龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎临床研究

目的:研究龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎(SOM)的效果。方法:选取78例肝胆湿热型分泌性中耳炎患者,按随机数字表法分为试验组和对照组各39例。2组均采用鼓膜穿刺术治疗,对照组术后给予头孢克洛和氯雷他定抗感染治疗,试验组给予龙胆泻肝胶囊。评价2组治疗效果,检测治疗前后血清干扰素γ(IFN-γ)和白细胞介素-4(IL-4)水平,计算IFN-γ/IL-4,进行中医证候评分,观察患耳含积液情况。结果:试验组总有效率为92.31%,高于对照组71.79%(P<0.05)。治疗前,2组IFN-γ、IL-4和IFN-γ/IL-4比较,差异无统计学意义(P>0.05)。治疗后,2组IFN-γ、IL-4和IFN-γ/IL-4较治疗前降低,且试验组IFN-γ、IL-4和IFN-γ/IL-4均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组各项中医症状评分比较,差异无统计学意义(P>0.05)。治疗后,2组各项中医症状评分及总分较治疗前降低,试验组各项中医症状评分及总分均低于对照组,差异有统计学意义(P<0.05)。试验组耳内含积液率为71.79%,低于对照组89.74%(P<0.05)。结论:采用龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎,疗效令人满意,能够显著改善患者症状,可下调IFN-γ、IL-4表达,调节Th1/Th2平衡,值得临床推广应用。

Clinical Study on Longdan Xiegan Capsules for Secretory Otitis Media of Livergallbladder Damp-heat Type

Objective:To study the effect of Longdan Xiegan capsules for secretory otitis media(SOM) of liver-gallbladder damp-heat type. Methods: A total of 78 SOM patients of liver-gallbladder damp-heat type were selected and randomly divided into the experiment group and the control group,39 cases in each group. Both groups were treated with paracentesis of tympanic membrane,and after treatment,the control group was given cefaclor and loratadine to resist infection,while the experiment group was given Longdan Xiegan capsules. The therapeutic effect in both groups was evaluated;the levels of interferon-γ(IFN-γ) and interleukin-4(IL-4) in serum were detected before and after treatment,and the value of IFN-γ/IL-4 was calculated;Chinese medicine syndrome was scored,and the hydrops in the affected ear was observed. Results:The total effective rate was 92.31% in the experiment group,higher than that of 71.79% in the control group(P<0.05). There was no significant difference being found in the comparison of the levels of IFN-γ,IL-4 and IFN-γ/IL-4 between the two groups before treatment(P > 0.05). After treatment, the levels of IFN-γ, IL-4 and IFN-γ/IL-4 in both groups were decreased when compared with those before treatment,and the above levels in the experiment group were lower than those in the control group,differences being significant(P<0.05). There was no significant difference being found in the comparison of the scores of TCM symptoms between the two groups before treatment(P > 0.05). After treatment,each score of TCM symptoms and its total score were decreased when compared with those before treatment, and the above scores in the experiment group were lower than those in the control group, the difference being significant(P<0.05). The rate of ear hydrops was 71.79% in the experimental group, lower than that of 89.74% in the control group(P<0.05). Conclusion:Longdan Xiegan capsules has significant effect in treating SOM of liver-gallbladder damp-heat type,which can significantly improve the syndrome of patients, decrease the expression of IFN-γ and IL-4, regulate the balance of Th1/Th2 and is worthy of clinical promotion and application.