耳聪丸联合针灸、激素治疗突发性聋临床观察及预后因素分析

Clinical observation and prognostic factor analysis of Er Cong Wan combined with acupuncture and glucocorticoid in the treatment of sudden deafness

目的探讨耳聪丸联合针灸、激素治疗突发性聋的临床效果以及影响突发性聋治疗效果的预后因素。方法回顾性分析2012年1月~2019年7月间就诊于我科的355例突发性耳聋的病例资料。根据患者是否使用耳聪丸分为两组,其他基础治疗条件相同,对比两组治疗效果,并探讨影响突发性聋的预后因素。结果共收集治疗前后资料完整病例355例,男女比例为0.84∶1,年龄11岁~85岁,平均年龄(43.97±14.75)岁,总有效率为57.7%,使用耳聪丸治疗组有效率为59.11%,未使用耳聪丸治疗组为53.49%,差异不具有统计学意义(χ^(2)=0.843,P=0.358)。多因素logistic回归分析显示:年龄(OR=0.982,95%CI=0.966~0.997,P=0.019)、眩晕(OR=2.199,95%CI=1.315~3.677,P=0.003)、发病至干预时间(OR=0.940,95%CI=0.901~0.980,P=0.004)与突发性聋治疗效果相关。结论①耳聪丸配合针灸并联合激素治疗突发性聋可能取得更好的疗效,但对气滞血瘀型可能更佳。②发病至干预时间、年龄以及伴发眩晕情况与疗效相关。

Objective To explore the clinical effect and prognostic factor of Er Cong Wan combined with acupuncture and glucocorticoid in the treatment of sudden deafness.Methods A retrospective analysis of 355 cases of sudden deafness in our department from January 2012 to July 2019 was completed.The patients were divided into two groups according to whether they used Er Cong Wan or not,and the other basic treatment conditions are the same.The therapeutic effects of the two groups were compared.Results A total of 355 cases were collected.The ratio of male and female is 0.84∶1,the age is 11~85 years old,the average age is 44.0 years old.The total effective rate was 57.7%,59.11%in Er Cong Wan group and 53.49%in non-Er Cong Wan group.The difference was not statistically significant(χ^(2))=0.843,P=0.358.Multivariate logistic regression analysis:age(OR=0.982,95%CI=0.966~0.997,P=0.019),vertigo(OR=2.199,95%CI=1.315~3.677,P=0.003),time from onset to intervention(OR=0.940,95%CI=0.901~0.980,P=0.004)were correlated with the therapeutic effect of sudden deafness.Conclusion Er Cong Wan combined with acupuncture and hormone may have better effect on sudden deafness,and it may be better for qi stagnation and blood stasis type.The time from onset to intervention,age and concomitant vertigo were related to the curative effect.