| Objective:In this study,patients with chronic subjective tinnitus were selected as the observation objects.According to the scores of tinnitus disability scale before and after treatment,the therapeutic effects of different drugs on patients with retroauricular injection were compared and their therapeutic safety was observed,providing new ideas for the treatment of chronic subjective tinnitus invalid by oral conventional drug treatment.Methods:A total of 120 patients with chronic subjective tinnitus who were ineffective with oral conventional medication in the otolaryngology department of Yulin First Hospital from December 2020 to February 2022 and met the inclusion criteria were randomly divided into 4 groups by random number table method,each group consisted of 30 patients.Group A: 40 mg MTH 1ml+2% lidocaine 1ml mixure;Group B: 40 mg MTH 1ml;Group C: 2% lidocaine injection 1ml;Group D: 0.9% sodium chloride injection 1ml.According to the plasma half-life and efficacy maintenance time of the injected drugs,all the enrolled patients received retroauricular injection once a day for 5consecutive days.Meanwhile,patients are advised to rest,avoid contact with the voice,and keep a good mood.All the enrolled patients were instructed by the same clinician to fill in the tinnitus disability scale before,after and 2 weeks after treatment.According to the filling of THI scale of the patients,the therapeutic effects of different drugs injected retroauricular for chronic subjective tinnitus patients were evaluated.Results:1.Comparison of general information: The differences in the baseline data of gender,age,disease course,tinnitus side and mean hearing threshold weren’t statistically significant between the 4 groups(P>0.05),that is,the general data of the 4groups before treatment were homogeneous.2.Comparison of THI scores before treatment: There was no significant difference in THI scores between the 4 groups(P<0.05).3.Comparison of THI scores after treatment: There were statistically significant differences in THI scores among the 4 groups after treatment(P<0.05).The THI scores of group A and group D,group C and group D after treatment were compared,and the difference were statistically.significant(P<0.008).The THI scores of group B and group D after treatment were compared,but the difference were not statistically significant(P>0.008).4.Comparison of THI scores before and after treatment: There were statistically significant differences in THI scores before and after treatment among the 4 groups(P<0.05).THI scores of patients in each group were compared before and after treatment,and the difference were statistically significant(P<0.05).5.Comparison of clinical effective rate after treatment: the clinical effective rate of group A was 43.3%;The clinical effective rate was 23.3% in group B and 36.7% in group C.The clinical response rate of group D was 6.7%.The clinical effective rates of group A and group D,group C and group D after treatment were compared,and the differences were statistically significant(P<0.008).There was no statistically significant difference in clinical effective rate between group B and group D after treatment(P>0.008).6.Analysis of influencing factors of curative effect: the therapeutic effects of different age groups,gender,tinnitus side and average listening and reading patients in the 4 groups were compared respectively,and the difference wasn’t statistically significant(P>0.05).Patients in each group with different course of disease were compared respectively,and the difference were statistically significant(P<0.05).7.Comparison of clinical effective rate 2 weeks after treatment: The clinical effective rate of group A was 43.3%;The clinical effective rate of group B was 20.0%.The clinical effective of group C was 26.7%.The clinical effective of group D was 3.3%.The clinical effective rate of group A and group D at 2 weeks after the end of treatment was compared,and the.difference was statistically significant(P<0.008).The clinical effective rates of group B and group D,group C and group D at 2 weeks after the end of treatment were compared,and the difference was not statistically significant(P>0.008).It can be seen that the therapeutic effect of group A is stable,while the therapeutic effect of group C gradually decreases with time.8.Incidence of adverse events: During the treatment,2 patients in group A and group B had subcutaneous swelling and pain behind the ear,respectively,and the incidence of adverse reactions was 6.7%.In group D,1 patient had pain behind the ear,and the incidence of adverse reactions was 3.3%.The symptoms were completely relieved after 30 minutes of observation.Conclusion: 1.Retroauricular injection of 40 mg MTH +2% lidocaine mixture can be one of the options for chronic subjective tinnitus patients who have failed to respond to conventional medical treatment.2.The therapeutic effect of chronic subjective tinnitus is related to the course of the disease.The longer the course of the tinnitus,the worse the therapeutic effect,so it should be paid attention to as soon as possible and actively treated.3.The operation of retroauricular injection is simple,with high receptivity and patient exchange coefficient.It is a drug delivery path worthy of further expansion. |
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