不同剂量泼尼松联合谷维素及甲钴胺治疗无听力变化耳鸣疗效观察

Therapeutic effect of different doses of prednisone combined with oryzanol and mecobalamin on tinnitus without hearing loss

目的探究不同剂量泼尼松联合谷维素及甲钴胺在治疗无听力变化耳鸣患者中的应用效果。方法选择2017年1月~2020年12月接受治疗的90例(133耳)无听力变化耳鸣患者,按照随机数字表法将其均分为A、B、C三组,每组30例患者,三组患者均接受谷维素联合甲钴胺治疗,同时A组患者(30例51耳)加用0.2 ml/d泼尼松龙灌耳,B组患者(30例50耳)加用0.5 ml/d泼尼松龙灌耳,C组患者(30例32耳)加用0.7 ml/d泼尼松龙灌耳,三组患者治疗时间均为20 d,对比三组患者治疗总有效率,对比治疗前、治疗第10天及治疗第20天,三组患者耳鸣残疾评估量表(THI)得分及耳鸣症状控制率,最后对比三组患者治疗期间不良反应发生率。结果①A组患者治疗总有效率为78.43%(40/51),B组患者治疗总有效率为92.00%(46/50),C组患者治疗总有效率为93.75%(30/32),三组对比B、C两组明显优于A组(P<0.05),B、C两组对比差异无统计学意义(P>0.05);②治疗前三组患者THI评分对比,差异无统计学意义(P>0.05),治疗后三组患者THI评分均有所下降,同时B、C组优于A组(P<0.05);③对比发现不同时间B、C两组患者耳鸣控制率均优于A组(P<0.05);④A组患者不良反应发生率为15.69%(8/51),B组为16.00%(8/50),C组为28.13%(9/32),C组要高于A、B两组(P<0.05)。结论应用0.5 ml/d泼尼松龙灌耳联合谷维素及甲钴胺对无听力变化耳鸣患者具有较好的治疗效果,能够显著改善患者临床症状,同时也具有较低的不良反应发生率。

Objective To explore the effects of different doses of prednisone combined with oryzanol and mecobalamin in the treatment of tinnitus patients without hearing loss.Methods 90 tinnitus patients(133 ears)without hearing loss treated in our hospital from January 2017 to December 2020 were selected as subjects.They were divided into A,B and C groups according to the random number table method,each group of 30 patients.All the patients were treated with oryzanol combined with mecobalamin,while 0.2 ml/d prednisolone irrigation ear was add to the treatment of group A patients(30 patients with 51 ears),0.5 ml/d prednisolone irrigation ear to group B patients(30 patients 50 ears),0.7 ml/d prednisolone irrigation ear to group C patients(30 cases 32 ears),and the treatment time of the three groups were 20 d.Then the efficiency,the THI tinnitus disability assessment scale,tinnitus symptom control rate and the incidence of adverse reactions during the treatment were compared among the three groups.Results①The effective rate of treatment in group A was 78.43%(40/51),the effective rate in group B was 92.00%(46/50),and the effective rate in group C was 93.75%(30/32).The comparison between groups B and C was significantly better than that of group A(P<0.05).There was no significant difference between groups B and C(P>0.05).②The difference of THI scores between the three groups was not the same without statistically significant before treatment(P>0.05),and the THI scores of the three groups were decreased after treatment,and the B and C groups were better than the A group(P<0.05).③The tinnitus control rate in the groups B and C were better than that of group A(P<0.05)at different times.④The incidence of adverse reactions in group C was 28.13%(9/32),which was higher than group A 15.69%(8/51),group B 16.00%(8/50)(P<0.05).Conclusion 0.5 ml/d prednisolone combined with oryzanol and mecobalamin has better therapeutic effect on tinnitus patients without hearing loss,can significantly improve the tinnitus patient's clinical symptoms,but also has a lower incidence of adverse reactions.