耳周穴位注射联合认知行为疗法对老年慢性特发性耳鸣的疗效及影响因素分析  

Analysis of effect and influencing factors of periauricular acupoint injection combined with cognitive behavioral therapy on chronic idiopathic tinnitus in the elderly

作　　者：张弢 罗建敏[1] 董伟[1] 刘畅[1] 兰家辉 郑荣华[1] 陈跃来 Zhang Tao;Luo Jianmin;Dong Wei;Liu Chang;Lan Jiahui;Zheng Ronghua;Chen Yuelai(Department of Otorhinolaryngology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200032,P.R.China;Department of Acupuncture,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200032,P.R.China)

机构地区：[1]上海中医药大学附属龙华医院耳鼻咽喉科,上海200032 [2]上海中医药大学附属龙华医院针灸科,上海200032

出　　处：《老年医学与保健》2024年第1期89-94,共6页Geriatrics & Health Care

基　　金：上海领军人才项目(2021-013)。

摘　　要：目的探讨耳周穴位注射联合认知行为疗法治疗老年慢性特发性耳鸣的疗效及影响因素分析。方法将2021年10月—2022年9月在上海中医药大学附属龙华医院耳鼻喉科就诊的128例老年慢性特发性耳鸣患者采用随机数字法将其分为观察组和对照组各64例。对照组进行耳周穴位注射治疗,观察组在对照组基础上联合进行认知行为疗法治疗,治疗4周,并于治疗前、治疗结束时、治疗结束后1个月时进行耳鸣严重程度评估量表、匹兹堡睡眠质量指数量表、汉密顿焦虑量表评分,比较治疗前与治疗结束时、治疗结束1个月后的改善情况,观察组和对照组的差异,分析观察组的疗效的影响因素分析。结果耳周穴位注射联合认知行为疗法治疗老年慢性特发性耳鸣总有效率达到37.5%,与本组治疗前相比,在治疗结束时和治疗结束1个月后在耳鸣严重程度、PSQI、HAMA评分方面差异均有统计学意义(P<0.01),与对照组比较差异也有统计学意义(P<0.05)。年龄是耳周穴位注射联合认知行为疗法治疗老年慢性特发性耳鸣疗效的影响因素之一。结论耳周穴位注射联合认知行为疗法能有效治疗老年慢性特发性耳鸣,但是高龄患者疗效有限。Objective To investigate the effect and influencing factors ofperiauricularacupoint injection combined with cognitive behavioral therapy on chronic idiopathic tinnitus in the elderly.Method A total of 128 elderly patients with chronic idiopathic tinnitus treated in the Department of Otorhinolaryngology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from October 2021 to September 2022 were divided into observation group and control group by random number method,with 64 cases in each group.The control group received periauricular acupoint injection treatment,and the observation group received cognitive behavioral therapy on the basis of the control group.Both groups were treated for 4 weeks.The Tinnitus Severity Assessment Scale,Pittsburgh Sleep Quality Index Scale and Hamilton Anxiety Scale were used to score before treatment,at the end of treatment and 1 month after treatment.The improvement of the two groups was compared at the end of treatment and 1 month after treatment.The factors affecting the curative effect of the observation group were analyzed.Results The total effective rate of periauricular acupoint injection combined with cognitive behavioral therapy in the treatment of chronic idiopathic tinnitus in the elderly reached 37.5%.Compared with before treatment,there were statistically significant differences in the scores of Tinnitus Severity,PSQI,and HAMA in both groups at the end of treatment and one month after treatment(P<0.01),and the improvement in the observation group was significantly better than that in the control group(P<0.01).Age was one of the influencing factors of the therapeutic effect of periauricular acupoint injection combined with cognitive behavioral therapy on chronic idiopathic tinnitus in the elderly.Conclusion Periauricular acupoint injection combined with cognitive behavioral therapy can effectively treat chronic idiopathic tinnitus in the elderly,but the therapeutic effect is limited in senile patients.

关 键 词：老年 认知行为疗法 特发性耳鸣 慢性 穴位注射 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]