Objective: To observe the clinical effect of Tongdu Tiaoshen acupuncture (acupuncture for promoting the circulation of the governor vessel and regulating the spirit) for subjective tinnitus, and explore its potential mechanism.
Methods: A total of 92 patients with subjective tinnitus were randomly divided into an acupuncture group (46 cases, 5 cases dropped out) and a medication group (46 cases, 2 cases dropped out). The acupuncture group received Tongdu Tiaoshen acupuncture at Shuigou (GV 26), Yintang (GV 24+), Shenting (GV 24), Baihui (GV 20), Fengfu (GV 16), Dazhui (GV 14) and Zhongzhu (TE 3), Tinghui (GB 2), Yifeng (TE 17) on the affected side, 30 min each time, once every other day, 3 times a week. The medication group was orally administered ginkgo biloba leaves tablets (40 mg each time) and mecobalamin tablets (0.5 mg each time), 3 times a day. Both groups were treated for 4 weeks. The scores of tinnitus severity, tinnitus loudness visual analogue scale (VAS) and depression anxiety stress scale-21(DASS-21) before and after treatment were observed in the two groups, serum level of brain-derived neurotrophic factor (BDNF) before and after treatment in the two groups was detected, and the clinical effect was evaluated in the two groups.
Results: After treatment，the scores of tinnitus severity, tinnitus loudness VAS and DASS-21 were decreased compared with those before treatment in the two groups (P<0.01), and the scores in the acupuncture group were lower than those in the medication group (P<0.05). After treatment, the serum level of BDNF was decreased compared with that before treatment in the two groups (P<0.01), and the serum level of BDNF in the acupuncture group was lower than that in the medication group (P<0.05). The total effective rate of the acupuncture group was 82.9% (34/41), which was higher than 70.5% (31/44) in the medication group (P<0.05).
Conclusion: Tongdu Tiaoshen acupuncture could improve the severity of tinnitus, tinnitus loudness and negative emotion in patients with subjective tinnitus. Its mechanism may be related to the regulation of serum level of BDNF and thus affect auditory central plasticity.
目的：观察“通督调神”法针刺治疗主观性耳鸣的临床疗效，并探讨其可能的作用机制。方法：将92例主观性耳鸣患者随机分为针刺组（46例，脱落5例）和药物组（46例，脱落2例）。针刺组予“通督调神”法针刺治疗，穴取水沟、印堂、神庭、百会、风府、大椎和患侧中渚、听会、翳风，每次30 min，隔日1次，每周3次；药物组予口服银杏叶片（40 mg/次）、甲钴胺片（0.5 mg/次），均每日3次。两组均连续治疗4周。观察两组患者治疗前后耳鸣严重程度评分、耳鸣响度视觉模拟量表（VAS）评分和情绪自评量表（DASS-21）评分，检测治疗前后两组患者血清脑源性神经营养因子（BDNF）含量，并评定临床疗效。结果：治疗后，两组患者耳鸣严重程度评分、耳鸣响度VAS评分和DASS-21评分均较治疗前降低（P<0.01），且针刺组均低于药物组（P<0.05）。治疗后，两组患者血清BDNF含量均较治疗前降低（P<0.01），且针刺组低于药物组（P<0.05）。针刺组总有效率为82.9%（34/41），高于药物组的70.5%（31/44，P<0.05）。结论：“通督调神”法针刺可改善主观性耳鸣患者的耳鸣严重程度、耳鸣响度和不良情绪，其机制可能与调节血清BDNF含量、影响听觉中枢可塑性有关。.
Keywords: Tongdu Tiaoshen; acupuncture; brain-derived neurotrophic factor (BDNF); randomized controlled trial (RCT); subjective tinnitus; visual analogue scale (VAS) score.