突发性聋不同证型指标差异性及气滞血瘀型临床特征研究
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R276.1

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福建省科技厅自然科学面上项目(2026J001930);福建省卫生健康委员会医学创新课题(2025CXA050);国家中医优势专科建设项 目(老年病科)(2026) 0368号


Study on the Differences in Indicators Among Different Syndrome Types of Sudden Sensorineural Hearing Loss and the Clinical Characteristics of Qi Stagnation and Blood Stasis Type
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    摘要:

    目的:探讨突发性聋(SSHL) 患者临床特征与中医证型的相关性,为中医辨证提供客观化参考。方法:采用回顾性研究方法,纳入2022年1月—2024年12月福建中医药大学附属第三人民医院收治的SSHL住院患者,收集其临床资料及中医证型。通过单因素分析筛选相关指标,构建多因素logistic 回归模型,绘制ROC曲线验证模型的预测效能。结果:最终纳入151例SSHL患者,其中以气滞血瘀型为主(62例,41.06%),其次为外邪侵袭型(49例,32.45%)、痰火郁结型(26例,17.22%)、肝火上炎型(14例,9.27%)。不同中医证型患者在颅脑磁共振(MR) 异常率、颈部血管超声异常率、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C) 及空腹血糖(FBG) 水平方面组间总体差异有统计学意义(P<0.05)。气滞血瘀型患者TC及LDL-C 水平高于其他证型(P<0.05), TG 水平未见升高。多因素Logistic 回归显示, TC[OR=2.009,95%CI (1.292~3.125)] 与LDL-C [OR=6.209, 95%CI (3.193~12.076)] 均是气滞血瘀型的独立预测因子(P<0.01)。ROC曲线分析显示,LDL-C的曲线下面积(AUC) 为0.839 [95%CI (0.772~0.905)],灵敏度79.0%、特异度84.3%,联合TC后AUC提升至0.865 [95%CI(0.807~0.923)]。结论:LDL-C可作为SSHL气滞血瘀型的辅助判别指标,当LDL-C≥2.91 mmol/L时具有最佳诊断效能,可为中医辨证客观化提供实验室依据。

    Abstract:

    Abstract:Objective:To explore the correlation between clinical characteristics of sudden sensorineural hearing loss( SSHL) patients and traditional Chinese medicine syndrome types,and to provide objective reference indicators for traditional Chinese medicine syndrome differentiation. Methods: A retrospective study was conducted on SSHL inpatients admitted to The Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine from January 2022 to December 2024. Clinical data and traditional Chinese medicine syndrome types were collected. Relevant indicators were screened through univariate analysis, and a multivariate logistic regression model was constructed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the model. Results: A total of 151 SSHL patients were finally included, in terms of the traditional Chinese medicine syndrome types,the qi stagnation and blood stasis type being the most prevalent( 62 cases,41.06%),followed by the external pathogen invasion type (49 cases, 32.45%), the phlegm-fire stagnation type (26 cases,17.22%),and the liver fire flaring upward type (14 cases, 9.27%). Significant overall differences were found among patients with different traditional Chinese medicine syndrome types in terms of brain magnetic resonance (MR) abnormality rate, cervical vascular ultrasound abnormality rate, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and fasting blood glucose (FBG) levels (P<0.05). Patients with the qi stagnation and blood stasis type had significantly higher TC and LDL-C levels than those with other syndrome types (P<0.05), while no elevation was observed in TG. Multivariate logistic regression showed that both TC [OR=2.009, 95% CI (1.292- 3.125) ] and LDL-C [OR=6.209,95% CI (3.193-12.076)] were independent predictors of the qi stagnation and blood stasis type (P<0.01). ROC curve analysis showed that the area under the curve (AUC) of LDL-C was 0.839 [95% CI (0.772-0.905)],with a sensitivity of 79.0% and specificity of 84.3%. After combining with TC,the AUC increased to 0.865 [95% CI (0.807-0.923)]. Conclusion: LDL-C can serve as an auxiliary discriminatory indicator for the qi stagnation and blood stasis type of SSHL,with the optimal diagnostic efficacy at LDL-C ≥ 2.91 mmol/L. This provides a laboratory basis for the objective differentiation of traditional Chinese medicine syndromes.

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艾斌,黄武松.突发性聋不同证型指标差异性及气滞血瘀型临床特征研究[J].新中医,2026,58(20):35-40

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  • 在线发布日期: 2026-10-21
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