电针法、穴位注射法治疗突发性聋的临床疗效研究

doi:10.3760/cma.j.issn.1007-1245.2022.18.002

摘要/Abstract

摘要： 目的　比较电针法、穴位注射法治疗突发性聋的临床疗效。方法　采用随机对照前瞻性研究方法，将2018年4月至2021年1月就诊于暨南大学附属广州红十字会医院耳鼻咽喉头颈外科、符合突发性聋诊断标准的165例患者，其中男67例，女98例，年龄（53.1±11.3）岁，分层随机分为电针组、穴位组及对照组。电针组给予电针法+药物治疗，穴位组给予穴位注射+药物治疗，对照组仅给予药物治疗。比较其疗效、血液流变学、脑血管多普勒、听性脑干反应、并发症及疼痛评分，并探讨其可能的机制。采用Pearson’s Chi-Square检验、协方差分析、Mann-Whitney U检验。结果　电针组总有效率87.3%（48/55），穴位组总有效率67.3%（37/55），对照组总有效率63.6%（35/55），Pearson’s Chi-Square检验方法两两比较提示，电针组总有效率优于穴位组及对照组（均P<0.05）。血液流变学检查提示，3组治疗后全血黏稠度、血浆黏稠度均有好转，两两比较提示，电针组优于穴位组及对照组（均P<0.05）。脑血管多普勒检查提示，治疗前电针组、穴位组及对照组分别有45例、47例、45例存在异常，包括血流速度增快或减慢、脉冲指数（PI）异常等，而治疗后分别有40例、31例、28例患者改善，改善率分别为88.9%、66.0%、62.2%，两两比较提示，电针组改善率明显优于穴位组及对照组（均P<0.05）。听性脑干反应检查提示，治疗前电针组、穴位组及对照组分别有49例、47例、47例异常，治疗后有43例、31例、30例得到改善，改善率分别为87.8%、66.0%、63.8%，两两比较，电针组优于穴位组及对照组（均P<0.05）。在安全性评价方面，电针组及穴位组均未发生皮肤损伤、感染等并发症，疼痛评分提示，电针组及穴位组中位数均为2分，Mann-Whitney U检验方法提示，差异无统计学意义（P>0.05）。结论　在治疗突发性聋疗效方面，电针法优于穴位注射和药物治疗，且安全可靠，其机制可能与改善血液黏稠度、脑供血及听神经功能相关。

关键词: 突发性聋, 电针法, 穴位注射法, 疗效

Abstract: Objective　To compare the efficacies of electroacupuncture and acupoint injection in the treatment of sudden deafness. Methods　Using a randomized controlled prospective study method, 165 patients who met the inclusion criteria of sudden deafness were treated in the Department of Otolaryngology, Head, and Neck Surgery, Guangzhou Red Cross Hospital, Jinan University from April 2018 to January 2021, including 67 males and 98 females, aged (53.1±11.3) years. They were stratified and randomly divided into an electroacupuncture group, an acupoint group, and a control group. The electroacupuncture group was given electroacupuncture + drug treatment, the acupoint group was given acupoint injection + drug treatment, and the control group was only given drug treatment. The efficacy, hemorheology, cerebrovascular Doppler, auditory brainstem response, complications, and pain score were compared, and the possible mechanism was explored. Pearson's Chi-square test, analysis of covariance, and Mann-Whitney U test were used. Results　The total effective rate of the electroacupuncture group was 87.3% (48/55), that of the acupoint group was 67.3% (37/55), and that of the control group was 63.6% (35/55); Pearson's Chi-square test showed that the total effective rate of the electroacupuncture group was better than those of the acupoint group and the control group (both P<0.05). Hemorheological examination showed that the whole blood viscosity and plasma viscosity of the three groups were improved after treatment, and the pairwise comparison showed that those in the electroacupuncture group were better than those in the acupoint group and the control group (all P<0.05). Cerebrovascular Doppler examination showed that 45 cases in the electroacupuncture group were abnormal before treatment, 47 cases in the acupoint group, and 45 cases in the control group, including the increase or decrease of blood flow velocity, abnormal pulse index (PI), etc., 40 cases, 31 cases, and 28 cases were improved after treatment, with the improvement rates of 88.9%, 66.0%, and 62.2% respectively, and the pairwise comparison showed that the improvement rate of the electroacupuncture group was significantly better than those of the acupoint group and the control group (both P<0.05). The examination of auditory brainstem response showed that 49 cases in the electroacupuncture group were abnormal before treatment, 47 cases in the acupoint group, and 47 cases in the control group, 43 cases, 31 cases, and 30 cases were improved after treatment, with the improvement rates of 87.8%, 66.0%, and 63.8% respectively, and the pairwise comparison showed that the improvement rate of the electroacupuncture group was better than those of the acupoint group and the control group (both P<0.05). In terms of safety evaluation, there were no complications such as skin injury or infection in the electroacupuncture group and the acupoint group. The pain score suggested that the median scores of the electroacupuncture group and the acupoint group were 2 points, Mann Whitney U test suggested that the difference was not statistically significant (P>0.05). Conclusions　In the treatment of sudden deafness, electroacupuncture is better than acupoint injection and drug treatment, and it is safe and reliable. Its mechanism may be related to improving the blood viscosity, cerebral blood supply, and auditory nerve function.

Key words: Sudden deafness, Electroacupuncture, Acupoint injection, Curative effect

于超生于锋邓海燕李军政黄昌锦李慧. 电针法、穴位注射法治疗突发性聋的临床疗效研究[J]. 国际医药卫生导报, 2022, 28(18): 2522-2527.

Yu Chaosheng, Yu Feng, Deng Haiyan, Li Junzheng, Huang Changjin, Li Hui. Clinical efficacy of electroacupuncture and acupoint injection in the treatment of sudden deafness[J]. International Medicine and Health Guidance News, 2022, 28(18): 2522-2527.

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