摘要
目的分析伴眩晕的突发性聋（突聋）初诊患者的临床资料,探讨其病因病机,为临床辨证提供参考.方法回顾性分析2013年7月至2017年7月住院治疗的223例伴有眩晕的突聋患者四诊、辨证及相关临床资料.结果223例伴眩晕的突聋患者,占同期住院突聋患者的27.5%;其中男性105例（47.1%）,女性117例（52.9%）;年龄23~76岁,平均（41.7±16.1）岁;单耳发病209例（93.7%）,双耳14例（10.8%）;发病至就诊时间1~189d,中位数8d.患者听力损失程度以极重度聋居多（65.3%）,听力曲线以全聋型（41.6%）和中高频下降型（29.7%）为主.耳蜗症状与前庭症状出现的时间,其中113例听力下降与眩晕同时出现,82例听力下降早于眩晕,28例眩晕症状早于听力下降.223例患者均详细记录了舌、脉象、局部及全身四诊资料,其中辨证为外邪侵袭型47例（21.1%）,肝火上扰型32例（14.3%）,痰火郁闭型29例（13.0%）,气滞血瘀型89例（40.1%）,其它证型26例（11.7%）.经规范药物治疗后,其中痊愈1例,显效9例,有效137例,无效76例.结论突聋伴眩晕患者发病率较高,多单耳发病,听力损害程度较重,总体疗效欠佳.初诊患者临床证型分布以气滞血瘀及外邪侵袭型为主,其次为肝火上扰和痰火郁闭型,多以实证为主.提示外邪侵袭或脏腑虚损终致气血不和,窍络闭塞,可能为本病主要病机.
Objective To analyze the clinical characristics of patients with sudden deafness in patients with vertigo, to explore their etiology and pathogenesis,and help to the syndrome differentiation in clinical. Methods Retrospective analysis the four methods of diagnosis,syndrome differentiation and relevant clinical characristics of 223 sudden deafness paitients combined with vertigo from July 2018 to July 2017. Results 223 sudden deafness patients with vertigo accounted for 27.5%of patients with sudden deafness during the same period. There are 105 males （47.1%） and 117 females （52.9%）. Age：23-76 years old,average （41.7 ± 16.1）;There are 209 cases of single ear （93. 7%） and 14 cases （10. 8%）of two ears. The period from morbidity to treatment is 14189 d,the median is 8 d The degree of hearing loss in patients was most severe deafness（65.3%）,the hearing curve type is mainly total deafness （41. 6%） and high frequency drop type （29. 7%）. The time of symptoms of cochlear and vestibular symptoms have 113 cases of hearing loss the emergence of vertigo, 82 cases of hearing loss before vertigo, 28 patients with vertigo symptom before the hearing loss . 223 patients were detailed records the tongue and pulse condition local and systemic four diagnostic data. including 47 cases （21.1 %） ,are attacks,32 cases （14.3%） ,are liver fire,29 cases （13.0%） are closed by phlegm and fire , qi stagnation and blood stasis type 89 cases （40. 1 %）areqi stagnation and blood stasis type, other syndrome types have 26 cases （11.7 %）. After standardized drug treatment, 1 cases were cured,9 cases were markedly effective, 137 cases were effective, and 76 cases were invalid. Conclusion Sudden deafness patients with vertigo with high incidence, more single ear disease, is more than two ears disease the degree of hearing impairment is heavier, the overall effect was poor First diagnosisis given priority to with qi and blood stasis type and attacks, followed by liver fire and closed by phlegm and fi
作者
王贤文
朱镇华
马月湘
杨伟丽
Wang Xianwen;Zhu Zhenhua;Ma Yuecciang;Yang Weili(The First Affiliated Hospital of Hunan University of Traditional Chinese,Changsha,Hunan,410208)
出处
《中医眼耳鼻喉杂志》
2018年第3期139-141,共3页
Journal of Chinese Ophthalmology and Otorhinolaryngology
关键词
突聋
眩晕
暴聋
临床证型
Sudden deafness
Vertigo
Clinical patterns
