Meta-analysis Of A Randomized Controlled Trail Of Acupuncture For Sudden Hearing Loss

Objective: Sudden deafness is a Sudden,unexplained sensorineural hearing loss.As a common emergency in otolaryngology,it often causes the hearing loss to reach its lowest point in a very short period of time.Currently,there are few epidemiological data on this disease in China.However,in recent years,studies have shown that the incidence of sudden deafness tends to be younger,and the unexplained nature of the disease also lead to an increase in the proportion of patients with insignificant therapeutic effect[1].The unclear pathogenesis[2]brings inconvenience to western medicine in the treatment of this disease,so that the disease cannot be effectively cured.In recent years,various scholars published articles on the treatment of sudden deafness by acupuncture and moxibustion constantly updated,indicating that acupuncture and moxibustion therapy has played a great role in the treatment of this disease.Based on the collection of randomized controlled clinical trials of acupuncture and moxibustion and related therapies for the treatment of sudden deafness,this study screened and evaluated the treatment of this disease by acupuncture and moxibustion,and explored the clinical effect of acupuncture and moxibustion on the treatment of sudden deafness and the improvement of hemorheology and concomitant symptoms through a complete and rigorous systematic evaluation and meta-analysis.Therefore,it can provide evidence-based medicine support for the treatment of sudden deafness by acupuncture and moxibustion.Methods: Computer search CNKI?CBM?VIP?WF?Pubmed?The Cochrane Library,Springer Link and Science Direct,manual retrieval of relevant documents in the Library of Hubei University of Chinese medicine literature.Randomized controlled trials of acupuncture in the treatment of sudden deafness that met the inclusion criteria were collected,and the search time was from the establishment of the database to January 2020.The final study was selected according to the stipulated inclusion and exclusion criteria,the research data were extracted,and the literature quality was evaluated using the internationally recognized "bias risk assessment tool".Meta analysis of relevant data was carried out with Rev Men 5.3 software.Because eventually incorporated into the research results of the evaluation according to the number and the ear number evaluation of the difference,will eventually into 17 makes an analysis of the study is divided into two groups,based on the number of effective treatment standard of mark for group1,ear number for effective treatment standard as group 2,after through sensitivity analysis to choose the appropriate statistical methods were evaluated.Results: The meta-analysis finally included 17 studies,all of which were in Chinese literature.Results of literature quality evaluation: the Jadad scores of all the 17 literatures were greater than 3 points,all of which were high-quality literatures.A total of 1397 patients were included in the 17 literatures,including702 patients in the treatment group and 695 patients in the control group.The results of the meta-analysis suggested that:(1)Effective rate: due to the particularity of the disease,it was divided into two groups:group byperson and group by number of ears.Both groups indicated that the treatment group containing acupuncture was superior to the drug group.(2)Concomitant symptoms: acupuncture treatment of tinnitus has a significant advantage.(3)Decibels of hearing loss: acupuncture therapy for patients with hearing loss db has significant advantage.(4)The improvement in hemorheology(HR): acupuncture therapy for patients with Whole Blood Viscosity(BV),Plasma Viscosity(PV),Hematocrit(Hct)has obvious advantages,and there was no advantages to the improvement of Fibrinogen(Fb).(5)The degree of deafness efficient: acupuncture therapy for the treatment of patients with light to moderate efficient has no obvious advantage,for patients with seere and profound binaural deafness has obvious advantages.Only 3 of the 17 references mentioned adverse reactions,2 of which mentioned no adverse reactions.Only 4 of the 17 literatures mentioned the exit and fall of.Conclusion:The systematic evaluation indicated that acupuncture for the treatment of sudden deafness has a significant effect,whether it is a simple acupuncture therapy alone or in combination with other methods,such as drugs or hyperbaric oxygen combined effect is stable,but the current domestic and foreign research on sudden deafness treatment outcome assessment in addition to the above indexes,and Tinnitus Handicap Inventory(THI),Self-rating anxiety scale(SAS),Pittsburgh Sleep Quality Index(PSQI)and so on.Comprehensive evaluation is also needed to improve the efficacy of acupuncture in the treatment of sudden hearing loss.The risk of bias is unknown in the most of the included literatures,which hint design of clinical randomized controlled trials in the literature is not very serious.So we need to treat the evaluation results carefully,and expriments are mostly small samples,single center research,and the reports of follow-up and adverse reactions are not complete,and the authenticity is not high.Therefore,the results still need to be supported by standard and prudent multicenntre,large sample size and high quality research.