Enhanced response and safety of combining dunhuang 'moxibustion classic' acupuncture with carbamazepine in treating neuropathic tinnitus and identifying risk factors affecting sleep quality.

Objective: To evaluate the response and safety of combining acupuncture based on the Dunhuang "Moxibustion Classic" with carbamazepine in the treatment of neuropathic tinnitus.

Methods: A retrospective analysis was conducted on 105 patients with neuropathic tinnitus treated at The First People's Hospital of Lanzhou City from January 2019 to February 2023. Of these, 49 patients received acupuncture based on the Dunhuang "Moxibustion Classic" (research group), while 56 patients received conventional acupuncture (control group). Both groups were treated with carbamazepine in combination. The Tinnitus Handicap Inventory (THI), Tinnitus Evaluation Questionnaire (TEQ), Visual Analogue Scale for Aural Fullness (VAS), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD) scores were compared between the two groups. Treatment response and Pittsburgh Sleep Quality Index (PSQI) scores were also analyzed. Logistic regression analysis was performed to identify risk factors affecting patients' sleep quality.

Results: The overall response rate in the control group was significantly lower than that in the research group (P = 0.037). After treatment, THI, PSQI, TEQ, VAS, HAMA, and HAMD scores were higher in the control group than in the research group (P<0.05). The incidence of adverse reactions was significantly higher in the control group than in the research group (P = 0.025). Multivariate logistic regression analysis identified treatment options (P = 0.002, OR = 8.612, 95% CI = 2.466-39.565), disease duration (P = 0.687, OR = 0.779, 95% CI = 0.219-2.544), pre-treatment THI (P = 0.002, OR = 7.061, 95% CI = 2.17-26.368), pre-treatment TEQ (P<0.001, OR = 14.654, 95% CI = 4.196-65.376), and pre-treatment HAMA (P = 0.019, OR = 3.805, 95% CI = 1.271-12.209) as independent risk factors for impaired sleep quality.

Conclusion: The combination of Dunhuang "Moxibustion Classic" acupuncture with carbamazepine is an effective and safe treatment for neuropathic tinnitus, leading to greater improvements in symptoms, sleep quality, anxiety, and depression compared to conventional acupuncture.