老年性耳鸣耳聋的中医药研究进展

老年性耳鸣耳聋属难治性老年病。通过回顾现代医家治疗老年性耳鸣耳聋的临床经验,总结了以肾精渐亏为本,以肝、心、脾、肺功能失调、痰瘀互结、运气变化为标三方面为主的致病因素以及内治与外治相结合、重视预防保健及心理干预为主的治疗方法。同时指出了在治未病思想的指导下,辨证论治、防治结合能够达到比较满意的临床疗效。研究发现,中医综合治疗是老年性耳鸣耳聋研究的方向所在。

以眩晕/头晕伴耳鸣耳聋为主要表现的小脑前下动脉梗死四例分析并文献复习

目的探讨小脑前下动脉(anterior inferior cerebellar artery,AICA)梗死的临床表现及影像学特点。方法报告4例曾疑诊为周围性眩晕疾病,经头颅磁共振成像(magnetic resonance imaging,MRI)证实诊断的AICA梗死患者,分析其临床、影像学表现及治疗预后情况,并复习相关文献。结果4例AICA梗死患者中,多以急性眩晕/头晕(4例),伴恶心呕吐(2例),耳鸣(4例)、耳聋(3例)和步态不稳(4例)起病。神经科查体发现患侧面部感觉障碍(3例)、面瘫复视(1例)、患侧肢体或步态共济失调(4例),但未见眼球震颤等体征。头颅MRI表现为脑桥下外侧(4例)、桥臂(3例)、小脑前下部(3例)急性梗死(任一部位发生即可确诊AICA梗死)。结论AICA梗死很易误诊为前庭周围性疾病。对急性眩晕伴耳鸣、耳聋的患者需警惕AICA梗死,应注意检查患侧有否面部麻木、感觉障碍和肢体共济失调等体征,必要时行头颅MRI以确诊。

The NGF Point-Injection for Treatment of the Sound-Perceiving Nerve Deafness and Tinnitus in 68 Cases

Objective: To observe the therapeutic effects of the point-injection with nerve growth factor (NGF) for the sound-perceiving nerve deafness and tinnitus. Methods: The 140 cases in this series were randomly divided into a treatment group of 68 cases treated by NGF injection at the points of Yifeng (TE 17) and Wangu (GB 12), and a control group of 72 cases orally taking Xibiling (西比灵) and adenosine triphosphate (ATP) and intramuscular injection with VB1 and VB12. Results: The total effective rate was 78.6% in the treatment group and 31.8% in the control group, with significant difference between the two groups (P<0.05). Conclusion: For treating nervous deafness and tinnitus, NGF point-injection may show good therapeutic effects, but inversely proportional to the illness course, age and the extent of hypoacusis.