龙胆泻肝汤加减治疗肝胆湿热型分泌性中耳炎耳鸣临床研究

Clinical study of modified Longdan Xiegan Decoction in the treatment of secretory otitis media with tinnitus (liver and gallbladder damp-heat type)

目的观察龙胆泻肝汤加减治疗肝胆湿热型分泌性中耳炎(SOM)耳鸣的临床疗效。方法将80例肝胆湿热型SOM耳鸣患者按照随机数字表法分为2组。对照组40例(50耳)予常规西医治疗,治疗组40例(50耳)在对照组治疗基础上加龙胆泻肝汤加减治疗,2组均治疗4周。比较2组治疗前后耳鸣程度、汉密尔顿抑郁量表(HAMD)评分、血清血小板活化因子(PAF)水平,并比较2组起效时间及临床疗效。结果治疗组总有效率95.0%(38/40),对照组总有效率72.5%(29/40),治疗组临床疗效优于对照组(P<0.05)。治疗后2组耳鸣程度均较本组治疗前减轻(P<0.05),且治疗组较对照组更轻(P<0.05)。治疗后2组HAMD评分、血清PAF水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗组起效时间早于对照组(P<0.05)。结论龙胆泻肝汤加减治疗肝胆湿热型SOM耳鸣临床疗效确切,且起效快,能有效改善耳鸣对情绪的影响,下调血清PAF水平。

Objective To observe the clinical effect of modified Longdan Xiegan Decoction in the treatment of secretory otitis media(OSM)with tinnitus(liver and gallbladder damp-heat type).Methods Totally 80 SOM patients with tinnitus(liver and gallbladder damp-heat type)were randomly assigned into treatment group(n=40,50 ears with SOM with tinnitus)and control group(n=40,50 ears with SOM with tinnitus).All patients were managed by conventional Western medicine,and those in treatment group were additionally treated with modified Longdan Xiegan Decoction.Treated for 4 weeks,the aim was to compare degree of tinnitus,Hamilton Depression Rating Scale(HAMD),platelet-activating factor(PAF),onset time;the curative effect was counted.Results The overall effective rate was 95.0%(38/40)in treatment group,higher than that of 72.5%(29/40)in control group(P<0.05).After treatment,the degree of tinnitus in groups were decreased(P<0.05),which decreased notably in treatment group than in cortrol group(P<0.05);HAMD scores and PAF levels in groups were decreased(P<0.05),improvement of which in treatment group were significantly better(P<0.05);the onset time in treatment group was less than that in control group(P<0.05).Conclusion The clinical effect of modified Longdan Xiegan Decoction for SOM patients with tinnitus(liver and gallbladder damp-heat type)is outstanding,with quick onset,and it can effectively improve the influence of tinnitus on mood and reduce the PAF level.