不同掩蔽方式治疗耳鸣的疗效观察  

The Evaluation of the Effects of Different Masking Methodologies to the Management of Tinnitus

作　　者：文雅[1,2] 冯永[1] 梅凌云[1] 张海林[1] 

机构地区：[1]中南大学湘雅医院耳鼻咽喉科,长沙410008 [2]长沙市八医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2010年第6期562-565,共4页Journal of Audiology and Speech Pathology

基　　金：国家863计划(2007AA02Z445);国家自然科学基金(30470954;30671150);"十一五"国家攻关计划(2007BA118B13);高等学校博士学科点专项基金(20060533043)资助

摘　　要：目的探讨完全掩蔽、不全掩蔽及循序掩蔽三种方式治疗主观性耳鸣的疗效差异。方法将58例主观性耳鸣患者随机分为三组:完全掩蔽组20例,不全掩蔽组18例,循序掩蔽组20例,分别进行掩蔽治疗半年,评价每组在治疗1、3、6个月的疗效。结果①三组在同一阶段的疗效比较:治疗1个月后,三组疗效分别为75.00%、75.00%和33.33%,完全掩蔽组和循序掩蔽组较不全掩蔽组疗效高(P<0.05);治疗3个月后,三组疗效分别为85.00%、40.00%和38.89%,循序掩蔽组较完全掩蔽组及不全掩蔽组疗效高(P<0.05);治疗6个月后,三组疗效分别为90.00%、72.22%和25.00%,不全掩蔽组和循序掩蔽组较完全掩蔽组疗效高(P<0.0125)。②各组在不同阶段的疗效比较:完全掩蔽组疗效随时间降低,有效率从75.00%降低至25.00%;不全掩蔽组疗效随时间增高,有效率从33.33%增高至72.22%;循序掩蔽组疗效稳定,不随时间显著变化,有效率均在75.00%以上。结论循序掩蔽治疗综合了完全掩蔽的早期治疗优势和不全掩蔽的后期治疗优势,与仅使用单一掩蔽方式治疗相比,疗效更好。Objective To evaluate the effects of the tinnitus treatment in stages by using complete,partial and progressive masking on patients with subjective tinnitus and to determine a more appropriate masking approach for the clinical application.Methods 58 patients with subjective tinnitus were randomly divided into three study groups：20 cases in complete masking group,18 patients in partial masking group and 20 cases in progressive masking group.All the patients underwent masking therapy for 6 months,and the effects were assessed at 1,3 and 6 months.Results When comparing the efficacy of three groups at the same stage：①The effects of complete and progressive masking groups are more noticeable than that of partial group at the end of one month treatment,75%,75% and 33.33%,respectively;②The effects of progressive masking group are more noticeable than that of complete and partial masking groups at the end of three months treatment,85%,40% and 38.89%,respectively; and ③The effects of progressive and partial masking groups are more noticeable than that of complete masking group at the end of six months,90%,72.22% and 25%,respectively.When comparing the effects of the three groups at different stages,the findings are：①The effects of complete masking group decreased from 75% to 25% over the time; ②the effects of partial masking group increased from 33.33% to 72.22% over the time; ③the effects of progressive masking group has been maintained above 75% throughout the whole treatment time.Conclusion The progressive masking treatment has shown to have the advantages of the other two treatment mythologies without losing its effectiveness over the time.Therefore,the progressive masking approach is more effective than any one of a single method in treating tinnitus.

关 键 词：耳鸣 完全掩蔽 不全掩蔽 循序掩蔽 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]