【目的】观察中医综合治疗难治性突聋 （即病程超过2周的突发性聋） 的疗效，并对可能影响预后的因素进行分析。 【方法】回顾性分析2005年至2022年期间在广州中医药大学第一附属医院耳鼻喉科住院部接受治疗的405例难治性突聋患 者，经个体化辨证后进行中药内服、针灸治疗、耳穴贴压等中医综合治疗后的临床疗效，分析不同病程、耳聋程度、听力 曲线类型、既往治疗史、伴随症状及不同证型患者的疗效差异。 【结果】405例难治性突聋患者中，痊愈率为5.7%，总有效率 为28.1%；其中，轻度聋、低频下降型、既往未经治疗者疗效最好，差异均有统计学意义 （P＜0.05或P＜0.01） ；而不同病 程、有无伴随症状及不同证型患者的疗效比较，差异均无统计学意义 （P＞0.05） 。 【结论】中医综合治疗对难治性突聋具有一 定疗效，经西医常规治疗效果不佳的患者仍可从中医综合治疗中获益。

Objective To observe the curative effect of comprehensive traditional Chinese medicine （TCM） therapy for the treatment of refractory sudden hearing loss （i.e.，suffering sudden hearing loss more than 2 weeks） ，and to analyze the factors that may affect the prognosis. Methods A retrospective analysis was carried out in 405 hospitalized patients with refractory sudden hearing loss who were treated in the Department of Otorhinolaryngology，the First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2005 to 2022. The patients were all treated by comprehensive TCM therapy including oral administration of Chinese medicine，acupuncture，acupoint seed- pressing application after individualized syndrome differentiation. The overall clinical efficacy was evaluated，and the difference of efficacy in the patients with various courses of disease，degrees of deafness，types of hearing curve，concomitant symptoms and TCM syndrome types，having or not having previous treatment history was analyzed. Results For the 405 patients with refractory sudden hearing loss，the cure rate was 5.7% and the total effective rate was 28.1%. Among the 405 patients，the best efficacy was achieved in the patients with mild hearing loss，low-frequency decline type of hearing curve，and having no previous treatment history，and the differences were statistically significant （P＜0.05 or P＜0.01） . There was no significant difference in the efficacy of patients with different courses of disease，with or without concomitant symptoms，or with various syndrome types（P＞ 0.05） . Conclusion The comprehensive TCM therapy has a certain effect on refractory sudden hearing loss. Patients with poor efficacy after conventional western medicine can still benefit from the comprehensive TCM therapy.

R276.1

国家自然科学基金面上项目 （编号：82274590，81974581）；国家中医药管理局2023年中央财政转移支付地方项目—突发性耳聋 （暴 聋） 的中医药治疗循证能力提升建设项目；广州市科技计划项目 （编号：202201020308）