不同类型营养神经药物治疗突发性聋的比较评价研究

Comparative evaluation of difterent types of neurotophic drugs in treatment of sudden deafness

目的评价不同类型营养神经药物联合糖皮质激素+改善内耳微循环药物,治疗突发性聋的有效性、安全性及经济性。方法选取2015年1月~2019年12月人住医院发病在1 w以内,未接受过任何治疗的突发性聋患者263例(单侧)进行回顾性分析,治疗方案为营养神经药物+甲泼尼龙+舒血宁注射液,若为全频听力下降者加用巴曲酶,根据应用营养神经药物不同,分为3组。A组:甲钴胺+甲泼尼龙+舒血宁注射液;B组:奥拉西坦+甲泼尼龙+舒血宁注射液;C组:鼠神经生长因子+甲泼尼龙+舒血宁注射液,比较3组患者临床表现、住院时间及营养神经药物费用等情况。结果3组患者入院时--般资料比较差异无统计学意义(P>0.05),具有可比性。3组患者治疗后住院时间.临床治疗有效率及不良反应发生率等差异无统计学意义(P>0.05)。营养神经药物费用、住院总费用等差异有统计学意义(P<0.05)。治疗方案的成本-效果比,A组明显低于B组及C级。结论不同营养神经药物联合糖皮质激素+改善内耳微循环药物治疗方案治疗突发性聋具有相似的有效性和安全性但甲钴胺+甲泼尼龙+舒血宁注射液治疗的方案更具经济性。

Objective To evaluate the efficacy,safety and economy of different types of neurotrophic drugs combined with glucocorticoids and drugs for improving inner ear microcirculation in the treatment of sudden deafness.Methods A total of 263 patients with sudden unilateral deaf within one week who had not received any treatment in our hospital from January 2015 to December 2019 were selected for retrospective analysis.All the patients received neurotrophie drugs+methylprednisolone+Shuxuening injection,and those with full-frequency hearing loss were additionally treated with batroxobin.They were divided into three groups according to the neurotrophic drugs.Group A was given mecobalamin+methylprednisolone+Shuxuening injection;group B was given oxiracetam+methylprednisolone+Shuxuening injection and group C was given mouse nerve growth factor+methylprednisolone+Shuxuening injection.The elinical performance,hospital stay and cost of neurotrophic drugs were compared among the three groups.Results There was no statistically significant difference in general data of the three groups of patients on admission(P>0.05)and the data were comparable.After treatment,the hospital stay,clinical response rate and adverse reaction rate among the three groups were not significantly difference(P>0.05).The cost of neurotrophic drugs and total hospitalization cost were significantly different(P<0.05)..The cost-effctiveness ratio of the treatment was significantly lower in group A than in groups B and C.Conclusion Different neurotrophic drugs combined with glucocorticoid and drugs for improving inner ear microcirculation have similar efficacy and safety in the treatment of sudden deafness,but the regimen of mecobalamin+methylprednisolone+Shuxuening injection is more economical.