摘要
目的小儿分泌性中耳炎常规治疗往往达不到预想效果,而中医治疗具有独特优势。本研究探究五苓散加减联合鼓膜正负压治疗分泌性中耳炎疗效。方法选取2017-06-10-2019-04-13洛阳市第一中医院收治的分泌性中耳炎患儿为研究对象,根据组间性别、年龄和病程等因素匹配的原则选择观察组与对照组,各60例。对照组给予鼓膜正负压治疗,观察组给予五苓散加减联合鼓膜正负压治疗。对比两组疗效及治疗前后纯音听阈气导值、鼓室阻抗图变化、耳积液纤维粘连蛋白、一氧化氮(nitric oxide,NO)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、干扰素-γ(interferon-γ,IFN-γ)、白介素-2(interleukin,IL-2)、IL-10和IL-6水平。结果观察组总有效率为93.33%,高于对照组的66.67%,χ^2=13.333,P<0.001。治疗后,观察组0.25 KHZ纯音听阈值为(13.36±4.08)dBHL,低于对照组的(20.57±7.42)dBHL,t=6.595,P<0.001;0.5KHZ纯音听阈值为(10.75±3.28)dBHL,低于对照组的(20.24±6.19)dBHL,t=10.493,P<0.001;1KHZ纯音听阈值为(11.26±4.17)dBHL,低于对照组的(22.39±6.75)dBHL,t=10.866,P<0.001;2KHZ纯音听阈气导值为(8.84±4.53)dBHL,低于对照组的(17.74±5.58)dBHL,t=9.592,P<0.001;4KHZ纯音听阈气导值为(7.86±3.15)dBHL,低于对照组的(18.47±6.10)dBHL,t=11.971,P<0.001。治疗后,观察组A型比例患儿高于对照组,C型比例患儿低于对照组,u=2.382,P=0.017。治疗后,观察组耳积液纤维粘连蛋白水平为(26.35±8.67)mg/L,低于对照组的(37.06±9.14)mg/L,t=6.585,P<0.001;NO水平为(306.42±62.84)ng/L,低于对照组的(529.27±84.05)ng/L,t=16.449,P<0.001。治疗后,观察组血清TNF-α水平为(0.22±0.09)μg/L,低于对照组的(0.35±0.13)μg/L,t=6.369,P<0.001;观察组血清IFN-γ水平为(0.39±0.11)μg/L,低于对照组的(0.67±0.26)μg/L,t=7.683,P<0.001;观察组血清IL-2水平为(0.31±0.15)μg/L,低于对照组的(0.49±0.20)μg/L,t=5.577,P<0.001;观察组血清IL-10水平为(0.13±0.06)μg/L,低于对照�
OBJECTIVE Conventional treatment of pediatric secretory otitis media often fails to achieve the expected results,and chinese medicine treatment has unique advantages.This study explores the efficacy of Wuling san plus or minus tympanic membrane pressure in the treatment of secretory otitis media.METHODS The children with secretory otitis media treated in Luoyang No.1 Traditional Chinese Medicine Hospital from June 10,2017 to April 13,2017 were selected as the research objects.The observation group and the control group were selected according to the principle of matching factors such as gender,age,and course of disease between 60 cases.The control group was given tympanic membrane positive and negative pressure treatment,and the observation group was given Wulingsan powder plus and minus tympanic membrane positive and negative pressure combined treatment.Compare the effect,pure tone hearing threshold air conductance values,changes in tympanic impedance maps,level of fibronectin,nitric oxide(NO),tumor necrosis factorα(TNF-α),interferon-γ(IFN-γ),interleukin-2(IL-2),IL-10 and IL-6 in the two groups before and after treatment.RESULTS The total effective rate in the observation group was 93.33%,which was higher than that of the control group(66.67%,χ^2=13.333,P<0.001).After treatment,the 0.25 KHZ pure tone hearing threshold value in the observation group was(13.36±4.08)dBHL,which was lower than the control group’s(20.57±7.42)dBHL,t=6.595,P<0.001.The0.5 KHZ pure tone hearing threshold value was(10.75±3.28)dBHL,which was lower than the control group’s(20.24±6.19)dBHL,t=10.493,P<0.001.1 KHZ pure tone hearing threshold value was(11.26±4.17)dBHL,which was lower than the control group’s(22.39±6.75)dBHL,t=10.866,P<0.001.2 KHZ pure tone hearing threshold value was(8.84±4.53)dBHL,which was lower than the control group’s(17.74±5.58)dBHL,t=9.592,P<0.001.4 KHZ pure tone hearing threshold value was(7.86±3.15)dBHL,which was lower than the control group’s(18.47±6.10)dBHL,t=11.971,P<0.001.After treatment,the
作者
张雅珂
董明
ZHANGYA ke;DONG Ming(Department of Otolaryngology,Luoyang First Hospital of Traditional Chinese Medicine,Luoyang 471000,P.R.China)
出处
《社区医学杂志》
2020年第6期436-440,共5页
Journal Of Community Medicine
关键词
五苓散
鼓膜正负压
分泌性中耳炎
细胞因子
免疫功能
Wulingsan
positive and negative pressure of the tympanic membrane
secretory otitis media
cytokines
immune function
