Abstract:

Objective　To explore the effect of postauricular acupoint injection of methylprednisolone sodium succinate combined with modified Longdan Xiegan decoction in the treatment of patients with sensorineural hearing loss (SNHL). Methods　Sixty patients with SNHL treated in Department of Vertigo Diseases, Yinchuan Hospital of Traditional Chinese Medicine, Ningxia Medical University from January to September 2024 were selected for the randomized controlled trial, and were divided into a treatment group (30 cases) and a control group (30 cases) by the random number table method. In the treatment group, there 15 males and 15 females; they were (49.53±10.38) years old; their disease duration was (6.43±2.33) months. In the control group, there were 16 males and 14 females; they were (49.63±10.11) years old; their disease duration was (6.30±2.35) months. The treatment group took the postauricular acupoint injection of methylprednisolone sodium succinate and Longdan Xiegan decoction, and the control group methylcobalamin tablets, for 4 weeks. The pure tone hearing threshold measurement, scores of Tinnitus Assessment Scale, and auditory brainstem response I-wave latency before and after the treatment, clinical efficacies, and adverse reactions were compared between the two groups by t, U, rank sum, and χ² tests. Results　Before and after the treatment, the values of pure tone hearing threshold determination [low-frequency (0.5 kHz), middle-frequency (1.0 kHz), and high-frequency (2.0 kHz)], score of Tinnitus Assessment Scale, and auditory brainstem response I-wave latency in the treatment group were (57.33±13.16) dB, (31.83±6.94) dB, 52.50 (45.00, 65.00) dB, 34.50 (27.00, 37.00) dB, (53.73±10.99) dB, (24.73±4.78) dB, 53.07±13.18, 29.20±6.99, 0 (0, 0.50) s, and 0 (0, 0.20) s, respectively; and the above indicators in the control group were (56.10±12.27) dB, (33.77±7.68) dB, 53.00 (44.00, 65.00) dB, 34.00 (27.75, 41.25) dB, (53.83±1.49) dB, (31.96±1.68) dB, 52.60 (26.30, 78.90), 35.50 (28.50, 42.25), 0.15 (0, 0.50) s, and 0.10 (0, 0.40)s, respectively; there were statistical differences in the above indicators between before and after the treatment in both groups (all P<0.05). The total effective rate in the treatment group was higher than that in the control group [96.67% (29/30) vs. 90.00% (27/30)], with a statistical difference (χ²=4.250; P<0.05). The overall tolerability in both groups during the treatment was good, and no serious adverse reactions occurred. Conclusion　Postauricular acupoint injection of methylprednisolone sodium succinate combined with modified Longdan Xiegan decoction in the treatment of patients with SNHL is effective and safe, and can improve their clinical symptoms and hearing status.

Key words: Sensorineural hearing loss,  , Methylprednisolone sodium succinate,  , ModifiedLongdan Xiegan , decoction,  , Acupuncture point injection

摘要：

目的　探讨耳后穴位注射甲泼尼龙琥珀酸钠联合龙胆泻肝汤加味治疗感音神经性耳聋（SNHL）患者的效果。方法　选取2024年1月至9月在宁夏医科大学附属银川市中医医院眩晕病科治疗的SNHL患者60例进行随机对照试验。采用随机数字表法将其分为治疗组和对照组，各30例。治疗组男15例，女15例，年龄（49.53±10.38）岁，病程（6.43±2.33）个月。对照组男16例，女14例，年龄（49.63±10.11）岁，病程（6.30±2.35）个月。治疗组耳后穴位注射甲泼尼龙琥珀酸钠联合龙胆泻肝汤加味治疗，对照组口服甲钴胺片治疗，均连续用药4周。对比两组治疗前、治疗后纯音听阈测定、耳鸣残障量表评分、听性脑干反应Ⅰ波潜伏期、临床疗效与不良反应情况。统计学方法采用t检验、U检验、秩和检验、χ²检验。结果　治疗前及治疗后，治疗组患者纯音听阈测定［低频（0.5 kHz）、中频（1.0 kHz）、高频（2.0 kHz）］、耳鸣残障量表评分、听性脑干反应I波潜伏期分别为（57.33±13.16）dB、（31.83±6.94）dB、52.50（45.00，65.00）dB、34.50（27.00，37.00）dB、（53.73±10.99）dB、（24.73±4.78）dB、（53.07±13.18）分、（29.20±6.99）分、0（0，0.50）s、0（0，0.20）s；对照组上述指标分别为（56.10±12.27）dB、（33.77±7.68）dB、53.00（44.00，65.00）dB、34.00（27.75，41.25）dB、（53.83±1.49）dB、（31.96±1.68）dB、52.60（26.30，78.90）分、35.50（28.50，42.25）分、0.15（0，0.50）s、0.10（0，0.40）s；两组治疗前后上述指标比较，差异均有统计学意义（均P<0.05）。治疗组总有效率96.67%（29/30），高于对照组的90.00%（27/30），差异有统计学意义（χ²=4.250，P<0.05）。两组患者治疗期间总体耐受性良好，均未出现严重不良反应。结论　耳后穴位注射甲泼尼龙琥珀酸钠联合龙胆泻肝汤加味治疗SNHL患者效果显著，安全性好，可改善患者临床症状和听力状况。

关键词: 感音神经性耳聋, 甲泼尼龙琥珀酸钠, 龙胆泻肝汤加味, 穴位注射