摘要
目的 评价颈部七线法结合耳周穴位针刺作为突发性聋非急性期挽救疗法的有效性和安全性。方法将66例病程在15~90天的突发性聋非急性期患者随机分为治疗组和对照组各33例。治疗组给予颈部七线法结合耳周穴位针刺治疗;对照组在相同穴位采用假针刺和假电针。两组均每周治疗3次,连续6周。治疗前、治疗结束后及随访时(第10周)检查患者受损频率纯音平均听阈,计算受损频率纯音平均听阈治疗前后的差值;计算治疗后及随访时受损频率纯音平均听阈改善≥10 dB患者的比例;治疗前后比较患者耳鸣评价量表(TEQ)评分、中医生命质量评价量表(CQ-11D)健康效用值及治疗前后差值,并记录不良事件发生情况。结果 治疗组治疗结束后和随访时的受损频率纯音平均听阈分别为(50.57±18.07) dB和(47.70±17.42) dB,对照组治疗后和随访时为(54.38±21.77) dB和(53.36±20.99) dB。与治疗前比较,两组患者治疗后及随访时受损频率纯音平均听阈均显著降低(P<0.05)。治疗组治疗后和随访时受损频率纯音平均听阈较治疗前的差值均低于对照组(P<0.05)。治疗后,治疗组有13例(39.39%)患者受损频率纯音平均听阈改善≥10 dB,对照组有10例(30.30%);随访时,治疗组有18例(54.55%)患者受损频率纯音平均听阈改善≥10 dB,对照组有10例(30.30%),两组治疗后和随访时比较差异均无统计学意义(P>0.05)。治疗组TEQ评分治疗后较治疗前明显降低(P<0.05);治疗后治疗组TEQ评分及治疗前后差值均明显低于对照组(P<0.05)。两组治疗后CQ-11D健康效用值差异、治疗前后差值差异均无统计学意义(P>0.05)。66例患者中有8例发生针灸相关的不良事件,包括针刺后皮下留有血肿,针刺时疼痛较为剧烈和晕针,对症处理后均消失,未影响后续治疗。结论 颈部七线法结合耳周穴位针刺作为挽救疗法可以提高突发性聋非急性期患者受损频率的纯音平均听阈,改善耳鸣症状,且安全性较好。
Objective To evaluate the effectiveness and safety of neck seven-line method combined with periauricular acupuncture as salvage treatment for sudden hearing loss in non-acute stage.Methods Sixty-six patients with non-acute stage of sudden hearing loss with a disease duration of 15-90 days were randomly divided into 33 cases each in treatment group and control group.The treatment group was given neck seven-line method combined with acupuncture at periauricular points;the control group used sham acupuncture and sham electroacupuncture at the same points.Both groups were treated 3 times a week for 6 weeks.The pure tone average hearing threshold of impaired frequencies were examined before treatment,after treatment finish and at follow-up(week 10),and the difference between pure tone average hearing threshold of impaired frequencies before and after treatment was calculated;calculate the proportion of patients with≥10 dB improvement in pure tone average hearing threshold of impaired frequency after treatment and at follow-up;compare the patients'Tinnitus Evaluation Scale(TEQ)scores,Chinese Medicine Quality of Life Assessment Scale(CQ-11D)health utility values and the difference between before and after treatment,and record the occurrence of adverse events.Results The pure tone average of impaired frequency in the treatment group were(50.57±18.07)dB and(47.70±17.42)dB at post-treatment and follow-up respectively,and(54.38±21.77)dB and(53.36±20.99)dB in the control group at post-treatment and follow-up.Compared with the pre-treatment period,the pure tone average hearing threshold of impaired frequency in the two groups significantly decreased(P<0.05)at post-treatment and follow-up.The difference of pure tone average hearing threshold of impaired frequency in the treatment group after treatment and at the follow-up visit compared to that before treatment was lower than those in the control group(P<0.05).After treatment,13 patients(39.39%)in the treatment group and 10 patients(30.30%)in the control group showed improvement of≥10 dB in pure tone average hearing threshold of impaired frequency;at the follow-up visit,18 patients(54.55%)in the treatment group and 10 patients(30.30%)in the control group showed improvement of≥10 dB in the pure tone average hearing threshold of impaired frequency,and there was no statistical significance for comparison between groups at the time of post-treatment and follow-up(P>0.05).The TEQ score of the treatment group significantly lower than that before treatment(P<0.05);the TEQ score of the treatment group and the difference between before and after treatment significantly lower than that of the control group(P<0.05).The difference in CQ-11D health utility values and the difference between before and after treatment were not statistically significant between the two groups(P>0.05).Eight cases of acupuncture-related adverse events occurred among 66 patients,including subcutaneous haematomas after needling,severe pain during needling and needle fainting,which disappeared after symptomatic treatment and did not affect the following treatment.Conclusion Neck seven-line method combined with periauricular acupuncture could be used as salvage treatment for sudden hearing loss in non-acute stage to improve the pure tone average hearing threshold of impaired frequency,alleviate tinnitus,with safety.
作者
张重阳
梁俊杰
李阳
王新茹
邢御
邸学士
孙文婷
白鹏
ZHANG Chongyang;LIANG Junjie;LI Yang;WANG Xinru;XING Yu;DI Xueshi;SUN Wenting;BAI Peng(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing,100029;Dongzhimen Hospital,Beijing Universityof ChineseMedicine)
出处
《中医杂志》
CSCD
北大核心
2024年第15期1571-1577,共7页
Journal of Traditional Chinese Medicine
基金
国家中医药管理局青年岐黄学者培养项目(国中医药人教函[2022]256号)。
关键词
突发性聋
电针
纯音平均听阈
耳鸣
随机对照试验
颈部七线法
sudden hearing loss
electroacupuncture
pure tone average hearing threshold
tinnitus
randomized controlled trial
neck seven-line method
