| Purpose: To discover the pattern of meridian injury in patients with chronic idiopathic tinnitus based on meridian theory,using palpation and data mining,and to provide a basis for acupuncture treatment of this disease by developing a prospective randomized controlled trial protocol.Material and method:Part 1A total of 204 patients with chronic idiopathic tinnitus in the outpatient clinics of the First Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Tianren Unity Wisdom Chinese Medicine Hospital,and Korean Superintendent Han Hospital between 2021.12 and 2023.01 were included.There were 130 male cases and74 female cases;237 mild cases and 245 moderate cases,age(29.21±9.64)years,BMI(24.78±6.16)kg/m,duration of illness(40.93±22.2)months.The criteria for palpation of meridian tendon injury in idiopathic tinnitus were developed in conjunction with the Chinese Meridian Tendonology.These included the hand-foot Yangming meridian tendon,hand-foot Shaoyang meridian tendon,and hand-foot Sun meridian tendon;visual analogue scale(VAS)was used for visual analogue scoring to assess the positive response level by simulating the pain level;Epidata 3.1 was used to create the "Questionnaire for the study of the pattern of meridian tendon injury in patients with idiopathic tinnitus" and to record the palpation data;SPSS Apriori algorithm in Clementine 12.0 software was used to process the palpation data for data mining.Part 2Ninety-three patients with chronic idiopathic tinnitus,44 males and 49 females,were selected from the outpatient clinics of the First Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Tianren Unity Wisdom Chinese Medicine Hospital,and Korean Superintendent Han Hospital between December 2021 and January 2023.This study was assigned according to a 1:1 ratio.The sample sizes of46 cases each in the control and acupuncture groups(47 cases in the actual acupuncture group)were calculated according to the shedding rate of 20% based on the efficiency results reported in the previous literature,and the significance level was set at α=0.05,β=0.1,and δ=0.1,and all voluntarily signed the informed consent form.The study was reviewed and approved by the ethics committee(approval number:).The general conditions of the patients were recorded,and the patients’ names,gender,age,contact information,duration of disease,ear part,severity,and time of consultation were asked and recorded in detail.Patients were asked to fill in the Tinnitus Handicap Inventory(THI)before and after treatment,respectively,to calculate the scores;they were also evaluated according to tinnitus severity assessment,safety testing,and efficacy evaluation criteria,and finally,SPSS23.0 software was used for statistical processing.Results:1.analysis of the frequency of positive occurrence of nodal tendon lesion points: all226 nodal tendon lesion points were present,and 159 had a frequency of >50%.The overall percentage of strong positives was <24.51%.The overall percentage of moderate positives was <41.91%.The overall percentage of low positives was<61.76%.2.Analysis of data mining results: the association of 2 nodal tendon lesion points in the cephalic region,and 12 associations were established.In the case of the association of the 3 cephalopelvic foci,13 associations were established.The association of the cephalad-periacetabular tendon foci was established with a minimum support level of 10% and a minimum confidence level of 60%,and 20 associations were established.The association of cephalad-arm tendon foci was established with a minimum support level of 10% and a minimum confidence level of60%.The association of cephalad-chest and abdominal tendon foci was established with a minimum support of 10% and a minimum confidence level of 60%,and 15 associations were established.The association of 2 tendon nodes in the cephalad and lumbar dorsal regions was established with a minimum support of 10% and a minimum confidence level of 60%.27 associations were established.The association of the cephalic-foot-leg kink foci was established with a minimum support of 10% and a minimum confidence of 60%,and 5 associations were established.3.Enrollment and shedding: 3 cases were shed in the control group and 2 cases were shed in the acupuncture group.The shedding rate was 5.38%.4.THI: There was no statistically significant difference between the emotional score,functional score,catastrophic score,and total score of the two groups before treatment(P>0.05).In the control group,emotional scores,functional scores,catastrophic scores,and total scores were significantly better than those before treatment(P<0.05),and in the acupuncture group,emotional scores,functional scores,catastrophic scores,and total scores were significantly better than those before treatment(P<0.05).After treatment,compared with the control group,the acupuncture group showed significant improvement in emotional scores,functional scores,catastrophic scores,and total scores(P<0.05).At follow-up compared with the control group,the acupuncture group showed significant improvement in emotional scores,functional scores,catastrophic scores,and total scores(P<0.05).5.Evaluation of tinnitus severity:There was no significant difference in TSIS scores between the two groups before treatment(P > 0.05).The TSIS scores of the control group and the acupuncture group were significantly improved compared with those before treatment(P < 0.05).After treatment and follow-up,compared with the control group,the TSIS score of the acupuncture group was significantly improved(P< 0.05).There was no significant difference in TSIS grade distribution between the two groups before treatment(P > 0.05).In the distribution of TSIS grade before and after treatment in the two groups,the number of grade 3 in the acupuncture group decreased by 16,the number of grade 4 decreased by 14,and the number of grade 5 decreased by 1.In the control group,the number of grade 4 decreased by 10,and the number of grade 5 decreased by 1.The number of high-grade people in the two groups decreased significantly(P < 0.01).Compared with the control group,the acupuncture group decreased by 31 people in the high grade 3,4 and 5,and 9 people had no grade.The control group decreased by 14 people,and the score of the acupuncture group was higher than that of the control group.There was a significant difference between the acupuncture group and the control group(P < 0.05),indicating that the acupuncture group was superior to the control group.6.Safety testing:There were no accidents such as fainting needle,bending needle,pneumothorax,sticking needle,broken needle and hematoma.7.Efficacy evaluation criteria:Among 46 patients in the treatment group,17 cases were clinically cured,14 cases were effective,12 cases were effective,and 3 cases were invalid,with a total effective rate of 95.7%;among 46 patients in the control group,10 cases were clinically cured,12 cases were effective,15 cases were effective,and 9 cases were invalid,with a total effective rate of 80.4%.The statistical treatment:rank sum test yielded Z =-2.197,P = 0.028 < 0.05,the comparison of efficacy between the two groups after treatment was statistically significant,and the total effective rate of the treatment group was higher than that of the control group.This shows that the clinical efficacy of meridian prescription acupuncture for neurogenic tinnitus is superior to the cognitive behavioral treatment mode.Conclusion1.There is an anatomical basis for the association between tendon injury and tinnitus,and it has the characteristics of tendon injury and muscle injury.2.Injuries to the meridian tendons in idiopathic tinnitus tend to occur in the upper cervical spine and temporomandibular joint,and the linkage between the two may be an important factor in the occurrence of idiopathic tinnitus.3.Meridian acupuncture treatment had a significant effect on the improvement of emotional,functional and catastrophic score indicators in patients with idiopathic tinnitus,and the treatment effect lasted until the follow-up period.4.Meridian acupuncture treatment significantly alleviated the effects of tinnitus symptoms on the environment,duration,sleep,work,and mood of patients,and the treatment effects lasted until the follow-up period.5.The treatment of idiopathic tinnitus with meridian acupuncture is safe,effective,and has sustainable long-term effects,and is worthy of further clinical promotion. |
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