[1]刘婉婷,陈荣荣,张雅婷,等.宁神通窍法治疗神经性耳鸣伴听力下降随机对照试验及相关性分析[J].陕西中医,2025,46(4):550-554.[doi:DOI:10.3969/j.issn.1000-7369.2025.04.025]
　LIU Wanting,CHEN Rongrong,ZHANG Yating,et al.Randomized controlled trial and correlation analysis of Ningshen Tongqiao therapy for neurotic tinnitus with hearing loss[J].,2025,46(4):550-554.[doi:DOI:10.3969/j.issn.1000-7369.2025.04.025]
点击复制

宁神通窍法治疗神经性耳鸣伴听力下降随机对照试验及相关性分析
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年4期
页码:
550-554
栏目:
针灸经络
出版日期:
2025-04-20

文章信息/Info

Title:
Randomized controlled trial and correlation analysis of Ningshen Tongqiao therapy for neurotic tinnitus with hearing loss
作者:
刘婉婷1; 陈荣荣1; 张雅婷1; 刘思城1; 于雷雨1; 叶子愚1; 黄志霖1; 查必祥1; 杨 骏2
(1.安徽中医药大学第一临床医学院,安徽 合肥 230031; 2.安徽中医药大学第一附属医院,安徽 合肥 230031)
Author(s):
LIU Wanting1; CHEN Rongrong1; ZHANG Yating1; LIU Sicheng1; YU Leiyu1; YE Ziyu1; HUANG Zhilin1; ZHA Bixiang1; YANG Jun2
(1.The First Clinical Medical Collage of Anhui University of Chinese Medicine,Hefei 230031,China; 2.The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)
关键词:
神经性耳鸣;  宁神通窍;  针刺;  随机对照;  临床疗效;  相关性分析
Keywords:
Neurogenic tinnitus;  Ningshen Tongqiao;  Acupuncture;  Randomized controlled;  Clinical efficacy;  Correlation analysis
分类号:
R 276.1
DOI:
DOI:10.3969/j.issn.1000-7369.2025.04.025
文献标志码:
A
摘要:
目的:探讨宁神通窍法治疗神经性耳鸣伴听力下降患者的临床疗效及耳鸣病程与针刺效应、临床特征的相关性。方法:选取120例神经性耳鸣伴听力下降患者,通过随机数字表法分为观察组(60例,脱落2例)和对照组(60例,脱落2例)。对照组予以钝头Streitberger安慰剂针治疗,穴取大椎穴、百会穴、哑门穴和患侧听宫穴、头窍阴穴、翳风穴、中渚穴,听宫、头窍阴连接两极,不接通电流; 观察组采用对照组中相同穴位,予以宁神通窍法针刺治疗,听宫、头窍阴两穴接入电针仪,采用疏密波,频率2/50 Hz,以患者能耐受为度; 两组均治疗20次,每周3次,每次30 min,共2个疗程。观察两组治疗前后的耳鸣残疾评估量表(THI)、耳鸣评价量表(TEQ)评分、平均气导听阈值、匹茨堡睡眠质量指数(PSQI)及医院用焦虑抑郁量表(HADS)评分。结果:观察组总有效率为87.93%,对照组总有效率62.07%,两组比较差异有统计学意义(P<0.05)。治疗后,两组THI、TEQ、PSQI、HADS评分及平均气导听阈值显著改善(均P<0.05),且观察组改善程度优于对照组(均P<0.05)。相关性分析结果显示,病程与神经性耳鸣患者治疗前平均气导听阈值(r=0.333,P<0.01)呈正相关,与THI、TEQ、PSQI、HADS评分无明显相关性。观察组中平均听阈值变化值与病程(r=-0.306,P<0.05)呈负相关,与THI变化值(r=0.372,P<0.05)呈正相关; 对照组中平均听阈值变化值与THI变化值(r=0.371,P<0.05)呈正相关,与病程无明显相关性。结论:宁神通窍法治疗神经性耳鸣有较好的临床疗效,且病程越长,听力受损越严重,针刺改善听力水平和耳鸣症状的效果越差,应在疾病初期介入治疗,以改善患者听力水平,降低耳鸣严重程度,改善生活质量。
Abstract:
Objective:To investigate the clinical efficacy of Ningshen Tongqiao method in the treatment of neurogenic tinnitus with hearing loss,as well as the correlation between the duration of tinnitus and the effect of acupuncture and the clinical characteristics of tinnitus.Methods:120 patients with neurogenic tinnitus with hearing loss were selected and divided into an observation group(60 cases,2 cases of shedding)and a control group(60 cases,2 cases of shedding)by using digital randomization table method.The control group was treated with blunt-ended Streitberger placebo needles,and the points were Dazhui,Baihui,Yamen,the affected side's Tinggong,Touqiaoyin,Yifeng and Zhongzhu.The points of Tinggong and Touqiaoyin were connected to the poles without electric current.The observation group was treated with the same acupoints as those in the control group and was given Ningshen Tongqiao acupuncture method,and the two points of Tinggong and Touqiaoyin were connected tothe electroacupuncture apparatus,and the sparse and dense wave was used with the frequency of 2/50 Hz,according to the patient's tolerance.Two groups were treated 20 times each,3 times a week,30 minutes each time,a total of two courses.Observe the scores of Tinnitus Handicap Inventory(THI),Tinnitus Evaluation Questionnaire(TEQ),average threshold of air permeability hearing,Pittsburgh Sleep Quality Index(PSQI)and Hospital Anxiety and Depression Scale(HADS)before and after the treatment of two groups.Results:The total effective rate was 87.93% in the observation group and 62.07% in the control group and there were statistical differences between the two groups(P<0.05).After treatment,there were significant improvements in THI,TEQ,PSQI,HADS scores and mean air-conducted hearing thresholds in both groups(all P<0.05),and the degree of improvement in the observation group was better than that in the control group(all P<0.05).The results of correlation analysis demonstrated that the duration of the disease was positively correlated with the mean air-conducted hearing thresholds before treatment in patients with tinnitus(r=0.333,P<0.01),and there was no significant correlation with THI,TEQ,PSQI,and HADS scores.In the observation group,the change value of mean hearing threshold was negatively correlated with the duration of the disease(r=-0.306,P<0.05),and positively correlated with the change value of THI(r=0.372,P<0.05).In the control group,the change value of mean hearing threshold was positively correlated with the change value of THI(r=0.371,P<0.05),and there was no significant correlation with the duration of the disease.Conclusion:The treatment of nerve-induced tinnitus by Ningshen Tongqiao has good clinical effect.Moreover,the longer the course of the disease,the more serious the hearing loss,the worse the effect of acupuncture to improve the hearing level and tinnitus symptoms,should be interventional treatment at the early stage of the disease to improve the hearing level of patients,reduce the severity of tinnitus,and improve the quality of life.

参考文献/References:

[1] ESMAILI A A,RENTON J.A review of tinnitus[J].Aust J Gen Pract,2018,47(4):205-208.
[2] 魏翠萍,张红文,王飒,等.神经性耳鸣的中医治疗研究进展[J].中国疗养医学,2024,33(10):77-79.
[3] TUNKEL D E,BAUER C A,SUN G H,et al.Clinical practice guideline:Tinnitus executive summary[J].Otolaryngol Head and Neck Surg,2014,151(4):533-541.
[4] 于艳艳,宋春侠,吕树泉.中西医治疗神经性耳鸣研究进展[J].河南中医,2021,41(6):969-972.
[5] 张蕊玉,马玉侠,董志斌,等.神经性耳鸣的中医外治法研究进展[J].现代中西医结合杂志,2022,31(20):2915-2920.
[6] YU S,WU J,SUN Y,et al.Advances in acupuncture treatment for tinnitus[J].Am J Otolaryngol,2024,45(3):104215.
[7] 范金桃.针灸疗法治疗耳鸣的临床研究概况和思考[J].中国民间疗法,2023,31(5):122-125.
[8] KUZUCU I,KARACA O.Acupuncture treatment in patients with chronic subjective tinnitus:A prospective,randomized study[J].Med Acupunct,2020,32(1):24-28.
[9] 龚淑兰.电针乳突四穴联合甲钴胺治疗特发性耳鸣的临床效果[J].中国当代医药,2024,31(16):90-93.
[10] 刘蓬,郑芸,卢兢哲,等.《欧洲多学科耳鸣指南:诊断、评估和治疗》解读[J].听力学及言语疾病杂志,2020,28(6):727-732.
[11] 武晓冬,黄龙祥,赵京生.《经穴名称与定位》(GB/T 12346-2021)标准解读[J].中国针灸,2022,42(5):579-582.
[12] 卢兢哲,钟萍,郑芸.欧洲多学科耳鸣指南:诊断、评估和治疗[J].听力学及言语疾病杂志,2020,28(1):110-114.
[13] 宋琳.耳鸣残疾量表评估耳鸣疗效的临床观察[J].海军医学杂志,2013,34(6):391-437.
[14] 倪嘉俞,李圆.边缘系统参与耳鸣相关负性情绪发生的研究进展[J].健康研究,2022,42(5):559-562.
[15] 柴泽锟,阿如娜,马锐,等.孟德尔随机化分析失眠与神经系统疾病及耳鸣的因果关系[J].神经损伤与功能重建,2024,19(9):518-523.
[16] CHARI D A,LIMB C J.Tinnitus[J].Med Clin North Am,2018,102(6):1081-1093.
[17] 武杰,朱新枝,马圣凯,等.针灸优势技术组合治疗神经性耳鸣的临床疗效观察[J].山西中医学院学报,2018,19(2):52-53.
[18] 徐海蓉,刘瑜,李贺,等.交替取穴电针治疗神经性耳鸣的疗效分析及对机体微循环状态和中枢神经递质的影响[J].现代生物医学进展,2023,23(20):3865-3868.
[19] 尹童,周鸿飞.浅议耳周三穴治疗耳聋的理论基础及作用机制[J].按摩与康复医学,2022,13(22):33-36,40.
[20] 孟培燕.翳风穴证治机理浅探[J].湖北中医杂志,2001,23(8):40.
[21] 李宁,高杰.哑门穴层次解剖结构与安全针刺的意义[J].中国中医药现代远程教育,2014,12(13):58-59.
[22] 张雅婷,杨骏,袁爱红,等.杨骏教授针灸治疗慢性耳鸣经验撷要[J].浙江中医药大学学报,2022,46(6):665-668.
[23] 许军.四神聪、百会穴针刺联合加味酸枣仁汤对失眠患者神经递质水平及睡眠质量的影响[J].光明中医,2020,35(23):3774-3776.
[24] 张雅婷,查必祥,石海平,等.基于fMRI初探宁神通窍法针刺对主观性耳鸣患者前扣带回与全脑功能连接的调控作用[J].中国针灸,2024,44(1):12-18.
[25] 吴炜,王敬卿,惠振.五风穴联合晕听区针刺与前庭代偿理论探讨[J].中国中医急症,2021,30(8):1423-1427.
[26] 徐静艳,魏小丽,阚俊微,等.电针晕听区配合耳鸣RS治疗脑鸣15例[J].中医外治杂志,2017,26(2):31-32.

相似文献/References:

[1]杨 允,刘崇敏,承伟康,等.理气化痰方联合西药治疗痰火郁结型神经性耳鸣及对患者微循环和中枢神经递质的影响[J].陕西中医,2022,(11):1563.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.017]
　YANG Yun,LIU Chongmin,CHENG Weikang,et al.Effects of Liqi Huatan recipe combined with western medicine in the treatment of phlegm-fire stagnation type nervous tinnitus on microcirculation and central neurotransmitters[J].,2022,(4):1563.[doi:DOI:10.3969/j.issn.1000-7369.2022.11.017]

备注/Memo

备注/Memo:
[基金项目]国家自然科学基金资助项目(82104994); 国家中医药管理局全国名中医杨骏传承工作室建设项目[皖中医药发展秘(2022)19号]; 安徽省临床医学研究转化专项(202304295107020125); 安徽省高校自然科学研究项目(2022AH050468)
更新日期/Last Update: 2025-04-08