[目的]探讨纯中医规范化综合治疗短病程突发性聋(简称突聋)的临床疗效及其影响因素.[方法]对516例采用纯中医规范化综合治疗的短病程突聋住院患者(中医组)的临床资料进行回顾性分析,并与《中国突发性聋分型治疗的多中心临床研究》的1 024例患者(西医组)的疗效进行对照,分析患者性别、耳别、年龄、耳聋程度、听力曲线类型、伴随症状(耳鸣、眩晕、耳闷)及中医证型对疗效的影响.[结果](1)基线资料比较:与西医组相比,中医组低频下降型占比较低,全聋型占比较高,治疗难度相对较大,而疗程缩短近2/3(12.60 d vs 30.00 d).(2)疗效分析:中医组516例患者中,痊愈175例,显效121例,有效90例,无效130例,总有效率为74.80%,与西医组1 024例相比,无论总体疗效还是按听力曲线分类统计疗效,差异均无统计学意义(P＞0.05).(3)疗效影响因素分析:听力曲线类型与突聋疗效关系密切(P＜0.001),低频下降型疗效最好,全聋型疗效最差;耳聋程度越轻,痊愈可能性越大(P＜0.001);无眩晕者疗效优于伴眩晕者(P＜0.001);青少年患者疗效较中老年好(P＜0.05);中医证型与疗效无关(P＞0.05).[结论]纯中医规范化综合治疗短病程突聋疗效较好,与西医常规治疗相比可能具有一定的优势;听力曲线类型、耳聋程度、是否伴随眩晕及年龄是影响疗效的相关因素.
Curative Effect of Standardized Comprehensive Pure Traditional Chinese Medicine Treatment for Short-Course Sudden Deafness:An Observation of 516 Cases
Objective To investigate the clinical efficacy of standardized comprehensive pure traditional Chinese medicine(TCM)treatment for short-course sudden deafness and to explore the influencing factors of clinical efficacy.Methods The clinical data of 516 short-course sudden deafness inpatients(TCM group)who were given standardized comprehensive pure TCM treatment were retrospectively analyzed,and their efficacy were compared with the efficacy of 1 024 cases in the Chinese multicenter clinical study of sudden deafness(western medicine group).The analysis was carried out for the influence of the gender,left or right ear,age group,degree of deafness,type of hearing curve,concomitant symptoms(tinnitus,vertigo,and dullness of the ear),and the TCM syndrome types on the efficacy.Results(1)The comparison of baseline data showed that in comparison with the western medicine group,TCM group had relatively low proportion of low-frequency descending type while relatively high proportion of total deafness type,and had relatively high treatment difficulty.The course of treatment in TCM group was shortened by nearly 2/3 in comparison with the western medicine group(12.60 days vs 30 days).(2)Among the 516 patients of the TCM group,175 cases were cured,121 cases were markedly effective,90 cases were effective and 130 cases were ineffective,and the total effective rate was 74.80%.Compared with the 1 024 cases in the western medicine group,there was no significant difference in the overall efficacy or the efficacy evaluated with the hearing curve classification(P＞0.05).(3)Analysis of influencing factors of curative effect showed that the type of hearing curve was closely related to the curative effect of sudden deafness(P＜0.001).The curative effect of low frequency descent type was the best,and the curative effect of total deafness type was the worst.The cure of deafness was correlated with the degree of deafness,the milder the degree of deafness,the greater the likelihood of recovery(P＜0.001).The curative effect of the patients without vertigo was superior to that of the patients with vertigo(P＜0.001).The curative effect of adolescent patients was superior to that of middle-aged and elderly patients(P＜0.05).There was no correlation between TCM syndrome types and curative effect(P＞0.05).Conclusion Standardized comprehensive pure TCM treatment exerts certain curative effect on short-course sudden deafness,and may have some advantages compared with conventional western medicine treatment.The type of hearing curve,degree of deafness,accompanied by vertigo or not,and age group are the influencing factors of the efficacy.
sudden deafnessshort-coursestandardized comprehensive pure traditional Chinese medicine(TCM)treatmentinfluencing factorstype of hearing curvedegree of deafnessvertigoage
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