针刺联合活血通络法治疗耳鸣40例临床疗效观察

Clinical Observation on the Treatment of 40 Cases of Tinnitus with Acupuncture Combined with Blood-activating and Collateral Clearing Methods

目的:对针刺联合活血通络法治疗气滞血瘀型耳鸣患者的临床疗效进行总结。方法:选取于我科门诊就诊,诊断为气滞血瘀型耳鸣患者80例。按随机数字表法,将患者分为对照组及观察组各40例。对照组以活血通络为治则,予以中药血府逐瘀汤加减口服;观察组在对照组基础上,加以针刺治疗;两组治疗时间均以7天为一疗程,在每个疗程之间间隔3天,连续治疗3个疗程。观察两组治疗前后的纯音听阈测听(PTA)、耳鸣残疾评估量表(THI)、耳鸣评估问卷(TEQ)、耳鸣视觉模拟评分法(VAS)、中医症状变化及总体临床疗效,对针刺联合活血通络法治疗气滞血瘀型耳鸣患者进行总体评估。结果:治疗3个疗程后,两组在PTA、TEQ、THI、VAS评分方面,治疗后与治疗前比较,均明显降低,且对照组评分下降幅度明小于观察组,差异均有统计学意义(P<0.05);两组在中医症状胸胁胀闷,走窜疼痛,胁下痞块,刺痛拒按评分方面,治疗后与治疗前比较均降低,且对照组评分明显高于观察组,差异均有统计学意义(P<0.05);对照组临床总有效率为77.5%,观察组临床总有效率为87.5%,两组总有效率差异有统计学意义(P<0.05)。结论:运用针刺联合活血通络法与单纯使用活血通络法治疗耳鸣相比较,有着更好的临床疗效。

Objective To summarize the clinical efficacy of acupuncture combined with the method of promoting blood circulation and unblocking collaterals in the treatment of tinnitus patients with qi stagnation and blood stasis type.Method 80 patients with tinnitus of qi stagnation and blood stasis type diagnosed at our outpatient department were selected and randomly divided into a control group and an observation group,with 40 cases in each group;The control group patients were treated with the principle of promoting blood circulation and unblocking collaterals,and were given the modified traditional Chinese medicine Xuefu Zhuyu Decociton orally;The observation group received acupuncture treatment on the basis of the control group;The treatment time for both groups of patients is 7 days per course,with a 3-day interval between each course,and continuous treatment for 3 courses.Observe The Puretone Listening Test(PTA),Tinnitus Handicap Inventory(THI),Tinnitus Evaluation Questionnaire(TEQ),Visual Analog Scale(VAS),changes in traditional Chinese medicine symptoms,and overall clinical efficacy of two groups of patients before and after treatment,Overall evaluation of acupuncture combined with activating blood circulation and unblocking collaterals method for the treatment of tinnitus patients with qi stagnation and blood stasis type.Result After three courses of treatment,the scores of PTA,TEQ,THI,and VAS in both groups of patients were significantly reduced after treatment compared to before treatment,and the decrease in scores in the control group was significantly smaller than that in the observation group,with statistical significance(P<0.05);In terms of traditional Chinese medicine symptoms such as chest and hypochondriac distension,pain in walking,subcutaneous lumps,and stinging,the scores of the two groups decreased after treatment compared to before treatment,and the scores of the control group patients were significantly higher than those of the observation group patients,with statistical significance(P<0.05);The total clinical effective rate of patients in the control group was 77.5%,while the total clinical effective rate of patients in the observation group was 87.5%.There was a statistically significant difference in the total effective rate between the two groups(P<0.05).Conclusion The use of acupuncture combined with the method of promoting blood circulation and unblocking collaterals has better clinical efficacy compared to the simple method of promoting blood circulation and unblocking collaterals in the treatment of tinnitus.