经颅重复针刺法结合电针治疗平坦下降型突发性耳聋:随机对照试验

Repeated transcranial acupuncture combined with electroacupuncture for flat descending sudden deafness:a randomized controlled trial

目的:观察经颅重复针刺法结合电针治疗平坦下降型突发性耳聋的临床疗效。方法:将80例平坦下降型突发性耳聋患者随机分为针药组(39例,脱落1例)和西药组(39例,脱落1例)。西药组采用“糖皮质激素+巴曲酶+银杏叶制剂”治疗。针药组在西药组的基础上,于百会、宁神、晕听区、乳突1穴、乳突2穴、风池、供血、听会等穴针刺。百会、宁神、晕听区施经颅重复针刺法;患侧乳突1穴与乳突2穴、风池与供血分别连接电针仪,选择连续波,频率2 Hz。留针30 min,每日1次,连续治疗6 d后休息1 d。均治疗3周。比较两组患者治疗前后平均听阈值、耳鸣致残量表(THI)评分、眩晕评定量表(DHI)评分、言语识别测试评分,并评定临床疗效。结果:治疗后,两组患者平均听阈值、THI评分、DHI评分均较治疗前降低(P<0.05),且针药组低于西药组(P<0.05);两组患者言语识别测试评分均较治疗前升高(P<0.05),且针药组高于西药组(P<0.05)。针药组总有效率为87.2%(34/39),高于西药组的74.4%(29/39,P<0.05)。结论:经颅重复针刺法结合电针可以改善平坦下降型突发性耳聋患者听力水平,缓解耳鸣、眩晕症状。

Objective To observe the clinical effect of repeated transcranial acupuncture combined with electroacupuncture on flat descending sudden deafness.Methods A total of 80 patients with flat descending sudden deafness were randomly divided into an acupuncture and medication group(39 cases,1 case dropped off)and a western medication group(39 cases,1 case dropped off).Patients in the western medication group were treated with glucocorticoid+batroxobin+ginkgo leaf preparation.On the basis of the western medication group,patients in the acupuncture and medication group were treated with acupuncture at Baihui(GV 20),Ningshen,Yunting area,Mastoid 1 point,Mastoid 2 point,Fengchi(GB 20),Gongxue,Tinghui(GB 2),etc.,repeated transcranial acupuncture was applied at Baihui(GV 20),Ningshen and Yunting area;Mastoid 1 point and Mastoid 2 point,Fengchi(GB 20)and Gongxue of the affected side were connected to the electroacupuncture instrument,continuous wave,2 Hz in frequency.The needle was retained for 30 min,once a day,and rest for 1 d after 6 d of continuous treatment.All patients were treated for 3 weeks.The average hearing threshold,tinnitus handicap inventory(THI)score,dizziness handicap inventory(DHI)score and speech discrimination test score were compared between the two groups before and after treatment,and the clinical effect was evaluated.Results After treatment,the average hearing threshold,THI and DHI scores of the two groups were lower than those before treatment(P<0.05),and above indexes in the acupuncture and medication group were lower than those in the western medication group(P<0.05).The speech discrimination test scores of the two groups were higher than those before treatment(P<0.05),and the score in the acupuncture and medication group was higher than that in the western medication group(P<0.05).The total effective rate was 87.2%(34/39)in the acupuncture and medication group,which was higher than 74.4%(29/39)in the western medication group(P<0.05).Conclusion Repeated transcranial acupuncture combined with electroacupuncture can improve the hearing level of patients with flat descending sudden deafness,relieve tinnitus and vertigo symptoms.