【摘要】 目的 分析盐酸氨溴索联合地塞米松鼓室内注射治疗分泌性中耳炎的疗效及安全性。方法 120例分泌性中耳炎患者,采用抽签方法分为观察组和对照组,各60例。观察组采用鼓室内注射盐酸氨溴索联合地塞米松治疗,对照组采用鼓室内注射地塞米松治疗。比较两组临床疗效及治疗前后纯音听阈、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)]、免疫指标水平,分析不良发反应发生情况。结果 治疗前,两组0.5、1.0、2.0 kHz纯音听阈比较差异无统计学意义(P>0.05)；治疗后,两组0.5、1.0、2.0 kHz纯音听阈均低于治疗前,且观察组0.5 kHz纯音听阈(17.72±6.02)dB、1.0 kHz纯音听阈(19.42±8.12)d B、2.0 kHz纯音听阈(20.03±3.03)d B均低于对照组的(20.72±4.94)、(23.01±6.34)、(24.84±4.73)d B,差异有统计学意义(P<0.05)。治疗前,两组TNF-α、IL-8、CD4~+水平比较差异无统计学意义(P>0.05)；治疗后,两组TNF-α、IL-8、CD4~+水平均优于治疗前,且观察组TNF-α(1.03±0.17)ng/ml、IL-8(9.94±0.83)μg/L、CD4~+(45.04±4.75)%均优于对照组的(2.04±0.41)ng/ml、(12.84±1.65)μg/L、(41.12±3.20)%,差异有统计学意义(P<0.05)。观察组治疗总有效率95.00%明显高于对照组的80.00%,差异有统计学意义(P<0.05)。两组用药后均未发生明显不良反应。结论 分泌性中耳炎选择盐酸氨溴索联合地塞米松鼓室内注射治疗能获得显著疗效,可有效调节机体炎性反应和免疫机能。更多还原

【Abstract】 Objective To analyze the efficacy and safety of intratympanic injection of ambroxol hydrochloride and dexamethasone in the treatment of secretory otitis media. Methods A total of 120 patients with secretory otitis media were divided into observation group and control group by lottery method, with 60 cases in each group. The observation group was treated with intratympanic injection of ambroxol hydrochloride and dexamethasone, and the control group was treated with intratympanic injection of dexamethasone. The clinical efficacy, pure tone hearing threshold, serum inflammatory factors [tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)] and immune indexes of the two groups were compared before and after treatment, and the occurrence of adverse reactions were analyzed. Results Before treatment, there was no statistically significant difference in pure tone hearing threshold at 0.5, 1.0 and 2.0 kHz between the two groups(P>0.05). After treatment,the pure tone hearing threshold at 0.5, 1.0 and 2.0 kHz in both groups was lower than that before treatment in this group; the pure tone hearing threshold at 0.5, 1.0 and 2.0 kHz in the observation group were(17.72±6.02),(19.42±8.12) and(20.03±3.03) dB, which were lower than those of(20.72±4.94),(23.01±6.34) and(24.84±4.73) dB in the control group; the differences were statistically significant(P<0.05). Before treatment,there were no statistically significant differences in the levels of TNF-α, IL-8 and CD4~+ between the two groups(P>0.05). After treatment, the levels of TNF-α, IL-8 and CD4~+ in both groups were better than those before treatment in this group; the observation group had TNF-α of(1.03±0.17) ng/ml, IL-8 of(9.94±0.83) μg/L and CD4~+ of(45.04±4.75)%, which were better than those of(2.04±0.41) ng/ml,(12.84±1.65) μg/L and(41.12±3.20)% in the control group; the differences were statistically significant(P<0.05). The total effective rate of 95.00% in the observation group was significantly higher than that of 80.00% in the control group, and the difference was statistically significant(P<0.05). No obvious adverse reactions occurred in the two groups.Conclusion Intratympanic injection of ambroxol hydrochloride and dexamethasone has significant efficacy for the treatment of secretory otitis media, and regulate the body’s inflammatory response and immune function.更多还原