| Objective:To investigate the routine adjuvanttreatment of sudden deafness with a combination of Trimetazidine and Compound depside salt clinical curative effect.Method:1.Reference reports have shown that Trimetazidine and Compound depside salt are effective in the adjuvant treatment of sudden deafness.Before determining the use of Trimetazidine and Compound depside salt in the treatment of sudden deafness,we performed a pilot study on the use of Trimetazidine alone and adjunctive therapy with Compound depside salt in the treatment of sudden deafness.Sibutramine Trimetazidine,Compound depside salt used alone have certain clinical curative effect in the treatment of sudden deafness,the pharmacological mechanism of two different,they are increasing the energy medicine cell from different angles,so we have the foundation of the two scholars in the successful treatment of cardiovascular and cerebrovascular diseases,to explore the clinical value of treatment of sudden deafness.2.Review from May 2012 to April 2015 in our hospital of Otolaryngology Head and Neck admitted to the Department of surgery of the sensorineural deafness,listen to the exclusive acoustic neuroma,explosive deafness and drug poisoning deafness,exclusion of patients with diabetes,thyroid dysfunction,coronary heart disease,malignant tumor,drug allergy and other basic lactating women disease,exclusive bilateral sensorineural deafness,midway because of economic reasons,exclusive working relationship,returns to the local treatment of foreign patients abandoned treatment,finally 125 cases were enrolled in the project.2.1 Collect 125 cases of sudden deafness patients,according to results of pure tone audiometry,the average hearing threshold of 500 Hz,1000Hz,2000 Hz and 4000 Hz as the benchmark,the condition is divided into mild,moderate,severe and severe.The patients with reference to the degree of injury and pure tone audioCmetry hearing curve were randomly divided into two groups: 62 cases in the control group,the treatment group of 63 cases.2.3 Vestibular and cochlear function evaluation:Among the 125 patients with sudden deafness,44 cases(35.2%)were accompanied by vertigo,81 cases(64.8%)without vertigo,and only partial cases involving vestibular function.Among the 125 patients with sudden deafness,115 cases(92%)with Ipsilateral Tinnitus,10 without tinnitus(8%).Most of the patients suffered from tinnitus accompanied by tinnitus and only a few patients had no tinnitus.2.4 The control group received conventional treatment:[1] Glucocorticoid treatment: take a dose of prednisone at morning and morning(the initial amount is 30 mg,decrease 5mg/d),the course of treatment is ten days.[2] Inhibition of platelet aggregation drugs: slow intravenous infusion of alprostadil,10g+10ml,physiological saline 1 times / day,for 10 days.[3] Neurotrophic drugs: oral Mecobalamin Tablets(500ug,3 times / day)for ten days.The experimental group was treated with Trimetazidine tablets(20mg 3 times / day)on the basis of the treatment of the control group,and Compound depside salt 200 mg +5%Glucose 250 ml and 1 times a day for ten days.2.5 In the experimental group,the control group treated with Trimetazidine tablets(20mg daily,3 times daily for 7:00AM 1:00PM 7:00PM continue to take 10 days);and intravenous5% glucose 250ml+ s Compound depside salt(200mg 1 times daily for 9:30AM,continuous intravenous infusion for 10 days).3.Observe the clinical curative effect of two groups of patients:3.1 The change of pure tone audiometry.3.2 Improvement of vertigo symptoms.3.3 Improvement of tinnitus.3.4 Hemorheological indexes: according to the changes of the whole blood viscosity,plasma viscosity,hematocrit and fibrinogen of the patients after treatment,the curative effect was evaluated.Result:1.Clinical efficacy comparison between the two groupsThe control group: 10 cases were cured,12 cases were markedly effective,8 cases were effective,15 cases were ineffective.The experimental group: 19 cases were cured,15 cases were markedly effective,7 cases were effective,4 cases were ineffective.The Wilcoxon rank sum test of two groups was used to complete random design,u=2.898,p=0.004.The difference was statistically significant,that the efficacy of the experimental group is better than the control group.2.Two groups of ten days after blood rheology index changesThe two groups after treatment were compared with test completely randomized design:whole blood viscosity,plasma viscosity and fibrinogen of the two groups had statistical significant differences after treatment,however the hematocrit of two groups after treatment had no significant difference.3.Adverse reactionsThere were 5 cases of adverse drug reaction process test groups,of which 2 cases were mild headache,1 cases had mild skin itching,rash,due to mild,non termination of medication.Conclusion:The treatment of combining Trimetazidine and Salvianolate with Compound depside salt can effectively reduce the concentration of fibrinogen,blood viscosity,thrombosis,calcium ion concentration in blood vessels.Besides,this treatment can inhibit erythrocyte aggregation,inhibition of vascular spasm,improve blood flow as well as blood rheology.Moreover it can get through the labyrinth barrier into the inner ear,improve hypoxia ischemia,and metabolic disorder of inner ear cells.Last but not least,it can also protect cochlear hair cells,so that patients with auditory function recovery,which is worthy of future integration. |
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