| Research purposesMeniere's disease(MD)is a paroxysmal,recurrent episode internal ear-related disease.According to its clinical manifestations,it is attributed to vertigo by Chinese medicine.At present the etiology and pathogenesis of the disease is still not clear,the most of academicians recognize "endolymphatic hydrops" as the main pathology,which is more in line with the pathogenesis of "phlegm" in TCM.As for treatment,there is still no specific gold standard,Present medicine use in clinic is symptomatic treatment strategy,betahistine is the most common used drugs for the treatment of the disease now,with good effect to improve dizziness;Chinese medicine thinks it as a disease of phlegm,in the treatment of the disease has a unique advantage,can quickly relieve dizziness,nausea,vomiting,tinnitus and other related symptoms,and shorten the course of the disease.The most famous representative formula is Zexie Decoction,which include Alisma and Atractylodes Two drugs,is effective for the treatment of phlegm retention associated vertigo in clinic.Alisma is a medicine of eliminating water evil which could decrease retained fluid;Atractylodes is good for spleen which could re-balancing the water circulation of whole body;Zexie Decoction is made up of these two medicine,which could clear phlegm and water stagnation.It is worth further studying and expanding application.The purpose of this study is to observe the clinical efficacy of Zexie Decoction combined with betahistine in the onset of Meniere's disease(phlegm-damp type)and objectively evaluate the clinical efficacy of traditional Chinese medicine in the treatment of this disease.to provide new ideas of the treatment of Meniere's disease;and also to provide relevant clinical evidence for future further study on the mechanism of traditional Chinese medicine treatment of Meniere's disease.Research methodsThe patients who were at acute stage of MD were the subjects of this study,these patients were found in Department of Neurology and Department of Otolaryngology in Dongzhimen hospital from November 2015 to December 2017.the subjects were randomly assigned to combined treatment group(A group),Zexie Decocion group(B group),Betahistine group(C group).The A group was given oral administration of Zexie Decoction,Twice a day,morning and evening,combined with 6mg Betahistine three times a day.The B group was given oral administration of Zexie Decoction,and a daily dose was given.The C group was given oral administration of 6mg Betahistine for three times a day.10 days is one course of treatment,and the three groups were treated continuously until the end of the 1 course of treatment.After the end of treatment,the TCM syndrome score,vertigo disorder scale(DHI)and tinnitus disability scale(THI)score of the three groups were observed,and the related clinical efficacy was judged;After the three months of treatment,The number of symptomatic seizures and changes in patients were used to evaluate the long-term efficacy.Research results1 Clinical efficacy of traditional Chinese medicine:After treatment,the total score of traditional Chinese medicine syndrome in three groups of patients decreased compared with that before treatment(P<0.05),having clinical significance.Among them,the symptoms of dizziness,nausea and vomiting,tinnitus and deafness,fatigue,sweating abnormal symptoms and the frequency of seizures were significantly different(P<0.05)in patients with Zexie Decoction combined with Betahistine and Zexie Decoction.In the Betahistine group,the symptoms of dizziness,nausea and vomiting and frequency of seizures were also significantly improved(P<0.05),however,no significant differences were found in the symptoms of tinnitus and deafness,fatigue and sweating abnormalities before and after treatment(P>0.05).After treatment,the overall efficacy of traditional Chinese medicine,the three groups showed some efficiency.In contrast,there was no significant difference between A(Zexie Decoction combined with Betahistine)and B(Zexie Decoction)group(P>0.05);However,compared with the Betahistine group,the curative effect was significantly different(P<0.05).2 In the matter of DHI scale:after the end of treatment course,the DHI scales of the three groups were significantly lower than those before the treatment(P>0.05).After treatment,the scores of DHI scale also showed differences between the three groups,and the integral improvement effect of Zexie Decoction group was better than that of Zexie Decoction plus Betahistine group,while the score of Zexie Decoction plus Betahistine group after treatment was also better than that of Betahistine group(P<0.05).3 In the matter of THI scale:after the end of treatment course,the.DHI scales of the three groups were significantly lower than those before the treatment(P>0.05).After treatment,the scores of THI scale also showed differences between the three groups,and the integral improvement effect of Zexie Decoction plus Betahistine group was better than that of Zexie Decoction group,while the score of Zexie Decoction group after treatment was also better than that of Betahistine group(P<0.05).4 Long-term efficacy:After three months of the end of treatment,the degree of attack and the number of seizures were significantly improved in patients who were followed up.Analysis conclusionZexie Decoction combined with betahistine in treatment of Meniere's disease exacerbation(phlegm-dampness type)has a significant clinical effect,can effectively relieve patients symptoms of vertigo,nausea and vomiting,tinnitus period,and lower DHI and THI scores of patients,it is worth further study;At the same time,both of them are more satisfactory for the long-term treatment of Meniere's disease(phlegm type). |
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