耳后注射舒血宁注射液与盐酸利多卡因注射液治疗中高频下降型突发性聋的效果

Effect of Shuxuening injection and lidocaine hydrochloride injection post-auricular in the treatment of medium and high frequency drop type sudden sensorineural hearing loss

目的观察耳后注射舒血宁注射液与盐酸利多卡因注射液治疗中高频下降型突发性聋(SSHL)的效果。方法前瞻性选取2017年1月至2019年12月丹东市第一医院收治的中高频下降型SSHL患者93例作为研究对象,随机分为观察组、对照1组、对照2组,每组各31例。3组患者均予以常规治疗,在此基础上对照1组予以耳后注射舒血宁注射液0.5 mL,对照2组予以耳后注射盐酸利多卡因注射液0.3 mL,观察组则予以耳后注射舒血宁注射液0.5 mL+盐酸利多卡因注射液0.3 mL治疗。比较3组患者临床疗效,治疗前、治疗1周后的中高频率听力提高值及治疗前后听觉脑干诱发电位(ABR),血液流变学[血浆黏度(PV)、血细胞比容(HCT)、红细胞聚集指数(EAI)、红细胞变形指数(EDI)],治疗前、治疗1周后的炎性因子水平[中性粒细胞激活肽-78(ENA-78)、高迁移率蛋白1(HMGB1)、可溶性血管细胞黏附分子-1(sVCAM-1)]以及不良反应发生率。结果观察组总有效率(90.32%)高于对照1组(64.52%)、对照2组(61.29%),差异有统计学意义(P<0.05)。治疗1周后,观察组2000 Hz、4000 Hz及8000 Hz听力提高值[(22.30±10.61)dBHL、(24.19±6.12)dBHL、(27.18±7.53)dBHL]高于对照1组、对照2组,差异有统计学意义(P<0.05)。治疗1周后,观察组Ⅰ波及Ⅴ波潜伏期[(1.39±0.12)ms、(4.62±0.27)ms]短于对照1组、对照2组,差异有统计学意义(P<0.05)。治疗1周后,观察组PV、HCT、EAI[(1.20±0.10)mPa·s、(42.21±3.58)%、1.57±0.15]低于对照1组、对照2组,EDI(0.62±0.08)高于对照1组、对照2组,差异有统计学意义(P<0.05)。治疗后观察组血清ENA-78、HMGB1、sVCAM-1水平[(117.58±19.62)ng/L、(2.27±0.14)ng/L、220.49±26.38]低于对照1组、对照2组,差异有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论耳后注射舒血宁注射液与盐酸利多卡因注射液治疗中高频下降型SSHL,疗效确切,能有效改善听觉脑干诱发电位,调节血液流变学,降低炎症反应,提高听力。

Objective To observe the effects of Shuxuening injection and lidocaine hydrochloride injection post-auricular in the treatment of medium and high frequency drop type sudden sensorineural hearing loss(SSHL).Methods From January 2017 to December 2019,93 patients with medium and high frequency drop type HFSL in The First Hospital of Dandong were selected as the research objects,and they were randomly divided into observation group,control group 1 and control group 2,with 31 cases in each group.All three groups were given conventional treatment,on the basis of this,the control group 1 was given Shuxuening injection 0.5 mL post-auricular,and the control group 2 was given lidocaine hydrochloride injection 0.3 mL post-auricular,the observation group was treated with Shuxuening injection 0.5 mL post-auricular+lidocaine hydrochloride injection 0.3 mL.The efficacy,hearing enhancement value at high and medium frequencies,auditory brainstem evoked potential(ABR),hemorheology[plasma viscosity(PV),hematocrit(HCT),red blood cell aggregation index(EAI),red blood cell deformation index(EDI)],inflammatory factor levels[neutrophil activating peptide-78(ENA-78),high mobility protein 1(HMGB1),and soluble vascular cell adhesion molecule-1(sVCAM-1)]before and after treatment,incidence of adverse reactions were compared in the three groups.Results The total effective rate of observation group was 90.32%higher than that of control group 1 of 64.52% and control group 2 of 61.29%(P<0.05).The values of hearing improvement at 2000 Hz,4000 Hz and 8000 Hz in the observation group[(22.30±10.61)dBHL,(24.19±6.12)dBHL,(27.18±7.53)dBHL]were higher than those in control group 1 and control group 2 after treatment(P<0.05).The incubation period of waveⅠand waveⅤin observation group[(1.39±0.12)ms,(4.62±0.27)ms]was shorter than those in control group 1 and control group 2 after treatment(P<0.05).After treatment,PV,HCT,and EAI in the observation group[(1.20±0.10)mPa·s,(42.21±3.58)%,1.57±0.15]were lower than those in control group 1 and control group 2,and EDI(0.62±0.08)was higher than those in control group 1 and control group 2(P<0.05).The serum ENA-78,HMGB1,and sVCAM-1 levels in the observation group[(117.58±19.62)ng/L,(2.27±0.14)ng/L,220.49±26.38]were lower than those in the control group 1 and the control group 2 after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions of the three groups(P>0.05).Conclusion The injection of Shuxuening injection and lidocaine hydrochloride injection post-auricular is effective in the treatment of medium and high frequency drop type sudden sensorineural hearing loss,which can effectively improve auditory brainstem evoked potentials,regulate blood rheology,reduce inflammation and improve hearing.