| ObjectiveSudden deafness which happen suddenly, but within minutes, hours or3days, for unknown reasons, sensorineural hearing loss, at least in the2frequency hearing is reduced more than20dB, unless the eighth cranial nerve, no other symptoms of cranial nerve. The main pathological changes of peripheral nerve injury to listen to, a few central change. In recent years, the sudden deafness rate is on the rise, and tended to be young, has become a common otological disease seriously endangering the health of human hearing.In the treatment of sudden deafness, traditional Chinese medicine has unique advantages, especially acupuncture, to improve patient listening, contribute to neurological recovery had a significant effect. The famous master of acupuncture, Chinese Medicine Society "of the traditional Chinese medicine special contribution award" winner professor Yu Yun summary, based on years of clinical experience, put forward to the deficiency syndrome patients, application of reinforcing method acupuncture can pray the replenishing qi and blood, promote air-transfer-chang role.Experimental study on the basis of injury, the guinea pig model of qi deficiency and blood stasis syndrome in Corti hair cells of guinea pig, acupuncture therapy. Observation of guinea pig cochlear Corti cell apoptosis, observe the acoustic reflex test data (hearing damage and repair situation reflected in the role of apoptosis), objective evaluation of needle acupuncture against cochlear cells, repair damage to hearing, and explore the possible mechanism; at the same time, through the method of randomized controlled trials, lily, lily of the acupuncture group. Acupuncture plus medication group, single drug treatment group, normal acupuncture group and blank control group. Clinical study of patients with sudden deafness were randomly divided into experimental group (pulse acupuncture group), normal acupuncture group and blank control group, before and after treatment were compared and the accompanying symptoms of hearing. Through the animal experiment and clinical research of acupuncture, the curative effect and safety of sudden deafness in the verification using needle acupuncture; more "tonic" role, especially suitable for the treatment of asthenia syndrome, and provide scientific basis for clinical treatment. For acupuncture in the treatment of sudden deafness may provide the scientific and theoretical basis of mechanism, which lay a foundation for improving the therapeutic effect of acupuncture and moxibustion needle acupuncture, popularization in clinical practice.MethodsExperimental research:first model with Qi with irregularity of food consumption is improved, using Xiaochengqi Decoction on guinea pig stomach, gastric perfusion of fasting day by day, enough to eat to the limited feeding. Then the photochemical reaction method, copy the Corti hair cell injury model of blood stasis. Intravenous injection of Tetrachlorotetraiodofluorescein disodium salt, exposure to bubble, in20min green light exposure cochlea. Detection of serum D-xylose content after modeling, otoacoustic emission DPOAE test, confirmed that the model was successful. After the modeling, the guinea pigs were randomly divided into acupuncture group acupuncture needle, needle+drug group, single drug treatment group and blank control group, intervention and observation, two weeks after otoacoustic emission DPOAE test review, and the detection of D-xylose content, guinea pig serum and cochlea, under light microscope observation of cochlea morphology and Corti.Clinical research:from2011November to2013April in Department of ENT, treatment of qi deficiency and blood stasis syndrome in patients with sudden deafness were randomly divided into experimental group (pulse acupuncture group), normal acupuncture group and blank control group, experimental group with acupuncture needle reinforcing method Tinggong, Waiguan, Zusanli, Baihui, Sishencong, Zhongwan, Tianshu, ordinary acupuncture group with the reinforcing-reducing method of acupuncture, two groups acupuncture once, continuous acupuncture for12days, the blank control group without acupuncture treatment. Groups were compared before and after treatment of pure tone audiometry results and the accompanying symptoms, evaluation of comprehensive effects, secondary symptoms curative effect, TCM efficacy and safety, using t test, analysis of variance, covariance analysis and rank sum test was used for statistical analysis.ResultsExperimental study:model of guinea pig serum D-xylose content is low, suggesting its gastrointestinal absorption function decline, with Qi deficiency; otoacoustic emission test results of DPOAE show, after making the model more before modeling the amplitude of DPOAE decreased, the difference was significant(p<0.01). Changes of cochlear tissue morphogenesis-model: spiral ligament, stria vascularis, spiral limbus microvascular basement membrane, and the corresponding modiolus capillary micro thrombosis, vascular dilatation, stria vascular edema, peel dissociation, spiral ganglion cells decreased, nucleus concentrate; Corti inner hair cell degeneration, necrosis, deletion. Two weeks after modeling success, again otoacoustic emission DPOAE testing, results:the needle acupuncture group, acupuncture plus medication group of Flammulina velutipes DPOAE amplitude, the amplitude of DPOAE monotherapy in the treatment group were improved, but the degree of improvement than the needle acupuncture group and needle acupuncture+drug group, blank control group did not improve significantly the amplitude of DPOAE, difference compared with the other groups (P<0.05). After the treatment of cochlear morphology and Corti inner hair cells to normal transformation.Clinical research:a comprehensive analysis of curative effect of acupuncture and moxibustion group; palpation cured, markedly effective and effective ratio is relatively higher than the ordinary acupuncture group and blank group, rank sum test, the difference was statistically significant (P <0.05), pulse acupuncture group is better than the ordinary acupuncture tips and blank group; analysis of traditional Chinese medicine curative effect: pulse acupuncture group and effective the ratio is higher than the ordinary acupuncture group and blank group, rank sum test, the difference was statistically significant (p<0.05), suggesting the pulse acupuncture group is better than the ordinary acupuncture therapeutic effect of traditional Chinese medicine and the blank group; baseline analysis showed that:before treatment in three groups before treatment symptom score ranging from before treatment, the symptom score as a covariate, using analysis of covariance therapy the total score (as covariate) indicating the results:after correction, three groups was statistically significant difference after treatment score (p<0.05), suggesting the pulse acupuncture group total curative effect is better than the ordinary acupuncture group and blank group; analysis of secondary outcomes in three groups (symptoms), but had no significant difference between three groups (P>0.05and vertigo), tinnitus, ear plug feeling in the stuffy, threshold between three groups, the difference was statistically significant (P<0.05). Analysis showed that, pulse acupuncture treatment groups in secondary outcomes (symptoms) is better than the ordinary acupuncture group and blank group. Safety evaluation:the three groups were no adverse reaction.ConelusionIndicated through the research, the consumption of modified Qi, irregular diet method and photochemical reaction method, can successfully copy the deficiency of Qi and blood stasis Corti hair cell injury animal model. Acupuncture can significantly improve the curative effect of sudden deafness with acupuncture needle acupuncture, feel more "tonic" role, especially suitable for the treatment of asthenia syndrome. From the animal experiment can be inferred, acupuncture in the repair of sudden hearing loss of Corti inner hair cell degeneration, improve the hearing has positive effect. Pulse acupuncture is a safe and effective method for treatment of sudden deafness, worthy of promotion in clinical practice. |
PDF Full Text Request