基于中医体质分型的针刺治疗突发性感音神经性聋疗效观察OACHSSCD

Objective:To investigate the distribution characteristics of traditional Chinese medicine(TCM)constitutions in patients with sudden sensorineural hearing loss(SSNHL),and to evaluate the clinical efficacy of acupuncture based on TCM constitution differentiation in the treatment of SSNHL.Methods:A total of 240 patients with SSNHL treated from June 2018 to December 2023 were selected and randomly divided into a constitution-based acupuncture group(n=120,acupoint selection based on constitution)and a conventional acupuncture group(n=120,standard acupoint selection),both combined with basic treatment.Clinical efficacy,hearing threshold,Tinnitus Handicap Inventory(THI)scores,TCM syndrome scores,and EQ-5D-5L scores were compared between the two groups.The relationships among constitution type,age,disease duration,and treatment efficacy were also analyzed.Results:The clinical efficacy of the constitution-based acupuncture group was significantly better than that of the conventional acupuncture group(P＜0.05).The constitution-based acupuncture group showed significantly greater improvements in THI scores,pure-tone hearing thresholds,hearing loss scores,TCM syndrome scores,and EQ-5D-5L scores compared with the conventional acupuncture group(P＜0.05).Analysis of the association between constitution types and therapeutic efficacy in the constitution-based acupunc-ture group showed that patients with phlegm-dampness constitution(OR=2.156,95％CI 1.324 to 3.518)and blood-stasis consti-tution(OR=1.872,95％CI 1.105 to 3.174)had better treatment outcomes,while increased age(OR=0.977,95％CI 0.956 to 0.998)and longer disease duration(OR=0.913,95％CI 0.857 to 0.973)may have negative effects on efficacy.Conclusion:Pa-tients with SSNHL mostly present with biased constitutions.Acupuncture based on constitution differentiation can significantly im-prove clinical efficacy and quality of life,with better effects observed in patients with phlegm-dampness and blood-stasis constitu-tions.