睡眠不足与耳鸣发病及其严重程度的相关性研究  

Study on the Correlation of Sleep Insufficiency with the Incidence and Severity of Tinnitus

作　　者：洪伟哲 陈跃凤 林文智 刘锦光 刘洁恒 王志琼 张丹慧 肖琪 刘蓬[4] HONG Wei-Zhe;CHEN Yue-Feng;LIN Wen-Zhi;LIU Jin-Guang;LIU Jie-Heng;WANG Zhi-Qiong;ZHANG Dan-Hui;XIAO-Qi;LIU Peng(Dept.of Otorhinolaryngology,Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan 528400 Guangdong,China;Community Health Service Center of Changhua Street,Liwan District,Guangzhou 510145 Guangdong,China;The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Otorhinolaryngology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学附属中山中医院耳鼻喉科,广东中山528400 [2]广州市荔湾区昌华街道社区卫生服务中心,广东广州510145 [3]广州中医药大学第一临床医学院,广东广州1510405 [4]广州中医药大学第一附属医院耳鼻喉科,广东广州510405

出　　处：《广州中医药大学学报》2023年第8期1884-1890,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:82274590,81974581)。

摘　　要：【目的】研究睡眠不足(包括睡眠障碍及熬夜)与耳鸣发病及其严重程度的相关性,为从中医整体观角度探讨耳鸣的病因提供有价值的临床流行病学资料。【方法】收集320例耳鸣患者的临床资料,调查患者耳鸣发病前后的睡眠情况,同时填写匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、中医脾胃系疾病PRO量表及耳鸣评价量表(tinnitus evaluation questionnaire,TEQ),并行必要的听力学检测。运用单因素及有序Logistics回归分析影响耳鸣严重程度的诸因素,进而分析睡眠不足与耳鸣发病及其严重程度的相关性。【结果】(1)320例耳鸣患者中,发病前存在睡眠不足者277例(86.56%),其中熬夜142例(44.38%),睡眠障碍135例(42.19%);PSQI评分(8.19±4.08)分,高于全国常模的(3.88±2.52)分(P<0.05);发病前存在睡眠障碍和/或熬夜的患者发病后耳鸣的严重程度均高于睡眠正常者(P<0.01或P<0.001);PSQI评分与TEQ评分呈正相关,相关系数r=0.575(P<0.05)。(2)320例耳鸣患者的脾胃功能平均得分(40.35±9.62)分,高于全国常模的(7.04±1.92)分(P<0.01);脾胃功能评分与TEQ评分呈正相关,相关系数r=0.259(P<0.05)。(3)睡眠不足者的脾胃功能评分大于睡眠正常者(P<0.05);PSQI评分与脾胃功能评分呈正相关,相关系数r=0.505(P<0.05)。(4)320例耳鸣患者中,有172例(53.75%)耳鸣患者当下存在睡眠障碍,其中有114例(66.28%)耳鸣发病之前就已存在睡眠障碍,58例(33.72%)耳鸣发病后才出现睡眠障碍。【结论】睡眠不足造成睡眠质量下降,导致脾胃失调,这可能是导致耳鸣发病的重要病因病机之一。Objective To study the correlation of sleep insufficiency(including sleep disorders and staying up late)with the incidence and severity of tinnitus,and to provide clinical epidemiological evidence for exploring the etiology of tinnitus from a holistic view of traditional Chinese medicine(TCM).Methods The clinical data of 320 tinnitus patients were collected and their sleep conditions before and after the onset of tinnitus were investigated.Meanwhile,the Pttsburgh sleep quality index(PSQI)questionnaire,the patient-reported outcome(PRO)scale for spleen and stomach disorders in TCM and the tinnitus evaluation questionnaire(TEQ)were flled,and the necessary auditory test was performed.Factors affecting the severity of tinnitus were analyzed using univariate and ordinal logistic regression,and then the correlation of sleep insufficiency with the onset and severity of tinnitus was analyzed.Results(1)Among the 320 tinnitus patients,277(86.56%)had sleep insufficiency before onset,manifested as staying up late(142 cases,44.38%)and sleep disorders(135 cases,42.19%),and their PSQI score was(8.19±4.08),higher than that of the national norm(3.88±2.52),the difference being significant(P<0.05).The severity of tinnitus in the patients who had sleep disorders and/or staying up late was higher than in those with normal sleep(P<0.01 or P<0.001).The PSQI score was positively correlated with the TEQ score,with a correlation coefficient being 0.575(P<0.05).(2)The mean score of spleen-stomach function in 320 tinnitus patients was(40.35±9.62),which was higher than that of the national norm(7.04±1.92),the dfference being significant(P<0.01).The spleen-stomach function score was positively correlated with the TEQ score,with a correlation coefficient being 0.259(P<0.05).(3)The spleen-stomach function score of the sleep-insufficiency patients was greater than those with normal sleep(P<0.05),and their PSQI scores were positively correlated with spleen-stomach function scores,with a correlation coefficient being 0.505(P<0.05).(4)Among the

关 键 词：耳鸣 睡眠不足 耳鸣严重程度 听力下降 脾胃失调 

分 类 号：R276.1[医药卫生—中医五官科学]