摘要
目的探讨前庭康复训练(VRT)联合高压氧治疗(HBOT)对伴眩晕症状的突发性耳聋(SD)患者听力恢复及血清炎症因子水平的影响。方法2021年3月至2024年3月采用便利抽样法选取济宁医学院附属医院收治的116例伴眩晕症状的SD患者,根据治疗方案不同分为对照组和观察组,每组58例。对照组患者采用高压氧常规治疗,观察组患者在对照组的基础上联合VRT。采用化学发光免疫法检测血清白细胞介素(IL)-6、双抗夹心法检测IL-1β、ELISA法检测肿瘤坏死因子-α(TNF-α)的水平;采用健康调查量表36(SF-36)评估患者生活质量。比较2组患者的治疗效果以及治疗前后血清炎症因子、血液流变学、听力指标及生活质量的变化。结果观察组患者治疗总有效率为96.55%(56/58),明显高于对照组的81.03%(47/58),差异有统计学意义(χ^(2)=7.017,P=0.008)。治疗14 d后,观察组IL-6为(31.18±5.82)pg/ml、IL-1β为(100.75±13.41)pg/ml、TNF-α为(6.75±2.10)pg/ml,对照组对应指标分别为(34.55±5.93)pg/ml、(108.42±15.14)pg/ml、(8.89±2.18)pg/ml;观察组全血低切黏度为(17.14±4.02)mPa·s、全血高切黏度为(3.87±0.79)mPa·s、全血中切黏度为(5.84±0.50)mPa·s,对照组对应指标分别为(21.43±4.19)mPa·s、(4.53±0.84)mPa·s、(6.17±0.52)mPa·s;观察组低频区听阈为(57.11±8.53)dB、高频区听阈为(69.61±5.30)dB、纯音听阈为(53.28±6.21)dB,对照组对应指标分别为(68.09±9.29)dB、(73.14±5.36)dB、(63.22±9.64)dB;观察组SF-36生理机能、社会功能、一般健康状况和精神健康4项评分分别为(89.68±11.25)分、(90.62±11.68)分、(88.67±11.08)分、(92.61±11.82)分,对照组对应指标分别为(82.65±10.59)分、(84.58±10.24)分、(82.92±10.21)分、(86.68±10.51)分。2组患者以上指标比较,差异均有统计学意义(均P<0.05)。结论VRT联合HBOT应用于伴眩晕症状的SD患者疗效较好,可以明显改善患者血清炎症因子水平以及血液黏度,促进听力恢复,对其生活质量提高也有积极影响。
Objective To investigate the effects of vestibular rehabilitation therapy combined with hyperbaric oxygen therapy(HBOT)on hearing recovery and serum inflammatory factor levels in patients with sudden deafness(SD).Methods From March 2021 to March 2024,116 SD patients with vertigo admitted to Affiliated Hospital of Jining Medical University were convenience-sampled and divided into control(n=58)and observation groups(n=58).Patients in the control group were treated with conventional hyperbaric oxygen therapy,while those in the observation group were treated with vestibular rehabilitation training in addition to the treatment of the control group.The levels of serum interleukin(IL)-6 were detected by chemiluminescence immunoassay,IL-1βby double antibody sandwich method,and tumor necrosis factor-α(TNF-α)by ELISA.The quality of life of the patients was evaluated by the 36-item short form health survey(SF-36).The therapeutic effects of the two groups and the changes in serum inflammatory factors,hemorheology,hearing indicators and quality of life before and after treatment were compared.Results The total effectiveness rate in the observation group[96.55%(56/58)]was higher than in the control group[81.03%(47/58)](χ^(2)=7.017,P=0.008).At 14 days post-treatment,the observation group showed lower interleukin(IL)-6[(31.18±5.82)pg/ml vs.(34.55±5.93)pg/ml)],IL-1β[(100.75±13.41)pg/ml vs.(108.42±15.14)pg/ml],and tumor necrosis factor(TNF)-α[(6.75±2.10)pg/ml vs.(8.89±2.18)pg/ml);reduced blood viscosity[low-shear:(17.14±4.02)mPa·s vs.(21.43±4.19)mPa·s;high-shear:(3.87±0.79)mPa·s vs.(4.53±0.84)mPa·s;medium-shear:(5.84±0.50)mPa·s vs.(6.17±0.52)mPa·s];improved hearing thresholds[low-frequency:(57.11±8.53)dB vs.(68.09±9.29)dB;high-frequency:(69.61±5.30)dB vs.(73.14±5.36)dB;pure-tone average:(53.28±6.21)dB vs.(63.22±9.64)dB];and higher SF-36 scores[physical function(89.68±11.25)points vs.(82.65±10.59)points;social function(90.62±11.68)points vs.(84.58±10.24)points;general health:(88.67±11.08)points vs.(82.92±10.21)points;mental health(92.61±11.82)points vs.(86.68±10.51)points].All between-group comparisons of the above indicators showed statistically significant differences(all P<0.05).Conclusion The combination of vestibular rehabilitation therapy and HBOT has shown favorable efficacy in treating SD patients with vertigo symptoms.It can significantly improve patients’inflammatory factor levels and blood viscosity,promote hearing recovery,and exert positive effects on enhancing their quality of life.
作者
钱晓林
耿文丽
乔妍
Qian Xiaolin;Geng Wenli;Qiao Yan(Department of Hyperbaric Oxygen Medicine,Affiliated Hospital of Jining Medical University,Jining 272000,China;Department of Ophthalmology,Affiliated Hospital of Jining Medical University,Jining 272000,China)
出处
《中华航海医学与高气压医学杂志》
2025年第11期1187-1192,共6页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
突发性耳聋
前庭康复训练
高压氧
炎症因子
听力
Sudden deafness
Vestibular rehabilitation therapy
Hyperbaric oxygen
Inflammatory factor
Hearing
