声治疗联合劳拉西泮治疗耳鸣的临床研究  

The Clinical Study of the Effects Research of Lorazepam with Sound Therapy as a Combined Treatment on Tinnitus Patients

作　　者：方祎[1,2] 马芙蓉[1] 赵一鸣[1] 李楠[1] 孔庆梅[1] 

机构地区：[1]北京大学第三医院耳鼻咽喉科,北京100083 [2]北京朝阳医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2012年第5期420-424,共5页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金(81070788);北京市自然科学基金(7082100)资助

摘　　要：目的观察声治疗联合劳拉西泮治疗耳鸣的疗效,并探讨作用机制。方法采用随机、对照、双盲的研究方法,将68例耳鸣患者分为试验组和对照组,每组34例,均予耳鸣咨询和声治疗作为基础治疗,试验组加用劳拉西泮,对照组加用维生素B6,治疗1周后观察近期疗效并停药,继续使用声治疗至2个月观察远期疗效。治疗前后行纯音测听和耳鸣匹配,填写耳鸣问卷(包含耳鸣残疾度量化表)和焦虑自评量表,对结果进行比较。结果用药1周后,试验组患者的耳鸣主观响度评分下降1.2±1.0分,残疾度评分下降14.0±13.5分,焦虑评分下降9.9±7.2分,对照组上述三个指标改善值分别为0.1±1.4、1.3±8.0、3.3±6.1分,两组间差异有统计学意义(P<0.05),且用药后2个月差异仍有统计学意义(P<0.05),三个评价指标的变化呈中度正相关(r=0.378～0.762,P<0.01);两组均未出现严重药物不良反应。结论劳拉西泮结合耳鸣咨询与声治疗可以改善患者的耳鸣症状和焦虑情绪;劳拉西泮治疗耳鸣安全有效。Objective To determine whether lorazepam is effective in treating subjective tinnitus and explore the mechanisms. Methods Randomized, prospective, double-blind, controlled trial was designed for the study. The group consisted of 68 adult patients complaining of tinnitus. Patients in experimental group（34 patients）were given lorazepam along with counseling and sound therapy, and others（34 patients）in control group were given vitamine B6 instead of lorazepam. After one week treatment the effects of different medicines were observed. We advised patients to continue sound therapy until 2 months to see long-term results. Pure tone audiogram, tinnitus pitch and loudness matching were performed before and after the treatment as well as tinnitus questionnaire（including tinnitus handicap inventory） and self--rating anxiety scale. Results After 1 week, the perceived tinnitus loudness, reported tinnitus severity and anxiety level of patients using lorazepam decreased 1.2±1.0, 14.0 ±13.5 and 9.9 ±7.2 separately with the corresponding index of control group were 0.1 ±1.4,1.3 ± 8.0 and 3.3± 6.1. There were significant differences between two groups, and these differences lasted to 2 months later. There were positive correlations between these three indexes（r=0. 378±0. 762, P〈0.01）. Nobody in both groups showed severe drug adverse reaction. Oonclusion Lorazepam with counseling and sound therapy is a safe and effective method in treatment of tinnitus.

关 键 词：耳鸣 焦虑 劳拉西泮 声治疗 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]