| Background:Tinnitus refers to self-perception of ringing in the ears without a corresponding sound source in the outside world.Tinnitus is a common disease in otolaryngology,and its incidence is increasing year by year.According to research statistics,the incidence of tinnitus ranges from 5%to 30%.Tinnitus can appear as a disease alone or as an accompanying symptom in other diseases.Because the mechanism of tinnitus is not yet clear,tinnitus has become one of the difficult diseases in otolaryngology,and because of the intractable nature of tinnitus,the majority of tinnitus patients are more likely to have bad moods and affect their lives and work.Therefore,the study of tinnitus has important clinical significance.Traditional Chinese medicine has certain advantages in the treatment of tinnitus,and TCM syndrome differentiation and treatment are the advantages of TCM.Accurating syndrome differentiation can improve clinical efficacy.For the treatment of tinnitus,there is currently no specific medicine in modern medicine.It can only be targeted to nourish the nerves and improve circulation,but the effect is not ideal.Therefore,non-pharmacological therapies such as acoustic therapy and cognitive behavioral therapy are gradually being used in the treatment of tinnitus.Acoustic therapy,as a therapy with the advantages of simple operation,small side effects,and easy acceptance by patients,is more widely used,and has been clinically verified and has a certain effect.The advantages of TCM therapy are highlighted when the mechanism of tinnitus is not determined.Clinical studies have also shown that combined TCM and Western medicine can further improve clinical efficacy and improve patient symptoms.Purposes:This study collects TCM syndromes and related information for patients with non-acute tinnitus,explores the correlation between TCM syndromes and the clinical characteristics of non-acute tinnitus,provides more relevant information for clinical syndrome differentiation and treatment,and is a research on non-acute tinnitus.Provide evidence of evidence-based medicine.At the same time,through clinical observation,the efficacy of Chinese medicine combined with compound sound is verified,and preliminary research is provided for further exploring the treatment of tinnitus with Chinese medicine combined with compound sound.Methods:Collect the medical history data of non-acute tinnitus patients who attended the Otorhinolaryngology Clinic of Guang'anmen Hospital of China Academy of Chinese Medical Sciences from 2020 to 2021.The tinnitus Disability Inventory(THI)was filled out by the patients themselves,and 2 outpatients of our hospital were attending Physicians of and above classify it according to syndrome differentiation.All patients were tested for tinnitus matching,the main tone frequency of tinnitus and the loudness of tinnitus were determined,and the residual suppression test was performed.The natural sound is selected according to the main tone frequency of tinnitus and the patient's preferences,and the matching main tone frequency and natural sound are applied to generate a sound combination prescription.On the basis of selecting patients who are willing to receive treatment,they were divided into two groups by random number table.Group A was treated with traditional Chinese medicine combined with compound sound for 4 weeks,group B was treated with compound sound for the first 2 weeks,and compound sound for the next 2 weeks.Add traditional Chinese medicine decoction on the basis of,and the patients receiving treatment are asked to fill in the THI scale in the second and fourth weeks after treatment,and evaluate the situation before and after treatment.Results:1.A total of 140 non-acute tinnitus patients meeting the criteria were included,including 75 males and 65 females.The age is between 18-65 years old,and the course of disease is between 3-120 months.5 cases of phlegm-dampness stagnation type accounted for 3.6%,50 cases of liver-qi stagnation type accounted for 35.7%,43 cases of spleen and stomach weakness type accounted for 30.7%,20 cases of heart and blood deficiency type accounted for 14.3%,and 22 cases of nephron depletion type accounted for 15.7%.The number of cases of phlegm-dampness stagnation type is too small to reflect the overall situation,so it is not analyzed.2.There is no difference in gender and tinnitus side distribution among the various syndromes of traditional Chinese medicine,and the difference in age distribution is statistically significant(P<0.05).The pairwise comparison results show that the average age of patients with nephron depletion type(52.64±8.443 years old)is greater than spleen and stomach weakness type(46.72±11.622 years old),liver-qi stagnation type(44.84±11.816 years old),and heart and blood deficiency type(42.15±9.224 years old)(all P values<0.05).3.There is a statistically significant difference in the distribution of the disease course among the various syndrome types of TCM(P<0.05).The pairwise comparison results show that the average disease course of patients with liver-qi stagnation type(7.98±3.543 months)is shorter than heart and blood deficiency type(14.70±5.658 months),spleen and stomach weakness type(29.28±24.001 months),nephron depletion type(62.73±34.129 months)(all P values<0.05),the mean disease course of patients with nephron depletion type was longer than that of patients with weak spleen and stomach and heart and blood deficiency type(all P values<0.05).4.There is a statistically significant difference in the frequency distribution of tinnitus among the various syndromes of traditional Chinese medicine(P<0.05).The pairwise comparison results show that the frequency of tinnitus in patients with liver-qi stagnation type(5.56±2.392khz)is higher than that of nephron depletion type(1.96±1.732).khz),heart and blood deficiency type(1.63±1.014khz),spleen and stomach weakness type(0.88±0.825khz)(all P values<0.05).5.There is a statistically significant difference in the distribution of the severity of tinnitus among the various types of TCM syndromes(P<0.05).The pairwise comparison results show that the average value of the THI scale(62.60±15.297)of patients with liver-qi stagnation type is higher than that of heart and blood deficiency type(46.00±12.616).),spleen and stomach weakness type(28.56±14.582),nephron deficient type(23.27±9.513)(P<0.05),the average value of THI scale in patients with hypocardiac blood deficiency is higher than that of spleen and stomach weak type and nephron deficient patients(all P values<0.05).6.A total of 100 patients were enrolled in the treatment,and were randomly divided into two groups using a random number table method,with 50 cases in each group,4 of whom dropped out,including 1 case in group A and 3 cases in group B.Finally,96 effective cases were included.There were 49 cases in group A and 47 cases in group B.7.There were differences in the THI scale scores within and between the two groups before and after treatment in the two groups(P<0.05).The difference of THI scale before and after treatment in group A was 11.16±8.745,and the difference in THI scale before and after treatment in group B was 5.32±4.535.The score of THI scale in group A decreased more than that in group B.8.Before treatment(47.91 ± 19.715),the second week of treatment(42.60±16.883),and the fourth week of treatment(29.06±13.239),the difference in THI scale scores in group B was statistically significant(P<0.05).The THI scale score in the second week of treatment was significantly lower than that before treatment by 5.31,and the THI scale score in the fourth week of treatment was significantly lower than that in the second week by 18.85.9.There was no difference in the total scores of the THI scale and the difference between the AB groups before and after 4 weeks of treatment,but the changes in the severity factor scores were statistically significant(P<0.05).The difference in severity factor before and after treatment in group A was 3.31±2.535,and the difference in severity factor before and after treatment in group B was 2.09±1.954.The severity factor score of group A decreased more than that in group B.Conclusion:The data of this study shows that the characteristics of TCM syndrome and non-acute tinnitus are related:(1)Non-acute tinnitus patients with nephron loss type are older than other syndrome types.(2)The frequency of tinnitus in non-acute tinnitus patients of liver-qi stagnation type is higher than that of other syndrome types.(3)The severity of tinnitus in non-acute tinnitus patients of liver-qi stagnation type and heart blood deficiency type is higher than that of other syndrome types,and the severity of tinnitus in non-acute tinnitus patients of liver-qi stagnation type is the highest.(4)Among the five syndromes of stagnant phlegm-dampness syndrome,stagnation of liver qi,deficiency of heart and blood,weak spleen and stomach,and deficiency of nephron,stagnation of liver qi and weak spleen and stomach are the more common clinical syndromes of non-acute tinnitus.Through therapeutic intervention,this study shows the clinical advantages of Chinese medicine combined with compound acoustic therapy.The conclusions are as follows:(1)Both compound acoustic therapy and traditional Chinese medicine combined compound acoustic therapy can effectively improve tinnitus and reduce the score of the THI scale.Compared with the use of compound sound alone,Chinese medicine combined with compound sound therapy can better improve the patient's THI scale score within 2 weeks of short-term treatment.(2)Regarding the use time of traditional Chinese medicine and compound sound,although there is no significant difference between the simultaneous use of the two and the first use of compound sound treatment and then the addition of Chinese medicine in improving the total score of the THI scale in the treatment time of 4 weeks,but in terms of improving the severity factor,the simultaneous use of the two is better than the first single use of the compound acoustic therapy group.The above suggests the advantages of traditional Chinese medicine intervention.When using compound acoustic therapy,traditional Chinese medicine intervention is faster and more effective in reducing tinnitus symptoms than early intervention,and improves patient confidence and compliance in treatment. |
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