本文關(guān)鍵詞：針刺治療氣滯血瘀型突發(fā)性耳聾的臨床療效觀察　出處：《福建中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 針刺 長春西汀 甲鈷胺 突發(fā)性耳聾 氣滯血瘀型

【摘要】：目的觀察針刺治療氣滯血瘀型突發(fā)性耳聾的臨床療效。方法1、選取2015年2月至2017年1月期間,就診于我院針灸科和耳鼻喉科的符合研究標準的氣滯血瘀型突發(fā)性耳聾患者60例,通過查隨機數(shù)字表將60例病例分為針刺組和西藥組,每組各30例。2、針刺組采用毫針針刺,取主穴:率谷透曲鬢、耳門、聽會、翳風(皆患側(cè)),配穴:血海、足竅陰、太沖(皆雙側(cè)),一日一次。西藥組口服長春西汀片和甲鈷胺片,長春西汀片餐后服,每次5mg,一日三次;甲鈷胺片餐后服,每次0.5mg,一日三次。兩組都以十日作為一個療程,兩療程間休息五日,治療兩個療程。3、觀察并記錄兩組治療前后的聽力值并進行耳鳴嚴重程度評分,統(tǒng)計分析發(fā)病相關(guān)因素,所有數(shù)據(jù)都采用SPSS20.0統(tǒng)計軟件進行統(tǒng)計分析。分析統(tǒng)計數(shù)據(jù)結(jié)果,比較針刺和口服西藥的臨床療效。結(jié)果1、兩組治療前后組內(nèi)比較:針刺、西藥組患者治療后聽力情況和伴隨耳鳴癥狀與治療前比較,差異均具有統(tǒng)計學意義(P0.05),說明兩種方法均能提高患者聽力情況和改善伴隨耳鳴癥狀。2、兩組治療后組間比較:①聽力改善方面:治療后針刺組與西藥組比較,平均聽閾值明顯提高(P0.05)。②改善耳鳴程度方面:治療后針刺組與西藥組比較,耳鳴程度評分下降無明顯差別(P0.05)。3、兩組臨床療效比較:①耳聾臨床療效:針刺組痊愈率24.14%,顯效率41.38%,有效率20.69%,總有效率86.21%;西藥組治愈率6.90%,顯效率20.69%,有效率34.48%,總有效率62.07%。兩組臨床療效經(jīng)統(tǒng)計學處理,差異具有統(tǒng)計學意義(P0.05)。提示針刺組耳聾臨床療效優(yōu)于西藥組。②耳鳴臨床療效:針刺組痊愈率15.00%,顯效率30.00%,有效率35.00%,總有效率80.00%;西藥組治愈率10.53%,顯效率31.58%,有效率31.58%,總有效率73.68%。兩組臨床療效經(jīng)統(tǒng)計學處理,差異不具有統(tǒng)計學意義(P0.05)。提示耳鳴改善方面兩組臨床療效沒有明顯區(qū)別。4、部分因素與耳聾療效相關(guān)性:①病程與耳聾療效關(guān)系:針刺組與西藥組所選病例的病程和療效關(guān)系均具有統(tǒng)計學意義(P0.05),病程7天組療效優(yōu)于7～14天病程組療效,考慮病程可能是影響聽力療效的因素之一。②有無伴隨耳鳴與耳聾療效關(guān)系:兩組所選病例有無伴隨耳鳴與聽力療效關(guān)系均無統(tǒng)計學意義(P0.05),故有無伴隨耳鳴與療效的關(guān)系尚需進一步大樣本研究。結(jié)論1、針刺和口服長春西汀、甲鈷胺兩種治療方法都可有效治療氣滯血瘀型突發(fā)性耳聾。2、針刺在改善氣滯血瘀型突發(fā)性耳聾的聽力損失情況上確有療效,對比西藥組具有明顯優(yōu)勢,在改善耳鳴方面與西藥組療效相當。3、病程與耳聾療效可能存在相關(guān)性,建議突發(fā)性耳聾患者發(fā)現(xiàn)癥狀后,盡早明確診斷進行干預治療,預后較好;有無伴隨耳鳴是否成為影響耳聾療效的因素之一尚不確切,需進一步大樣本研究。
[Abstract]:Objective to observe the clinical effect of acupuncture on sudden deafness with qi stagnation and blood stasis. Sixty patients with sudden deafness due to Qi stagnation and Blood stasis were selected from acupuncture department and otolaryngology department of our hospital. 60 cases were randomly divided into acupuncture group and western medicine group with 30 cases in each group. In the acupuncture group, the main points were selected as follows: the rate of the grain through the temples, the ear door, the hearing session, the Yifeng (all affected side), the matching points: blood sea, foot orifices and yin, Taichong (both sides). In 1st, the western medicine group took vinpocetine tablets and mecobalamin tablets, vinpocetine tablets, 5 mg each time, three times on 1st; Megabalamin tablets were taken after meals, 0.5 mg each time, three times on 1st. The two groups took 10th as a course of treatment, two courses of rest 5th, treatment of two courses of treatment. 3. To observe and record the hearing value of the two groups before and after treatment and to score the severity of tinnitus. All data were analyzed by SPSS20.0 statistical software. The results were analyzed to compare the clinical efficacy of acupuncture and oral western medicine. Results 1. The comparison between the two groups before and after treatment: acupuncture. Western medicine group patients after treatment with hearing and associated tinnitus symptoms compared with before treatment, the differences were statistically significant (P 0.05). The two methods can improve the hearing condition of the patients and improve the symptoms of tinnitus. The comparison of hearing improvement between the two groups after treatment: acupuncture group and western medicine group after treatment. The average auditory threshold increased significantly (P 0.05n.2) to improve the degree of tinnitus: there was no significant difference in the score of tinnitus between the acupuncture group and the western medicine group after treatment. Comparison of clinical efficacy between the two groups: the acupuncture group had a cure rate of 24.14%, a markedly effective rate of 41.38, an effective rate of 20.6910 and a total effective rate of 86.21; The cure rate of the western medicine group was 6.90, the markedly effective rate was 20.69m, the effective rate was 34.48m, the total effective rate was 62.07.The clinical efficacy of the two groups was treated statistically. The difference was statistically significant (P 0.05). It suggested that the clinical curative effect of acupuncture group was better than that of western medicine group. The cure rate of acupuncture group was 15.00, and the effective rate was 30.00%. The effective rate is 35.000.The total effective rate is 80.00; The cure rate of the western medicine group was 10.53, the effective rate was 31.58, the effective rate was 31.58, and the total effective rate was 73.68.The clinical efficacy of the two groups was treated statistically. The difference was not statistically significant (P 0.05). It suggested that there was no significant difference in clinical efficacy between the two groups in tinnitus improvement. Some factors were related to the curative effect of deafness: the relationship between the course of disease and the curative effect of deafness: the course of disease and the curative effect of acupuncture group and western medicine group were all statistically significant (P 0.05). The curative effect of 7 day group was better than that of 7 day 14 day group. Considering the course of disease may be one of the factors that affect the effect of hearing. 2 whether there is associated tinnitus and the effect of deafness: there is no significant relationship between tinnitus and hearing effect in the two groups (P 0.05). Conclusion 1 Acupuncture, oral vinpocetine and mecobalamin can effectively treat sudden deafness caused by stagnation of qi and blood stasis. Acupuncture is effective in improving hearing loss of sudden deafness of qi stagnation and blood stasis type. Compared with western medicine group, acupuncture has obvious advantages, and the curative effect is equivalent to that of western medicine group in improving tinnitus. There may be correlation between the course of disease and the curative effect of deafness. It is suggested that the patients with sudden deafness should be diagnosed and treated with intervention as soon as possible after finding the symptoms, and the prognosis is better. Whether tinnitus is one of the factors influencing the curative effect of deafness is uncertain and needs further study.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.81

【參考文獻】

相關(guān)期刊論文 前10條

1 韓明娟;趙宏;景向紅;劉佳;梁鳳霞;劉保延;;不同留針時間對針刺療效影響的文獻分析[J];中醫(yī)雜志;2017年04期

2 吳飛虎;朱丹華;;通竅活血湯聯(lián)合腦蛋白水解物治療氣滯血瘀型突發(fā)性耳聾的臨床觀察[J];中成藥;2017年01期

3 盧澤強;盧佳銘;;針灸配合推拿治療耳鳴耳聾療效觀察[J];上海針灸雜志;2017年01期

4 孫小迪;;通竅活血湯聯(lián)合針灸治療突發(fā)性耳聾[J];光明中醫(yī);2016年24期

5 郝亞楠;于閱盡;黃衛(wèi);;中西醫(yī)結(jié)合治療氣滯血瘀型突發(fā)性聾臨床研究[J];河北中醫(yī);2016年12期

6 唐愛華;;通竅活血湯加減聯(lián)合針灸辨治氣滯血瘀證突發(fā)性耳聾患者的臨床研究[J];中醫(yī)藥學報;2016年06期

7 鐘晶;安楊;;中西醫(yī)治療突發(fā)性聾的研究進展[J];中國中西醫(yī)結(jié)合耳鼻咽喉科雜志;2016年06期

8 齊佳;;巴曲酶治療突發(fā)性聾臨床療效觀察[J];聽力學及言語疾病雜志;2017年02期

9 汪瓊;陳其國;胡福云;孫群;李浩;;突發(fā)性耳聾的流行病學調(diào)查[J];中外醫(yī)學研究;2016年33期

10 賴小燕;梁凡;胡幼平;張琪;王卓慧;艾虹靜;;針灸治療暴聾的古代文獻探析[J];四川中醫(yī);2016年11期

相關(guān)會議論文 前4條

1 付平;陶曉燕;;針刺耳門穴對聽覺腦干誘發(fā)反應的影響[A];2011中國針灸學會年會論文集（摘要）[C];2011年

2 安軍明;董聯(lián)合;楊小波;;聽宮穴、外關(guān)穴合谷刺為主治療突發(fā)性耳聾30例臨床療效觀察[A];2011中國針灸學會年會論文集（摘要）[C];2011年

3 謝強;何興偉;;耳鼻咽喉疾病常用刺灸法[A];世界中聯(lián)耳鼻喉口腔專業(yè)委員會換屆大會及第三次學術(shù)年會暨中華中醫(yī)藥學會耳鼻喉科分會第十七次學術(shù)交流會暨廣東省中醫(yī)及中西醫(yī)結(jié)合學會耳鼻喉科學術(shù)交流會論文匯編[C];2011年

4 汪曉雷;凌祥;管沛;馬莉;顧明凡;郁琪;黃志俊;錢茂華;胡松群;周其熾;劉祖舜;;利多卡因?qū)Χ佈髁康挠绊懠捌渲委熗话l(fā)性聾療效的研究[A];中西醫(yī)結(jié)合“四種耳病”學術(shù)會匯編[C];2001年

，

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