目的 评估银杏叶片联合地塞米松治疗神经性耳鸣患者的临床疗效。方法 选取2019年6月—2020年6月在遂宁市中心医院耳鼻咽喉科住院的120例神经性耳鸣患者，随机分为对照组和治疗组，每组各60例。对照组鼓室内灌注地塞米松磷酸钠注射液，0.6 mL/次，首周治疗2次，然后1次/周。治疗组在对照组基础上口服银杏叶片，2片/次，3次/d。两组均持续治疗4周。观察两组患者临床疗效，比较治疗前后两组患者耳鸣致残量表（THI）评分、耳鸣响度和中枢神经递质水平。结果 治疗后，治疗组神经性耳鸣的临床症状改善的有效率（93.33%）显著高于对照组（68.33%）（P＜0.05）。治疗后，两组患者THI评分、耳鸣响度评分均较治疗前显著降低（P＜0.05），治疗后治疗组THI评分、耳鸣响度评分低于对照组（P＜0.05）。治疗后，两组患者血清5-羟色胺（5-HT）的水平显著降低，γ-氨基丁酸（GABA）的含量显著升高（P＜0.05）；且治疗组5-HT和GABA的变化比对照组更明显（P＜0.05）。结论 银杏叶片联合地塞米松治疗可显著改善神经性耳鸣患者的临床症状，降低患者的耳鸣响度，调节中枢神经递质的水平。

Objective To evaluate the clinical efficacy of Yinxingye Tablets combined with dexamethasone in treatment of nervous tinnitus. Methods Patients (120 cases) with nervous tinnitus in Suining Central Hospital from June 2019 to June 2020 were randomly divided into control and treatment group, and each group had 60 cases. Patients in the control group were intratympanic perfusion with Dexamethasone Sodium Phosphate Injection, 0.6 mL/time, twice daily for the first week, then once weekly. Patients in the treatment group were po administered with Yinxingye Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the THI scores, tinnitus loudness, the level of central neurotransmitters in two groups before and after treatment were compared. Results After treatment, the effective rate of clinical symptom improvement in the treatment group (93.33%) was significantly higher than that in the control group (68.33%) (P < 0.05). After treatment, the THI score and tinnitus loudness score in two groups were significantly lower than those before treatment (P < 0.05), and the THI score and tinnitus loudness score in treatment group were lower than those in control group (P < 0.05). After treatment, the level of serum 5-HT in two groups decreased significantly, the GABA levels were significantly increased (P < 0.05), the changes of 5-HT and GABA in the treatment group were more obvious than those in the control group (P < 0.05). Conclusion Yinxingye Tablets combined with dexamethasone can significantly improve the clinical symptoms of patients with nervous tinnitus, reduce the loudness of tinnitus, and regulate the level of central neurotransmitters.

R987

成都中医药大学"杏林学者"学科人才科研提升计划项目(YYZX2020095)