补阳还五汤联合巴曲酶对突发性耳聋患者中医证候、听力水平及血清ET-1、CysC、MMP-2的影响

Effects of Buyang Huanwu Decoction Combined with Batroxobin on Traditional Chinese Medicine Syndromes,Hearing Level and Serum Endothelin 1,Cystatin C and Matrix Metalloproteinase 2 in Patients with Sudden Deafness

【目的】探讨补阳还五汤联合巴曲酶治疗突发性耳聋的疗效及对患者中医证候、听力水平和血清血管内皮素1(ET-1)、胱抑素C(CysC)、基质金属蛋白酶2(MMP-2)水平的影响。【方法】将92例突发性耳聋患者随机分为对照组和观察组,每组各46例。对照组给予巴曲酶静脉滴注治疗,隔日1次;观察组在对照组的基础上联合补阳还五汤治疗,每日1剂;15 d为1个疗程,连续治疗3个疗程。观察2组患者治疗前后中医证候积分、听力水平及血清ET-1、CysC、MMP-2水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)治疗3个疗程后,观察组的总有效率为91.30%(42/46),对照组为71.74%(33/46),组间比较(χ2检验),观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的耳聋耳闷、头晕耳鸣、口苦咽干、舌红苔黄等各项中医证候积分均较治疗前降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者的纯音听觉阈值(PTA)、听觉诱发电位(AEP)、听觉脑干反应(ABR)等听力指标均较治疗前改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.01)。(4)治疗后,2组患者的血清ET-1、CysC、MMP-2水平均较治疗前降低(P<0.05),且观察组的降低作用均明显优于对照组(P<0.01)。(5)治疗期间,观察组的不良反应发生率为13.04%(6/46),对照组为8.70%(4/46),组间比较,差异无统计学意义(P>0.05)。【结论】补阳还五汤联合巴曲酶治疗突发性耳聋疗效显著,能有效改善患者中医证候,提高患者听力水平,改善血清学指标,且具有较高的安全性。

Objective To investigate the efficacy of Buyang Huanwu Decoction combined with Batroxobin for the treatment of sudden deafness and to observe the effects on traditional Chinese medicine syndromes,hearing level and serum vascular endothelin 1(ET-1),cystatin C(CysC)and matrix metalloproteinase 2(MMP-2)levels of the patients.Methods Ninety-two patients with sudden deafness were randomly divided into a control group and an observation group,with 46 cases in each group.The control group was given intravenous drip of Batroxobin every other day,and the observation group was given Buyang Huanwu Decoction orally one dose per day on the basis of treatment for the control group.Both groups were treated for 3 consecutive courses of treatment,and 15 days constituted one course of treatment.The changes of traditional Chinese medicine(TCM)syndrome scores,hearing level and serum ET-1,CysC,MMP-2 level of the two groups were observed before and after the treatment,and the clinical efficacy and safety of the two groups were evaluated.Results(1)After 3 courses of treatment,the total effective rate of the observation group was 91.30%(42/46)and that of the control group was 71.74%(33/46),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After the treatment,the TCM syndrome scores of deafness and stuffiness,dizziness and tinnitus,bitter mouth and dry throat,and red tongue and yellow coating of the patients in the two groups were reduced compared with those before the treatment(P<0.05),and the effect on reducing the scores in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the hearing indicators such as pure tone auditory(PTA)threshold,auditory evoked potential(AEP)and auditory brainstem response(ABR)of patients in the two groups were improved compared with those before treatment(P<0.05),and the improvement of hearing indicators in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the serum ET-1,CysC,and MMP-2 levels in the two groups were all decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(5)During the treatment period,the incidence of adverse reactions was 13.04%(6/46)in the observation group and was 8.70%(4/46)in the control group,and the intergroup comparison showed that the difference was not statistically significant(P>0.05).Conclusion The therapeutic effect of Buyang Huanwu Decoction combined with Batroxobin for the treatment of sudden deafness is remarkable.The combined therapy can effectively relieve the TCM syndrome scores,enhance the hearing level,and improve the serological indexes with high safety.