龙胆泻肝汤联合习服疗法治疗肝火上扰型耳鸣的临床疗效观察

Clinical Observation on Longdan Xiegan Decoction Combined with Tinnitus Retraining Therapy for the Treatment of Tinnitus with Syndrome of Up-disturbance of Liver Fire

【目的】观察龙胆泻肝汤联合习服疗法治疗肝火上扰型耳鸣的临床疗效。【方法】采用自身前后对照研究方法,选取62例肝火上扰型耳鸣患者为研究对象,给予口服龙胆泻肝汤配合习服疗法治疗,疗程为4周,并给予随访半年。观察治疗前、治疗4周后及随访半年后耳鸣残疾评估量表(THI)中情感性(E项值)、功能性(F项值)、严重性(C项值)等3个维度评分的变化情况,并比较其治疗4周后及随访半年后的临床疗效。【结果】(1)THI评分方面,治疗后和随访半年后,THI量表的情感性(E项值)、功能性(F项值)、严重性(C项值)等3个维度分值及总分值均较治疗前明显降低(P<0.01),而且随访半年后的各个维度分值及总分值也均较治疗后明显降低(P<0.01)。(2)疗效方面,治疗4周后和随访半年后的总有效率分别为87.1%(54/62)和91.9%(57/62);经秩和检验,随访半年后的疗效优于治疗4周后,差异有统计学意义(P<0.05)。【结论】龙胆泻肝汤联合习服疗法治疗肝火上扰型耳鸣疗效确切,且远期疗效较佳,对耳鸣相关证型患者的治疗具有借鉴意义。

Objective To observe the clinical effect of Longdan Xiegan Decoction combined with tinnitus retraining therapy(TRT)for the treatment of tinnitus with the syndrome of up-disturbance of liver fire. Methods The beforeafter study in the same patient was carried out in 62 tinnitus patients with the syndrome of up-disturbance of liver fire. The patients were treated with Longdan Xiegan Decoction combined with tinnitus retraining therapy for4 weeks,and then were followed-up for half a year. Before treatment,after 4 weeks of treatment and 6 months after the suspension of medication, we calculated the scores of the emotional(E)dimension, functional(F)dimension,and consequence(C)dimension in the Tinnitus Handicap Inventory(THI). The clinical efficacy was evaluated after 4 weeks of treatment and 6 months after the suspension of medication. Results(1)After 4 weeks of treatment and 6 months after the suspension of medication, the scores of E, F and C dimension as well as the overall THI scores of the patients were significantly lower than those before treatment(P < 0.01). And6 months after the suspension of medication,the scores were lower than those after 4 weeks of treatment(P <0.01).(2)The total effective rates after 4 weeks of treatment and 6 months after the suspension of medication were87.1%(54/62),and 91.9%(57/62)respectively,and the rank sum test results showed that the efficacy 6 months after the suspension of medication was superior to that after 4 weeks of treatment,the difference being statistically significant(P<0.05). Conclusion Longdan Xiegan Decoction combined with tinnitus retraining therapy(TRT)has obvious curative effect for the treatment of tinnitus with the syndrome of up-disturbance of liver fire,and the long-term effect is satisfactory. The combined therapy can supply reference for the treatment of tinnitus patients with related syndrome types.