针刺介入时机对突发性聋患者疗效的影响OA北大核心CSTPCDMEDLINE
Effect of acupuncture intervention time on the therapeutic effect in patients with sudden hearing loss
目的:研究不同针刺介入时机治疗突发性聋患者的临床疗效差异.方法:纳入突发性聋患者(87例,脱落1例),根据针刺介入时机分为早暴露组和晚暴露组,早暴露组为发病14 d内介入针刺治疗,晚暴露组为发病14 d后介入针刺治疗.应用倾向性评分匹配法均衡组间基线,最终成功匹配30对患者,每组各30例.两组患者均在西医基础治疗同时给予"颈部七线法"针刺治疗,每周针刺3次,隔日1次,共12次.治疗前、治疗后及治疗3个月后观察患者耳鸣残疾评估量表(THI)评分;治疗前后分别对患者进行纯音测听,评价临床疗效;采用多因素Logistic回归分析倾向性评分匹配前可能影响疗效的因素对临床疗效的影响.结果:与本组治疗前比较,两组患者治疗后及随访时THI评分均下降(P<0.05);与同时点晚暴露组比较,早暴露组治疗后及随访时THI评分均降低(P<0.05).早暴露组总有效率为80.00%(24/30),晚暴露组为53.33%(16/30),早暴露组总有效率高于晚暴露组(P<0.05).多因素Logistic回归分析结果显示,本研究中突发性聋的分型及中药使用情况并非影响总有效率的独立因素.结论:介入时机是影响针刺治疗突发性聋患者听力疗效及耳鸣残疾程度的重要因素,早期针刺介入的疗效优于晚介入.
Objective To observe the clinical efficacy of acupuncture intervention at different time for patients with sudden hearing loss.Methods According to the timing of acupuncture intervention,86 patients were divided into early exposure group(n=43)and late exposure group(n=43).The early exposure group was given acupuncture treatment within 14 days of onset,and the late exposure group was given acupuncture treatment after 14 days of onset.After propensity score matching(PSM,a statistical matching technique for observational data)processing by using SPSS26.0 software,outcomes of 30 cases in the early exposure group and 30 cases in the late exposure group were analyzed.In addition to receiving basic treatment with drugs for vascular dilatation,thrombolysis,nourishing nerve,etc.,all patients of the two groups were treated with neck acupuncture("Neck Seven Meridian Lines"acupuncture),once every other day except Sundays,for a total of 12 time.Before,after the treatment and 3 months after the treatment,the total score of the Tinnitus Handicap Inventory(THI,0,2 and 4 points for each of the 25 items,total scores=100 points)scale was used to evaluate the improvement of tinnitus symptoms caused by hearing loss.The clinical therapeutic effect was evaluated according to the efficacy grading criteria in the Guidelines for Diagnosis and Treatment of Sudden Deafness(2015)and the changes of pure tone audiometry curve.Multivariate Logistic regression was used to analyze the effect of factors that might influence efficacy before propensity score matching.Results The THI scores of patients in both groups decreased strikingly after the treatment and 3 months'follow-up(P<0.05).Compared with the same time-points of the late exposure group,the total THI scores of post-treatment and 3 months'follow-up were evidently lower in the early exposure group(P<0.05).The effective rate of the early exposure group(22/30,80.00%)was significantly higher(P<0.05)than that of the late exposure group(16/30,53.33%).The classification of sudden deafness and the application of traditional Chinese medicine in this study were not independent factors affecting the total effective rate.Conclusion The time point of acupuncture intervention is an important factor affecting the effect on hearing and tinnitus disability of patients with sudden deafness.The earlier acupuncture treatment is accepted,the better the therapeutic effect is.
石安妮;李阳;张佳佳;邢御;洪玉颖;白鹏
北京中医药大学东直门医院针灸科,北京 100700北京中医药大学第三附属医院针灸科,北京 100029
突发性聋针刺介入时机颈部七线法耳鸣残疾评估量表
Sudden hearing lossAcupunctureIntervention time"Neck Seven Meridian Lines"acupunctureTinnitus handicap inventory scale
《针刺研究》 2024 (006)
618-624 / 7
北京市自然科学基金面上项目(No.7222283);全国中医药创新骨干人才培训项目(No.国中医药人教函[2019]128号);2022年青年岐黄学者培养项目(No.国中医药人教函[2022]256)
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