摘要
梅尼埃病是一种内耳眩晕性疾病,以眩晕、耳鸣、听力下降、耳闷感为主要的临床特征,现代医学的药物、手术、前庭功能康复等治疗手段在缓解症状、减少复发等方面效果有限。梅尼埃病是中医药优势病种之一,中医治疗具有显著缓解症状、不良反应少、治疗开展便捷、注重情志调节等优势,治疗思路主要包括分期论治和分“邪”论治,在发作期和间歇期有不同的认识角度和治疗手段,对邪气的认识主要从虚、实两方面进行;治疗方法上内治法以汤药为主,多从痰湿水饮、风火、虚损及血瘀等角度治疗,外治法多采用针刺、灸法等。该文对已发表的中医药治疗梅尼埃病的文献进行梳理,结果显示近5年有关文献的类型主要集中在临床研究,其次是经验探讨(或病例报道)类,基础研究较少,在具体的研究方案中,西医诊断多参考《梅尼埃病的诊断依据和疗效评估(2006年,贵阳)》和《梅尼埃病诊断和治疗指南(2017)》,中医诊断多参考1994年国家中医药管理局发布的《中医病证诊断疗效标准》,疗效评价多采用临床疗效、量表、证候积分、纯音测听等,实验指标运用较少。现有的梅尼埃病临床研究存在证据质量较低、研究的干预方法较为单一等不足。未来中医药治疗梅尼埃病的研究可以从规范研究方案、提升证据质量、探索更多干预手段、加强基础研究等方面进行改善和深入探索。
Ménière's disease(MD)is an inner ear disease characterized by vertigo,tinnitus,hearing loss,and ear stuffiness.Modern therapies such as drugs,surgery,and vestibular function rehabilitation have limited effects in relieving the symptoms and reducing the recurrence.Traditional Chinese medicine(TCM)can alleviate the symptoms of MD with simple operation and mild adverse reactions while emphasizing psychological adjustment.The TCM treatment of MD is individualized depending on different stages and pathogenic factors.The internal treatment mainly targets phlegm,dampness,water,wind,fire,deficiency,and blood stasis.External interventions include acupuncture and moxibustion.This paper reviewed the published articles about the treatment of MD with TCM.In recent five years,the published studies were mainly clinical trials and experience discussion(or case reports),and few reports of fundamental research were published.In these studies,the Western medicine diagnosis of MD mostly refers to the Diagnostic Basis and Efficacy Evaluation of Ménière's Disease(Guiyang,2006)and the Guidelines for Diagnosis and Treatment of Ménière's Disease(2017),while the TCM diagnosis mostly refers to the Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine issued by the National Administration of TCM in 1994.The efficacy was mostly evaluated based on clinical efficacy,scales,syndrome scores,pure tone audiometry,etc.,while caboratory indexes were rarely used.The available clinical studies about the treatment of MD with TCM generally have low quality of evidence and single intervention means.In the future,the research on the treatment of MD with TCM can be improved by standardizing the research program,improving the quality of evidence,exploring more intervention methods,and strengthening basic research.
作者
吴子彧
王鑫
张莹
原晶晶
吴薇
董子君
洪沁妍
苏宇婷
辛忠海
闫占峰
张霄潇
WU Ziyu;WANG Xin;ZHANG Ying;YUAN Jingjing;WU Wei;DONG Zijun;HONG Qinyan;SU Yuting;XIN Zhonghai;YAN Zhanfeng;ZHANG Xiaoxiao(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Otolaryngology,Head and Neck Institute of Traditional Chinese Medicine,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102;China Association of Chinese Medicine,Beijing 100029,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第21期196-203,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
中国科协青年科学家沙龙项目(2022XSJLSL)
中华中医药学会青年求实项目(2021-QNQS-006)
北京中医药大学一流学科引导项目(中西医结合五官科学)
北京中医药大学2022年度新教师启动基金项目(2022-JYB-XJSJJ-055)。
关键词
梅尼埃病
中医治疗
优势病种
研究评述
Ménière's disease
traditional Chinese medicine treatment
disease suitable for traditional Chinese medicine treatment
review
