接纳与承诺疗法及耳鸣再训练疗法治疗耳鸣的疗效观察  

Effects of acceptance and commitment therapy with tinnitus retraining therapy on patients with tinnitus

作　　者：高国强[1] 何剑[2] 

机构地区：[1]南华大学附属第二医院耳鼻咽喉科,湖南衡阳421000 [2]中南大学湘雅医院耳鼻咽喉头颈外科,湖南长沙410008

出　　处：《中国现代医学杂志》2015年第5期94-99,共6页China Journal of Modern Medicine

摘　　要：目的比较接纳与承诺疗法(ACT)及耳鸣再训练疗法(TRT)治疗耳鸣的疗效。方法所有入选患者为该院门诊耳鸣就诊患者,共90例,随机分配到ACT组(n=30)、TRT组(n=30)和对照组(n=30),按照试验流程分别给予干预治疗。分别于治疗开始前、治疗开始后10周、6个月和18个月进行问卷调查。对问卷调查结果进行统计学分析。结果 ACT组和TRT组患者的依从性均较好。经治疗干预后,ACT组的主要终点THI显著改善,明显好于TRT组。6个月时ACT组患者的临床总体疗效-改善率高于TRT组。经治疗后,ACT组各时间点的次要终点变量失眠严重程度指数(ISI)和医院焦虑抑郁量表(HADS)均明显好于TRT组,QOLI亦有好转趋势。治疗后10周,ACT组的THI、ISI和HADS均明显好于对照组。结论 ACT治疗可改善耳鸣患者的心理困扰和生活质量。【Objective】 To compare the effects of acceptance and commitment therapy（ACT） with tinnitus retraining therapy（TRT） on the patients with tinnitus. 【Methods】 A total of 90 normal hearing subjects with tinnitus who were from our Outpatient Department were randomized to group ACT（n =30）, group TRT（n =30）and control group（n =30）. All the subjects were treated as the trial protocol. Assessments were made at baseline, 10 weeks, 6 and 18 months after the start of the therapies. The results of the assessments were statistically analyzed.【Results】 Patients’ treatment compliance in the group ACT and the group TRT were good. After treatment intervention, the primary endpoint THI in the group ACT was improved significantly, and significantly better than that in the group TRT. The overall clinical efficacy in the patients of the group ACT 6months after intervention was significantly improved compared to that in the group TRT. Through treatment,compared with the group TRT, the secondary endpoint variables at each time point in the group ACT, including ISI and HADS, were significantly better, and QOLI was also improved. Compared with the control group,THI, ISI and HADS in the group ACT were significantly better after 10 weeks of treatment. 【Conclusions】ACT can improve the quality of life and psychological distress in the patients with tinnitus.

关 键 词：耳鸣 ACT TRT 心理困扰 

分 类 号：R764[医药卫生—耳鼻咽喉科]