目的 評(píng)估銀杏葉片聯(lián)合地塞米松治療神經(jīng)性耳鳴患者的臨床療效。方法 選取2019年6月—2020年6月在遂寧市中心醫(yī)院耳鼻咽喉科住院的120例神經(jīng)性耳鳴患者，隨機(jī)分為對(duì)照組和治療組，每組各60例。對(duì)照組鼓室內(nèi)灌注地塞米松磷酸鈉注射液，0.6 mL/次，首周治療2次，然后1次/周。治療組在對(duì)照組基礎(chǔ)上口服銀杏葉片，2片/次，3次/d。兩組均持續(xù)治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者耳鳴致殘量表（THI）評(píng)分、耳鳴響度和中樞神經(jīng)遞質(zhì)水平。結(jié)果 治療后，治療組神經(jīng)性耳鳴的臨床癥狀改善的有效率（93.33%）顯著高于對(duì)照組（68.33%）（P＜0.05）。治療后，兩組患者THI評(píng)分、耳鳴響度評(píng)分均較治療前顯著降低（P＜0.05），治療后治療組THI評(píng)分、耳鳴響度評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組患者血清5-羥色胺（5-HT）的水平顯著降低，γ-氨基丁酸（GABA）的含量顯著升高（P＜0.05）；且治療組5-HT和GABA的變化比對(duì)照組更明顯（P＜0.05）。結(jié)論 銀杏葉片聯(lián)合地塞米松治療可顯著改善神經(jīng)性耳鳴患者的臨床癥狀，降低患者的耳鳴響度，調(diào)節(jié)中樞神經(jīng)遞質(zhì)的水平。

Objective To evaluate the clinical efficacy of Yinxingye Tablets combined with dexamethasone in treatment of nervous tinnitus. Methods Patients (120 cases) with nervous tinnitus in Suining Central Hospital from June 2019 to June 2020 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were intratympanic perfusion with Dexamethasone Sodium Phosphate Injection, 0.6 mL/time, twice daily for the first week, then once weekly. Patients in the treatment group were po administered with Yinxingye Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the THI scores, tinnitus loudness, the level of central neurotransmitters in two groups before and after treatment were compared. Results After treatment, the effective rate of clinical symptom improvement in the treatment group (93.33%) was significantly higher than that in the control group (68.33%) (P < 0.05). After treatment, the THI score and tinnitus loudness score in two groups were significantly lower than those before treatment (P < 0.05), and the THI score and tinnitus loudness score in treatment group were lower than those in control group (P < 0.05). After treatment, the level of serum 5-HT in two groups decreased significantly, the GABA levels were significantly increased (P < 0.05), the changes of 5-HT and GABA in the treatment group were more obvious than those in the control group (P < 0.05). Conclusion Yinxingye Tablets combined with dexamethasone can significantly improve the clinical symptoms of patients with nervous tinnitus, reduce the loudness of tinnitus, and regulate the level of central neurotransmitters.

R987

成都中醫(yī)藥大學(xué)"杏林學(xué)者"學(xué)科人才科研提升計(jì)劃項(xiàng)目(YYZX2020095)