金纳多治疗突发性耳聋、耳鸣和眩晕临床观察
2017-08-30闫春阳
闫春阳
(大连市普兰店区中心医院耳鼻咽喉科,辽宁大连116000)
金纳多治疗突发性耳聋、耳鸣和眩晕临床观察
闫春阳
(大连市普兰店区中心医院耳鼻咽喉科,辽宁大连116000)
目的研究分析金纳多治疗突发性耳聋、耳鸣和眩晕患者的临床效果。方法随机选择突发性耳聋、耳鸣和眩晕患者作为研究对象,共选择96例患者,并按照随机数字抽取表法随机将96例患者分为两组,每组48例。其中对观察组采用金纳多片剂治疗,复方丹参治疗组采用复方丹参注射液、西比灵等联合治疗,对两组患者的突发性耳聋、耳鸣、眩晕等治疗效果进行比较。结果观察组患者耳鸣治疗有效率为75.56%,对照组耳鸣治疗有效率为51.11%,差异具有统计学意义(P<0.05);观察组患者眩晕治疗有效率为95.45%,对照组眩晕治疗有效率为90.47%,差异无统计学意义;观察组患者听力改善治疗有效率为91.67%,对照组患者听力改善治疗有效率为75.00%,差异具有统计学意义(P<0.05)。结论给予突发性耳聋、耳鸣和眩晕患者采用金纳多治疗,具有显著的治疗效果,能够充分改善患者的耳鸣、眩晕症状,改善患者的听力,值得在临床上推广应用。
金纳多;突发性耳聋;耳鸣;眩晕;治疗效果
突发性耳聋属于突然发生的神经性听力损失,伴有耳鸣、眩晕等症状,具有起病快和进展快等特征,目前认为主要与患者内容供血障碍关联较大[1]。当前对突发性耳聋的治疗方式包含扩血管、抗病毒和高压氧等,治疗效果并不显著,而金纳多作为从银杏叶中提取治疗血液循环障碍的药物,能够充分改善患者的血流变参数,并起到保护组织的作用,治疗突发性耳聋具有显著的效果[2]。本次研究对金纳多治疗突发性耳聋、耳鸣和眩晕的疗效进行了探讨,现报道如下。
1 资料与方法
1.1 临床资料本文所有研究对象均选自在本院接受治疗的突发性耳聋、耳鸣和眩晕患者,选择时间为2015年3月~2016年3月,共选择96例患者。按照随机数字抽取表法将96例患者分为观察组和对照组,其中观察组患者共48例,男26例,28耳,女22例,23耳,年龄15~68岁,平均年龄(55.23±5.99)岁,病程1 d~3个月,平均(1.02±0.55)个月,包含听力损失轻度6耳、听力损失中度14耳、听力损失中重度18耳、听力损失重度7耳,听力损失极重度6耳;眩晕患者22例,耳鸣患者45例。对照组患者共48例,男25例,27耳,女23例,25耳,年龄15~70岁,平均年龄(55.92±5.46)岁,病程1 d~3个月,平均(1.03±0.52)个月,包含听力损失轻度7耳、听力损失中度14耳、听力损失中重度19耳、听力损失重度7耳,听力损失极重度5耳;眩晕患者21例,耳鸣患者45例。两组患者的性别、年龄、病程及听力损失程度等临床资料相互比较,差异无统计学意义。
1.2 治疗方法
1.2.1 对照组给予对照组常规采用血管扩张药、抗凝剂及维生素等药物治疗,其中能量制剂静脉滴注,每天1次。加用复方丹参注射液治疗,每天1次,每次20 mL。
1.2.2 观察组给予观察组采用金纳多片剂或针剂进行治疗,其中耳鸣患者以片剂治疗为主,每天2~3次,每次80 mg。针对严重眩晕患者和突发性耳聋患者采用针剂治疗,每天2次,每次15 mL金纳多针剂+500 mL生理盐水,治疗10 d后,依据病情恢复情况,改为金纳多片剂治疗。两组患者均至少连续治疗14 d。
1.3 观察指标对两组患者的突发性耳聋、耳鸣、眩晕等治疗效果进行比较。突发性耳聋治疗效果:痊愈为患者听力恢复至30 dB;有效为患者听力至少提高30 dB;有效为患者听力提高10~30 dB;无效为患者听力提高低于10 dB。耳鸣治疗效果:痊愈为患者耳鸣症状完全消失;显效为患者耳鸣症状消失,但会复发;有效而患者耳鸣程度减轻;无效为患者耳鸣症状无改善。眩晕程度采用眩晕障碍评定量表(DHI)评估,计算治疗前后的降低程度,治疗效果:痊愈为患者眩晕症状完全消失或眩晕程度降低70%以上;显效为患者眩晕程度降低50%~70%;有效为患者眩晕程度降低30%~50%;无效为患者眩晕程度降低30%以下。治疗总有效率=(痊愈例数+显效例数+有效例数)/总例数×100%。
1.4 统计学方法对于本次研究记录的数据采用统计学软件SPSS 14.0进行分析,计量资料采用“x±s”表示,组间比较采用t检验;计数资料用例数(n)表示,计数资料组间率(%)的比较采用χ2检验。P<0.05为差异具有统计学意义。
2 结果
2.1 两组患者耳鸣治疗效果比较观察组患者耳鸣治疗有效率为75.56%,对照组耳鸣治疗有效率为51.11%,差异具有统计学意义(P<0.05)。见表1。
表1 两组患者耳鸣治疗效果比较Table 1 Comparison of two groups of patients with tinnitus treatment
2.2 两组患者眩晕治疗效果比较观察组患者眩晕治疗有效率为95.45%,对照组眩晕治疗有效率为90.47%,差异无统计学意义。见表2。
2.3 两组患者听力改善效果比较观察组患者听力改善治疗有效率为91.67%,对照组患者听力改善治疗有效率为75.00%,差异具有统计学意义(P<0.05)。见表3。
3 讨论
目前临床上认为突发性耳聋主要与病毒感染、血管疾病内淋巴水肿、迷路膜破裂等关联较大,且各项影响因素会对患者内耳微循环造成影响[3]。目前治疗突发性耳聋的药物主要以扩血管药物为主,主要是起到改善患者内耳微循环,调整微血管张力,实现改善患者听力的目的[4-5]。复方丹参注射液是丹参的提取物,在治疗微循环障碍性疾病方面有明显的效果,其主要起到改善微循环和稳定细胞膜等作用[6-7]。金纳多作为银杏叶提取物,能够成分改善患者的血管功能,降低血液粘稠度,消除患者体内过多的自由基,且对血小板活化因子有拮抗作用,整体治疗效果比较显著[8-9]。本次研究对金纳多和复方丹参注射液治疗突发性耳聋、耳鸣和眩晕的效果进行了比较,结果显示观察组患者耳鸣治疗有效率为75.56%,对照组耳鸣治疗有效率为51.11%,差异具有统计学意义(P<0.05),表明金纳多治疗能够有效改善患者耳鸣症状,减轻患者的不适感,提高患者听力。观察组患者眩晕治疗有效率为95.45%,对照组眩晕治疗有效率为90.47%,差异无统计学意义,表明金纳多治疗能够有效改善患者眩晕症状,促使患者恢复正常状态,提高患者生活质量;观察组患者听力改善治疗有效率为91.67%,对照组患者听力改善治疗有效率为75.00%,差异具有统计学意义(P<0.05),表明与复方丹参注射液治疗效果相比,给予突发性耳聋、耳鸣及眩晕患者实施金纳多治疗效果更加明显,能够有效改善患者的听力状况、眩晕症状和耳鸣症状[10]。
表2 两组患者眩晕治疗效果比较Table 2 Comparison of two groups of patients with vertigo treatment
表3 两组患者听力改善效果比较Table 3 Comparison of two groups of patients with hearing improvement
综上所述,金纳多治疗突发性耳聋、耳鸣和眩晕显著,有效减轻和消除耳鸣、眩晕症状,改善听力程度,在临床上应用具有重要的治疗价值,但纳入本次研究的患者数量较少,研究存在一定的不足,需要进一步扩大研究。
[1]王敏,姜永刚,侯庆军.鼠神经生长因子联合金纳多注射液治疗突发性耳聋的临床研究[J].中国地方病防治杂志,2014, s1(30):7-7.
[2]Goto Fumiyuki,Arai Miki,Kitamura Mitusru,et al. A Case of Undiagnosed Sleep Disorder with Hearing Difficulty and Dizziness[J].Iranian journal of otorhinolaryngology,2016,28(85):149-152.
[3]李颖,李玉杰,于敏.金纳多联合鼠神经生长因子治疗突发性耳聋的疗效观察[J].中国社区医师,2014,19(27):102,104.
[4]王敏.鼓室注射甲基强的松龙联合改善微循环药物综合治疗突发性聋的疗效观察[J].中国医药导刊,2016,8(17):820-821.
[5]Sang-Ki Min,Ji-Ho Shin,Mun-Young Chang,et al.Impact of control of blood glucose level during treatment of sudden deafness in diabetics:relationship withprognosis[J].EuropeanArchivesofOto-Rhino-Laryngology,2017,274(3):1339-1343.
[6]谢怡.甲泼尼龙治疗青少年不同类型突发性耳聋的临床效果[J].中国当代医药,2016,8(8):107-110.
[7]苑明茹.复方丹参注射液联合声频共振耳聋治疗仪治疗神经性耳鸣耳聋[J].中医临床研究,2016,12(7):37-38.
[8]郑烨贤,彭利艳,崔永华,等.全身联合鼓膜置管鼓室给予地塞米松治疗重度特发性突聋的疗效分析[J].华中科技大学学报(医学版),2015,3(35):339-343.
[9]MRD Maslin,SK Lloyd,S Rutherford,et al.Rapid Increase in Neural Conduction Time in the Adult Human Auditory Brainstem Following Sudden Unilateral Deafness[J].Journal of the Association for Research in Otolaryngology,2015,16(5):631-640.
[10]陆雪,王鑫霞,肖楚志,等.甲强龙耳后乳突区骨皮质下注射治疗突发性感音神经性耳聋35例临床观察[J].中国民族民间医药,2016,5(24):88-89.
[11]Cho Tsung-Yi,Cheng Po-Wen,Young Yi-Ho.Evolution of postirradiated sudden deafness in nasopharyngeal carcinoma survivors during the past two decades[J]. The Laryngoscope,2016,126(9):2016-2021.
[12]李东波,孙丽萍,韩锦华.不同类型的突发性耳聋的临床疗效观察[J].当代医学,2012,18(3):49-50.
[13]Jiang Jiping,Wang Shuyun,Tong Kang.Synergic effect of alprostadil injection and ginaton in treating sudden deafness[J].Journal of Clinical Otorhinolaryngology Head and Neck Surgery,2011,25(13):597-599.
[14]程文海,赵璟晶.金纳多对突发性耳聋患者血流动力学的影响[J].海南医学院学报,2012,18(11):1669-1671,1674.
[15]罗宏伟,李玉环,侯庆军,等.巴曲酶注射液联合甲强龙和金纳多治疗不同类型突发性耳聋临床疗效观察[J].中国临床医生,2014,7(42):82-83.
Ginaton treatment of sudden deafness,tinnitus and vertigo clinical observation
Yan Chun-yang
(Department of Otorhinolaryngology,Central Hospital of Pulandian District,Dalian,Liaoning,116000,China)
Kinnado;Sudden deafness;Tinnitus;Vertigo;Treatment effect
10.3969/j.issn.1009-4393.2017.23.029
Abstract:Objective To study the clinical curative effect of Ginaton treatment of sudden deafness,tinnitus and vertigo patients.Methods A total of 96 patients with sudden deafness,tinnitus and vertigo were selected randomly,and 96 patients were randomly divided into two groups,48 patients in each group.The observation group was treated with Ginaton tablets,compound Danshen treatment group were treated with Compound Danshen injection and flunarizine combined treatment,compare two groups of patients with sudden deafness,tinnitus,vertigo and other therapeutic effect.Results The effective rate was 75.56%in the observation group of patients treatment of tinnitus,tinnitus and in the control group,the effective rate of the treatment is 51.11%,statistically significant differences between the two groups of data(P<0.05);the effective rate of the observation group of patients with treatment of vertigo was 95.45%,the effective rate of the control group treatment of vertigo was 90.47%,the difference was not statistically significant;the patients in the observation group were hearing improvement the effective rate of treatment was 91.67%,patients in the control group the improvement of hearing treatment efficiency was 75%,statistically significant differences between the two groups of data(P<0.05).Conclusion Sudden deafness,tinnitus and vertigo were treated with Ginaton can obtain obvious therapeutic effect,not only can improve patients with tinnitus and vertigo symptoms,can improve the patient's hearing,it is worthy of clinical application.