective treatment standard.In this study,the comprehensive treatment including traditional Chinese medicine,ozonated autohemotherapy and western medicine was adopted to treat patients with neurvous tinnitus,and the clinical efficacy and impact on patients’quality of life of the comprehensive treatment were evaluated.METHODS A total of 120 patients with neurotic tinnitus were selected from January 1,2016 to June 30,2018 in the Department of Encephalopathy,Taian Traditional Chinese Medicine Hospital.The patients were divided into four groups according to the random number table:routine western medicine group,ozonated autohemotherapy group,traditional Chinese medicine group,comprehensive treatment group,30 cases each.The total effective rate,tinnitus loudness score,tinnitus handicap inventory(THI)score and SF-36 quality of life survey were observed.RESULTS The total effective rates of the four groups after treatment were 56.7%,70.0%,73.3%and 86.7%,respectively.The comprehensive treatment group had the best effect(χ^2=6.731,P=0.043).After treatment,tinnitus loudness scores were(3.66±1.20),(3.02±0.90),(2.91±0.85)and(2.45±0.65),which were all lower than those before treatment.The comprehensive treatment group was the lowest,F=19.378,P=0.041.THI scores were(40.25±10.51),(36.78±8.43),(35.48±8.26)and(28.67±7.38),which were all lower than those before treatment.The comprehensive treatment group was the lowest,F=23.627,P=0.038.The scores of the SF-36 scale were(111.93±12.54),(118.62±13.32),(119.73±13.82)and(122.18±14.34),which were all higher than before treatment.The comprehensive treatment group was the highest,F=22.486,P=0.042.CONCLUSION Comprehensive treatment can significantly improve the total effective rate of patients,reduce the degree of tinnitus and improve the patients’quality of life.