针灸治疗特发性耳鸣的优势方案筛选研究*

作者：徐 怡，宋玉强，刘慧林，陈 鹏，李柏洁，倪雨彤，付渊博

单位：首都医科大学附属北京中医医院，北京 100010

引用：引用：徐怡，宋玉强，刘慧林，陈鹏，李柏洁，倪雨彤，付渊博.针灸治疗特发性耳鸣的优势方案筛选研究[J].中医药导报,2025,31(5):178-182.

DOI：10.13862/j.cn43-1446/r.2025.05.031

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摘要：

目的：基于多指标决策分析法，筛选针灸治疗特发性耳鸣的最优方案。方法：检索近20年针灸治疗特发性耳鸣的随机对照试验（RCT），采用改良后Jadad量表筛选出高质量临床研究，运用多指标决策法，确定评价指标，建立加权标准化矩阵，计算各方案与理想解的相对贴近度，筛选出最优方案。结果：共纳入10项高质量RCT，与理想解贴近度最高的方案为：常规针刺“老十针”+“四神穴”，具体取穴为上脘、中脘、下脘、气海、天枢（双）、内关（双）、足三里（双）、百会、四神聪、神庭、本神 （双）、神门（双）、听宫（双）；得气后留针30 min；1次/d，5 d为1个疗程，疗程之间休息2 d，共治疗4个疗程。结论：常规针刺是特发性耳鸣患者的首选干预措施，主穴的选取应兼顾耳部气血的调畅及整体调神止鸣，以达最佳疗效。

关键词：特发性耳鸣；针灸疗法；多指标决策；优势方案

Abstract：

Objective: To screen the optimal scheme of acupuncture-moxibustion treatment for idiopathic tinnitus based on multi-index decision analysis method. Methods: Randomized controlled trials (RCTs) of acupuncture and moxibustion in the treatment for idiopathic tinnitus in the past 20 years were retrieved. High quality clinical studies were screened out by using the modified Jadad scale. The multi-index decision-making method was used to determine the evaluation indexes, establish a weighted standardized matrix, calculate the relative closeness of each scheme to the ideal solution, and screen out the optimal scheme. Result: A total of 10 high-quality RCTs were included. The plan with the highest degree of closeness to the ideal solution was: routine acupuncture of "Old Ten Needles" + "Four God Points", with specific acupoints selected as Shangwan (RN13), Zhongwan (RN12), Xiawan (RN10), Qihai (RN6), Tianshu (ST25 bilateral), Neiguan (PC6 bilateral), Zusanli (ST36 bilateral), Baihui (DU20), Sishencong (EX-HN1), Shenting (DU24), Benshen (GB13 bilateral), Shenmen (HT7 bilateral), and Tinggong (SI19 bilateral). After achieving Deqi, the needles were retained for 30 minutes. Once a day, 5 days are considered as one course of treatment, with 2 days off between each course, for a total of 4 courses of treatment. Conclusion: Conventional acupuncture is the preferred intervention measure for patients with idiopathic tinnitus, and the selection of the main acupoint should take into account the regulation of Qi and blood in the ear and the overall regulation of the mind to stop ringing, in order to achieve the best therapeutic effect.

Key words：idiopathic tinnitus; acupuncture-moxibustion therapy; multiple-indexes decision-making; optimized treatment plan selection

发布时间：2025-12-31

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