不同灸量温针灸治疗主观性耳鸣的临床观察

Clinical Observations on Warm Needling Moxibustion with Different Dosages for Subjective Tinnitus

目的观察不同灸量温针灸治疗主观性耳鸣(ST)的临床疗效,探究温针灸治疗ST的适宜灸量。方法将90例患者随机分成温针灸A组(29例)、温针灸B组(31例)、温针灸C组(30例)。3组患者均予甲钴胺营养神经基础治疗,并针刺患侧听会、翳风、风池、百会与双侧中渚、侠溪,听会、翳风分别行1壮、3壮、5壮温针灸。比较3组治疗前后耳鸣残疾量表(THI)评分、耳鸣评价量表(TEQ)评分、气导平均听阈水平,并比较3组临床疗效。结果治疗后,3组THI、TEQ评分较治疗前均降低(P<0.05);温针灸B组、温针灸C组均低于温针灸A组(P<0.05);温针灸C组与温针灸B组比较,差异无统计学意义(P>0.05)。治疗后,3组气导平均听阈水平较治疗前均降低(P<0.05);温针灸B组、温针灸C组均低于温针灸A组(P<0.05);温针灸C组与温针灸B组比较,差异无统计学意义(P>0.05)。温针灸A组总有效率为69.0%(20/29),温针灸B组总有效率为87.1%(27/31),温针灸C组总有效率为93.3%(28/30);温针灸B组和温针灸C组总有效率优于温针灸A组(P<0.05);温针灸C组与温针灸B组比较,差异无统计学意义(P>0.05)。结论温针灸治疗ST疗效明确,可有效缓解耳鸣,改善听力损伤。不同灸量对疗效的影响较显著,温针灸治疗ST的适宜灸量建议为3壮。

Objective To observe the clinical efficacy of warm needling moxibustion with different dosages for subjective tinnitus(ST)and explore a suitable moxibustion dosage for its treatment of ST.Method Ninety patients were randomized to warm needling moxibustion group A(29 cases),group B(31 cases)and group C(30 cases).All the three groups of patients were given Mecobalamin as basic treatment for neuronutrition and acupuncture at affected-side points Tinghui,Yifeng,Fenfchi and Baihui and at bilateral points Zhongzhu and Xiaxi,with one,three and five moxa cones at Tinghui and Yifeng,respectively,for warm needling moxibustion.The tinnitus handicap inventory(THI)scores,the tinnitus evaluation questionnaire(TEQ)scores and mean air-conduction hearing thresholds were compared between the three groups before and after treatment.The clinical therapeutic effects were also compared between the three groups.Result After treatment,the THI score and the TEQ score decreased in the three groups compared with before(P<0.05),were lower in warm needling moxibustion groups B and C than in warm needling moxibustion group A(P<0.05)and had no statistically significant difference between warm needling moxibustion groups C and B(P>0.05).After treatment,the mean air-conduction hearing threshold decreased in the three groups compared with before(P<0.05),was lower in warm needling moxibustion groups B and C than in warm needling moxibustion group A(P<0.05)and had no statistically significant difference between warm needling moxibustion groups C and B(P>0.05).The total efficacy rate was 69.0%(20/29)in warm needling moxibustion group A,87.1%(27/31)in warm needling moxibustion group B(P<0.05)and 93.3%(28/30)in warm needling moxibustion group C.The total efficacy rate was higher in warm needling moxibustion groups B and C than warm needling moxibustion group A(P<0.05)and had no statistically significant difference between warm needling moxibustion groups C and B(P>0.05).Conclusion Warm needling moxibustion has a definite therapeutic effect on ST.it can effectively relieve tinnitus and reduce hearing impairment.Different moxibustion dosages significantly influence the therapeutic effect.Three moxa cones are suggested as a suitable dosage for warm needling moxibustion treatment of ST.