耳鸣是指在周围环境无声源的情况下,患者主观感受到耳中鸣响。它既可单侧患病,也可能双侧,若患者感觉鸣声来自头颅内部,又可称“颅鸣”或“脑鸣”。耳聋是指不同程度的听力下降。耳聋耳鸣症状可单一出现,也可同时伴随,两者在病因和治疗原则上相似,故临床上常常将耳鸣耳聋并称。近年来耳聋耳鸣发病率逐年上升,是耳鼻喉科常见的疾病,也是社会面临的难题之一。近年来,中医药治疗耳鸣耳聋取得了良好的疗效,且副作用小。本文将从两个实际的治疗病例中探讨柴胡桂枝干姜汤的应用,以此作为临床治疗肝脾不和型耳鸣耳聋的理论支持。Tinnitus refers to the subjective perception of the sound in the ear in the surrounding environment. It can be unilateral disease, may be bilateral. if the patient feels the song from the inside of the head, can also be called “cranial song” or “brain song”, Deafness refers to varying degrees of hearing loss. Deafness tinnitus symptoms can appear singly, can also be accompanied at the same time. The two in the etiology and treatment principle are similar. Therefore, clinically, tinnitus and deafness are often referred to as the same term. In recent years, the incidence of deafness and tinnitus has been increasing year by year, which is a common disease in otolaryngology and also one of the problems facing the society. In recent years, traditional Chinese medicine has achieved good results in the treatment of tinnitus and deafness, with little side effects. This paper will explore the application of Chai Hu Gui Zhi Dried Ginger Soup from two practical treatment cases as a theoretical support for the clinical treatment of liver-spleen incompatibility type tinnitus and deafness.
目的探讨柴黄泄浊汤辅助治疗慢性肾脏病4和5期透析肝脾不和证的临床疗效。方法将103例慢性肾脏病4和5期肝脾不和证患者随机分为两组。对照组49例(脱落3例)进行血液透析治疗;研究组49例(脱落2例)在对照组基础上运用柴黄泄浊汤治疗。比较两组3个月的总有效率;对患者肝脾不和证进行中医证候积分(traditional chinese medicine symptoms score,TCMSS)评估;对患者病情运用急性生理与慢性健康状况(acute physiology and chronic health evaluation,APACHE-Ⅱ)评估;测定患者血肌酐(serum creatinine,Scr)、尿素氮(urea nitrogen,BUN)、尿酸(uricacid,UA)、肾小球滤过率(glomerular filtrationrate,GFR)、白细胞介素22(interleukin 22,IL-22)、成纤维生长因子23(fibroblast growth factor 23,FGF-23)、肾损伤分子1(kidney damage molecule 1,KIM-1)的水平。结果两组患者3个月的总有效率分别为79.59%(47/49)、61.22%(43/49),研究组高于对照组,且组间差异显著(P<0.05)。治疗后,两组的TCMSS及主次症评分均低于治疗前,且研究组治疗后的水平较对照组更低(P<0.05)。治疗后,两组的APACHE-Ⅱ均低于治疗前,且研究组治疗后的水平更低(P<0.05)。治疗后,两组的Scr、BUN、UA低于治疗前,GFR高于治疗前(P<0.05);研究组治疗后的Scr、BUN、UA低于对照组,GFR高于对照组(P<0.05)。治疗后,两组的IL-22、FGF-23、KIM-1低于治疗前(P<0.05);研究组治疗后的IL-22、FGF-23、KIM-1低于对照组(P<0.05)。结论柴黄泄浊汤可提高慢性肾脏病4和5期透析肝脾不和证患者的疗效,进一步减轻临床症状和控制病情,改善肾功能,减轻微炎症状态。
