山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (3): 20-23.doi: 10.6040/j.issn.1673-3770.0.2015.024

• 论著 • 上一篇    下一篇

鼓室注射布地奈德混悬液治疗合并2型糖尿病的突发性耳聋42例

蒋路云, 谢慧, 谢艳, 李昕蓉   

  1. 成都中医药大学附属医院耳鼻咽喉头颈外科, 四川 成都 610072
  • 收稿日期:2015-01-09 修回日期:2015-04-07 发布日期:2015-06-16
  • 通讯作者: 李昕蓉。E-mail:amz.3@163.com E-mail:amz.3@163.com
  • 作者简介:蒋路云。E-mail:jly666@163.com

Intratympanic budesonide suspension injection to treat idiopathic sudden deafness with type Ⅱ diabetes mellitus in 42 patients

JIANG Luyun, XIE Hui, XIE Yan, LI Xinrong   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan, China
  • Received:2015-01-09 Revised:2015-04-07 Published:2015-06-16

PDF (PC)

575

摘要： 目的 研究在治疗合并2型糖尿病的突发性耳聋患者时, 于静脉用药基础上增加鼓室注射布地奈德混悬液, 探讨此方式与口服强的松方式治疗这类患者后所获得恢复听力的差别。方法 将符合纳入标准且合并2型糖尿病的突发性耳聋患者84例(87耳), 分为A组(口服强的松组)及B组(布地奈德混悬液鼓室注射组)各42例, 在相同静脉用药及控制血糖的基础上, 分别行口服强的松或鼓室注射布地奈德混悬液。结果 将纯音听力改善程度分为痊愈、显效、有效、无效4个等级作为疗效判定标准, 进行单向有序分类资料的秩和检验, Mann-Whitney U检验的结果显示, Z=-3.274, P=0.001, 两组间的疗效差异有统计学意义(P<0.05), 布地奈德混悬液鼓室注射组疗效更好。同时对两组患者血糖测定的异常次数行χ2检验, chi-square检验的结果显示, χ2=214.482, P<0.001, 组间血糖控制情况差异也具有统计学意义(P<0.05), 鼓室用药造成患者血糖波动的情况较少。结论 在相同静脉用药及控制血糖的基础上, 鼓室注射布地奈德混悬液治疗合并2型糖尿病突发性耳聋患者, 疗效优于口服强的松, 且更有利于调整、控制患者的血糖水平。

关键词: 强的松, 布地奈德混悬液, 突发性耳聋, 2型糖尿病

Abstract: Objective To observe the clinical effectiveness of oral prednisone and intratympanic plus intravenous budesonide injection in the treatment of the patients of sudden deafness with type Ⅱ diabetes mellitus (DM). Methods The patients with sudden deafness plus type Ⅱ diabetes mellitus (84 cases, 87 ears) were randomly divided into group A (42 cases, 43 ears) and group B(42 cases, 44 ears). Both groups were given individualized medication to lower blood glucose, but same conventional treatment for sudden hearing loss. Oral prednisone was added in group A, while intratympanic injection of Budesonide suspensinon was applied to group B. Results The improvements of pure tone average were classified as 4 grades: cured, markedly effective, effective, and ineffective. The result of Mann-Whitney U test showed the two strategies of treatment had significant difference in the improvement of profound idiopathic sudden hearing loss (Z=-3.274, P=0.001), and the result of chi-square showed that there was also a significant difference in the numbers of abnormal plasma glucose between group A and group B (χ2=214.482, P<0.001). Conclusion With the individualized medications to lower blood glucose and conventional treatments, Intratympanic Budesonide suspension injection plus conventional regimen could be more effective for idiopathic sudden deafness in type Ⅱ DM patients than oral prednisone. And it is beneficial to maintain the stability of blood glucose level by the way of intratympanic injection of glucocorticoid.

Key words: Prednisone, Idiopathic sudden deafness, Type Ⅱ diabetes mellitus, Budesonide suspension

中图分类号: 

  • R764.43
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会.突发性聋的诊断和治疗指南(2005年, 济南)[J].中华耳鼻咽喉头颈外科杂志, 2006, 41:569.Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, the Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association, The Guidelines for the Diagnosis and Management of sudden deafness (Ji Nan, Shan Dong province, China, 2005)[J]. Chin J Otorhinolarynol Head Neck Surg, 2006, 41:569.
[2] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志, 2011, 20(1):1-31. Chinese Diabetes Society.Chinese guideline for type 2 diabetes (2010)[J]. Chin J Diabetes, 2011, 20(1):1-31.
[3] Chandrasekhar S S, Rubinstein R Y, Kwartler J A, et al. Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents[J]. Otolaryngol Head Neck Surg, 2000, 122(4):521-528.
[4] McCall A A, Swan E E, Borenstein J T, et al. Drug delivery for treatment of inner ear disease: current state of knowledge[J]. Ear Hear, 2010, 31(2):156-165.
[5] 鲁海涛, 龚树生.圆窗膜的解剖结构、生理功能及临床意义[J].国外医学耳鼻咽喉科学分册, 2007, 26(4):214-216. LU Haitao, GONG Shusheng. The anatomy structures, physiological function and clinical significance of the round window membrane[J]. For Med Sci(Section of Otolray Ngology Foreign Medical), 2007, 26(4):214-216.
[6] Yang F, Zhao Y, An P, et al. Longitudinal results of intratympanic injection of Budesonide suspensing for otitis media with effusion in children over 12 years and adults[J]. Otol Neurotol, 2014, 35(4):629-634.
[7] 朱新华, 刘月辉. 鼻用皮质类固醇的基础与临床研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2008, 20(20):957-960 ZHU Xinhua, LIU Yuehui. Progress in basic and clinical research of intranasal corticosteroids[J]. J Clinical Otorhinolaryngol Head Neck Surg, 2008, 20(20):957-960.
[8] 刘硕, 柳国胜. 布地奈德雾化吸入治疗急性喉炎、急性喉气管支气管炎的疗效观察[J]. 儿科药学杂志, 2005, 11(2):42-44. LIU Shuo, LIU Guosheng. Observation on Efficacy of Nebulized Budesonide Inhalation in Treatment of Acute Laryngitis and Laryngotracheobronchitis in children[J]. J Pedia Phar, 2005, 11(2):42-44.
[9] 王吉安. 普米克令舒等雾化吸入治疗气管毛细支气管炎观察[J]. 泰山医学院学报, 2005, 24(4):357- 358. WANG Ji'an. Curative effect of budesonide in bronchiolitis[J]. J Taishan Coll, 2005, 24(4):357- 358.
[10] Rauch S D, Halpin C F, Antonelli P J, et al. Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss[J]. JAMA, 2011, 305(20):2071-2079.
[11] Piccirillo J F. Steroids for idiopathic sudden sensorineural hearing loss: some questions answered, others remain[J]. JAMA, 2011, 305(20):2114-2115.
[1] 邵娜,张晗. 糖尿病患者行白内障超声乳化术后视力及眼底的变化[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 83-87.
[2] 王露萍, 吴欣怡. 2型糖尿病患者糖化血红蛋白水平对干眼症的影响[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 71-73.
[3] 严小玲, 毛敏, 翟锦明, 陈观贵, 张建国, 刘绮明, 薛进平. 鼓室内注射治疗难治性突发性耳聋52例[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 23-26.
[4] 沈峰. 单唾液酸四己糖神经节苷脂钠治疗突发性耳聋临床观察[J]. 山东大学耳鼻喉眼学报, 2013, 27(1): 24-25.
[5] 刘冬梅1，徐开伦1，罗晓1，贾全凡1，任贤灵1，袁龙1，罗通勇1，刘军2，马殿伟2， 岳胜清1，文晓蛟1，付誉颖2. 鼓室联合静脉地塞米松+传统方法治疗突发性耳聋的近期疗效[J]. 山东大学耳鼻喉眼学报, 2013, 27(1): 26-30.
[6] 刘鹤，孙中武. 鼓室内注射激素在治疗突发性耳聋中的应用及疗效观察[J]. 山东大学耳鼻喉眼学报, 2012, 26(5): 33-35.
[7] 张宁，范传峰. 甲基强的松龙治疗视神经挫伤28例[J]. 山东大学耳鼻喉眼学报, 2010, 24(6): 77-78.
[8] 王风娟综述，范献良审校. 脂肪细胞脂肪酸结合蛋白与阻塞性睡眠呼吸暂停综合征及糖尿病的关系[J]. 山东大学耳鼻喉眼学报, 2010, 24(2): 67-70.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发