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掩蔽疗法联合天麻素注射液对突发性耳聋伴耳鸣患者的临床效果
张玉波,单春光,王卫娟,韩海霞,李杰
0
(河北医科大学第二医院耳鼻喉一科)
摘要:
【摘要】 目的 探讨突发性耳聋(SD)伴耳鸣应用掩蔽疗法联合天麻素注射液治疗的临床效果。方法 选取2018年4月~2018年9月我院收治的82例SD伴耳鸣患者,运用简单随机数字表法将其分成观察组与对照组,每组患者41例。对照组采取天麻素注射液治疗,连用10 d;观察组在此基础上联合掩蔽疗法治疗,连续治疗90 d。治疗10 d后评价两组SD疗效,并于治疗90 d后观察两组耳鸣疗效。治疗前及治疗10、30、90 d时对两组耳鸣致残情况[耳鸣致残量表(THI)]、耳鸣严重程度[耳鸣评价量表(TEQ)]各测评1次,同时利用酶联免疫法检测两组血清中可溶性血管细胞黏附分子(sVCAM-1)、高迁移率族蛋白(HMGB1)水平。记录两组与治疗相关的副反应。结果 观察组SD、耳鸣的总有效率均显著高于对照组(P<0.05)。随治疗时间的延长,两组THI评分和TEQ评分均逐渐下降(P<0.05),且观察组治疗10、30、90 d时的THI、TEQ评分较同期对照组均更低(P<0.05)。随治疗时间的延长,两组血清sVCAM-1、HMGB1浓度也均逐渐降低(P<0.05);观察组治疗10、30、90 d时的血清sVCAM-1、HMGB1含量均显著低于同期对照组(P<0.05)。所有患者均无明显副作用发生。结论 应用掩蔽疗法联合天麻素注射液治疗SD伴耳鸣有助于挽救患者的受损频率听力,改善耳鸣症状,减轻耳鸣对患者的不良影响,提高生存质量,其作用机制可能与下调血清中sVCAM-1、HMGB1的表达水平有关。
关键词:  突发性耳聋  耳鸣  掩蔽疗法  天麻素注射液  可溶性血管细胞黏附分子 1  高迁移率族蛋白β1
DOI:
基金项目:2018年河北省医学科学研究重点课题计划项目(20180286)
Effect of masking therapy combined with gastrodin injection on serum sVCAM-1 and HMGB1 levels in patients with sudden deafness and tinnitus
ZHANG Yubo,SHAN Chunguang,WANG Weijuan,HAN Haixia,LI Jie
(The First Department of E.N.T, The Second Hospital of Hebei Medical University)
Abstract:
【Abstract】 Objective To explore clinical effect of masking therapy combined with gastrodin injection on sudden deafness (SD) with tinnitus. Methods 82 SD patients with tinnitus admitted to our hospital from April 2018 to September 2018 were randomly divided into observation group and control group by simple random number table method, 41 patients in each group. The control group was treated with gastrodin injection for 10 days, and the observation group was treated with masking therapy for 90 days. The curative effect of SD in the two groups was evaluated 10 days after treatment, and tinnitus in the two groups was observed 90 days after treatment. Before and after 10, 30 and 90 days of treatment, the tinnitus disability (THI) and tinnitus severity (TEQ) were assessed once respectively. Meanwhile, the serum levels of soluble vascular cell adhesion molecule (sVCAM 1) and high mobility group protein (HMGB1) were detected by enzyme-linked immunosorbent assay. Side effects related to treatment were recorded in both groups. Results The total effective rates of SD and tinnitus in the observation group were significantly higher than those in the control group (P<0.05). With the prolongation of treatment time, the scores of thi and TEQ in the two groups decreased gradually (P<0.05), and the scores of thi and TEQ in the observation group were lower than those in the control group at the same time point (P<0.05). With the prolongation of the treatment time, the serum levels of sVCAM 1 and HMGB1 in the two groups decreased gradually (P<0.05), and the serum levels of sVCAM 1 and HMGB1 in the observation group were significantly lower than those in the control group (P<0.05). No side effects were found in all patients. Conclusion The application of masking therapy combined with gastrodin injection in the treatment of SD with tinnitus is helpful to save the hearing of the patients with damaged frequency, improve the tinnitus symptoms, reduce the adverse effects of tinnitus on the patients, and improve the quality of life. The mechanism may be related to the decrease of the expression level of sVCAM 1 and HMGB1 in serum.
Key words:  Sudden deafness with tinnitus  Masking therapy  Gastrodin injection  Soluble vascular cell adhesion molecule-1  High mobility group protein B1

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