声治疗慢性耳鸣患者的临床特征及疗效分析  

Analysis of clinical characteristics and curative effect of acoustic therapy for chronic tinnitus

作　　者：郭斌[1] 马新春[1] 张英[1] GUO Bin;MA Xinchun;ZHANG Ying(Department of Otolaryngology affiliated Hospital of Qinghai University,810001,China)

机构地区：[1]青海大学附属医院耳鼻咽喉科,810001

出　　处：《中国中西医结合耳鼻咽喉科杂志》2020年第5期350-354,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：青海省卫生与计划生育委员会重点科研项目(2018-wjzd-11)。

摘　　要：目的分析慢性主观性耳鸣患者的临床特征并探讨声治疗慢性主观性耳鸣的临床疗效。方法以就诊于青海大学附属医院耳鸣门诊的242例以耳鸣为第一主诉的患者为研究对象,根据患者测定的耳鸣频率及响度匹配频率近似的耳鸣治疗声,患者聆听治疗声每次30 min,1天1次,给予的治疗声频率与耳鸣匹配检查的主频率保持一致,响度可由患者自身情况选定,治疗时间为3个月、6个月及12个月。对其声治疗前,治疗后3个月、6个月、12个月为结点完成耳鸣主调声匹配,及耳鸣残障量表填写,初步判定青海地区声治疗慢性主观性耳鸣的临床疗效,并分析耳鸣主调声频率、治疗时间、残余抑制试验(residual inhibitiontest,RI)、佛德曼曲线与慢性主观性耳鸣转归的特点。结果①临床特征方面:青海地区242例慢性主观性耳鸣患者中听力异常者比例居高,为85.54%(207/242);耳鸣主调声频率位于高频段者比例居高,为64.46%(156/242);②临床治疗疗效方面:低、中、高频耳鸣患者声治疗3、6、12个月后均有较好的治疗效果,低频、中频在不同的治疗时间内有效率差异无统计学意(P>0.05),高频耳鸣患者在不同的治疗时间内有效率差异有统计学意义(P<0.05);声治疗前后,根据患者RI结果可将患者分为四型,各型组有效率无统计学差异(P>0.05),佛德曼曲线分组间有效率无统计学差异(P>0.05)。结论①青海地区耳鸣患者中伴有听力异常的耳鸣患者最常见,且以高频耳鸣主调声频率为主;②声治疗不同频率的慢性耳鸣效果明显,高频耳鸣的患者治疗时间越长,效果越佳;③声治疗并不受限于耳鸣残余抑制实验阳性或部分阳性者,并且适用于各型佛德曼曲线患者。Objective To analyze the clinical characteristics of patients with chronic subjective tinnitus and to discuss the clinical efficacy of acoustic therapy for chronic subjective tinnitus.Methods A total of 242 patients with tinnitus as the first complaint in the tinnitus clinic of Qinghai University Affiliated Hospital.According to the tinnitus frequency and tinnitus matching frequency determined by the patients,the patients listened to the therapy sound for 30 min each time,once a day,and the therapy sound frequency given was consistent with the main frequency of tinnitus matching examination.The loudness could be selected by the patients themselves,and the treatment duration was 3,6 and 12 months.To them as the research object,the acoustic therapy before and after therapy for 3 months,6 months and 12 months as node tinnitus sound tone match,and fill out of tinnitus handicap scale.To preliminarily determine the clinical efficacy of treating chronic subjective tinnitus in Qinghai region,and analyze the tinnitus sound tone frequency,therapy time and residual inhibition test,Feldmann curve and the characteristics of chronic subjective tinnitus outcome.Results①Clinical features:Among 242 patients with chronic subjective tinnitus in Qinghai,the proportion of hearing abnormalities was high(85.54%(207/242));and the proportion of tinnitus melody frequency located in the high frequency band was high,64.46%(156/242).②Clinical curative effect:the acoustic therapy for patients with low,medium and high frequency tinnitus showed good therapeutic effect after 3,6 and 12 months,and there was no statistically significant difference in the effective rate between low and medium frequencies in different therapy periods(P>0.05).The effective rates of patients with high frequency tinnitus in different therapy times were statistically significant(P<0.05);Before and after acoustic therapy,according to patients’RI results,patients could be divided into four groups.The effective rate of four groups was not statistically different(P>0.

关 键 词：主观性 耳鸣 声治疗 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]