1.Neck Seven-Line Method Combined with Periauricular Acupuncture for 33 Patients with Sudden Hearing Loss in Non-Acute Stage: A Randomized Controlled Trial
Chongyang ZHANG ; Junjie LIANG ; Yang LI ; Xinru WANG ; Yu XING ; Xueshi DI ; Wenting SUN ; Peng BAI
Journal of Traditional Chinese Medicine 2024;65(15):1571-1577
ObjectiveTo evaluate the effectiveness and safety of neck seven-line method combined with periauricular acupuncture as salvage treatment for sudden hearing loss in non-acute stage. MethodsSixty-six patients with non-acute stage of sudden hearing loss with a disease duration of 15-90 days were randomly divided into 33 cases each in treatment group and control group. The treatment group was given neck seven-line method combined with acupuncture at periauricular points; the control group used sham acupuncture and sham electroacupuncture at the same points. Both groups were treated 3 times a week for 6 weeks. The pure tone average hearing threshold of impaired frequencies were examined before treatment, after treatment finish and at follow-up (week 10), and the difference between pure tone average hearing threshold of impaired frequencies before and after treatment was calculated; calculate the proportion of patients with ≥10 dB improvement in pure tone average hearing threshold of impaired frequency after treatment and at follow-up; compare the patients' Tinnitus Evaluation Scale (TEQ) scores, Chinese Medicine Quality of Life Assessment Scale (CQ-11D) health utility values and the difference between before and after treatment, and record the occurrence of adverse events. ResultsThe pure tone average of impaired frequency in the treatment group were (50.57±18.07) dB and (47.70±17.42) dB at post-treatment and follow-up respectively, and (54.38±21.77) dB and (53.36±20.99) dB in the control group at post-treatment and follow-up. Compared with the pre-treatment period, the pure tone average hearing threshold of impaired frequency in the two groups significantly decreased (P<0.05) at post-treatment and follow-up. The difference of pure tone average hearing threshold of impaired frequency in the treatment group after treatment and at the follow-up visit compared to that before treatment was lower than those in the control group (P<0.05). After treatment, 13 patients (39.39%) in the treatment group and 10 patients (30.30%) in the control group showed improvement of ≥10 dB in pure tone average hearing threshold of impaired frequency; at the follow-up visit, 18 patients (54.55%) in the treatment group and 10 patients (30.30%) in the control group showed improvement of ≥10 dB in the pure tone average hearing threshold of impaired frequency, and there was no statistical significance for comparison between groups at the time of post-treatment and follow-up (P>0.05). The TEQ score of the treatment group significantly lower than that before treatment (P<0.05); the TEQ score of the treatment group and the difference between before and after treatment significantly lower than that of the control group (P<0.05). The difference in CQ-11D health utility values and the difference between before and after treatment were not statistically significant between the two groups (P>0.05). Eight cases of acupuncture-related adverse events occurred among 66 patients, including subcutaneous haematomas after needling, severe pain during needling and needle fainting, which disappeared after symptomatic treatment and did not affect the following treatment. ConclusionNeck seven-line method combined with periauricular acupuncture could be used as salvage treatment for sudden hearing loss in non-acute stage to improve the pure tone average hearing threshold of impaired frequency, alleviate tinnitus, with safety.
2.Discussion on Differentiation and Treatment of Sudden Hearing Loss by Traditional Chinese Medicine Based on the Classification of Hearing Curve
Xinru WANG ; Yang LI ; Jiajia ZHANG ; Yan MENG ; Chongyang ZHANG ; Xueshi DI ; Zhiwei FENG ; Junjie LIANG ; Peng BAI
Journal of Traditional Chinese Medicine 2024;65(11):1126-1131
Pure-tone audiometry can be performed to evaluate the type and degree of hearing loss, whose results can be divided into four types including low-frequency descending, high-frequency descending, flat descending and total deafness. The low-frequency descending type of sudden hearing loss (SHL) is more likely to be spleen deficiency and dampness exuberance, the high-frequency descending type is often due to yin deficiency of liver and kidney, the flat descending type is commonly associated with qi and blood depletion, and the type of total deafness is often linked to blood stasis. Our team has further developed a comprehensive diagnostic and therapeutic approach for SHL, emphasizing "the integration of disease and syndrome, the combination of acupuncture and herbal medicine, and dynamically administering treatment". Firstly, it advocates integrating disease diagnosis with syndrome differentiation. Secondly, it recommends combining acupuncture and herbal medicine, with local acupoints such as Ermen (TE 21), Tinggong (SI 19), Tinghui (GB 2), and Yifeng (TE 17) used to unblock the auditory orifice, and herbal prescriptions tailored to the hearing curve patterns. For the low-frequency descending type, it is recommended to fortify the spleen and percolate dampness by taking distal points of spleen channel and stomach channel and using Shenling Baizhu Powder (参苓白术散). For the high-frequency descending type, the method of nourishing kidney and calming liver is recommended, using distal points of kidney and liver channels and taking Erlong Zuoci Pills (耳聋左慈丸). Regarding the flat descending type, tonifying qi and nourishing blood is advised, for which acupoints of Conception Vessel, spleen, stomach and large intestine channels can be needled, and Yiqi Congming Decoction (益气聪明汤) can be administered. For the total deafness type, it is recommended to activate blood and dissipate stasis, often with Xuehai (SP 10) and Geshu (BL 17) needled and Tongqiao Huoxue Decoction (通窍活血汤) administered. All these are conducted to treat the root and branch simultaneously. At the same time, it emphasizes the need to consider complex syndrome presentations and disease progression, dynamically analyze the disease causes and mechanisms, and adjust treatment according to the changing syndromes. In conclusion, this article is expected to inspire clinical diagnosis and treatment of SHL.
3.Autologous blood transfusion drainage and simple drainage after lumbar surgery: A comparative study
Qiaomei YUAN ; Yusong JIA ; Jinyu LI ; Chenying ZHENG ; Chunxiao BAI ; Fan ZHANG ; Xueshi DI ; Shengqian KANG ; Shuiwen LONG ; Jiang CHEN
Chinese Journal of Blood Transfusion 2021;34(3):245-248
【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.