医师疗法治疗原发性耳鸣496例远期疗效随访  

Yishi Therapy for the Treatment of Primary Tinnitus:A Long-Term Efficacy Follow-up of 496 Cases

作　　者：陈艳芳 刘蓬[3,4] 林文智 刘锦光 刘洁恒 张海欣 何伟平 CHEN Yanfang;LIU Peng;LIN Wenzhi;LIU Jinguang;LIU Jieheng;ZHANG Haixin;HE Weiping(The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou,510405;Guangdong Clifford Hospital;The First Affiliated Hospital of Guangzhou University of Chinese Medicine;Lingnan Institute of Otolaryngology,Guangdong Clinical Research Academy of Traditional Chinese Medicine)

机构地区：[1]广州中医药大学第一临床医学院,广东省广州510405 [2]广东祈福医院 [3]广州中医药大学第一附属医院 [4]广东省中医临床研究院岭南耳鼻喉病研究所

出　　处：《中医杂志》2024年第24期2558-2564,共7页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局2023年中央财政转移支付地方项目。

摘　　要：目的探讨医师疗法治疗原发性耳鸣的远期疗效,并分析疗效影响因素。方法于2023年7月1日至2024年1月31日期间通过面诊、网络、电话方式对2017年1月1日至2023年6月30日运用医师疗法治疗的原发性耳鸣病例进行远期随访,了解原发性耳鸣的最终转归及生活方式的变化,回顾患者治疗前的基本资料,统计分析医师疗法治疗耳鸣的痊愈率和总有效率及相关因素(生活方式、年龄、病程、性别、耳鸣部位、耳鸣严重程度、伴随症状、合并基础疾病情况)对总有效率的影响。结果完成随访的原发性耳鸣患者共496例,随访时耳鸣评价量表(TEQ)评分较治疗前降低(P<0.001)。496例患者中临床痊愈101例(20.36%),显效189例(38.10%),有效116例(23.39%),无效90例(18.15%),总有效率为81.85%(406/496)。随访时生活方式评分较治疗前提高(P<0.001),以随访时生活方式评分均值作为切点,分为随访时习惯较好组和习惯较差组,总有效率分别为97.53%(237/243)、66.80%(169/253),差异有统计学意义(P<0.001)。以治疗前后生活方式评分差值均值作为切点,分为生活方式调整幅度较大组和调整幅度较小组,总有效率分别为97.55%(239/245)、66.53%(167/251),差异有统计学意义(P<0.001)。多因素二分类Logistic回归分析显示随访时生活习惯好、生活方式调整幅度大、耳鸣程度严重与总有效率呈正相关(P<0.001),年龄增长、听力下降与总有效率呈负相关(P<0.05)。结论医师疗法治疗原发性耳鸣具有较好的远期疗效,生活方式、耳鸣严重程度、听力下降与否、年龄是影响耳鸣疗效的相关因素,其中生活方式是影响疗效的主要因素。Objective To demonstrate the long-term effect of Yishi Therapy for primary tinnitus and analyze the factors affecting the effectiveness.Methods We conducted long-term follow-ups of primary tinnitus cases treated with Yishi Therapy during 1 January 2017 to 30 June 2023 by face-to-face,online and telephone between 1 July 2023 and 31 January 2024,to understand the final regression of primary tinnitus and lifestyle changes.We retrospectively analysed the basic data of patients before treatment,and statistically analysed the recovery rate and overall effective rate of tinnitus treated by the Yishi Therapy,and the factors affecting the effectiveness such as lifestyle,age,duration of disease,gender,tinnitus location,severity of tinnitus,accompanying symptoms and complications on the overall effective rate.Results A total of 496 cases of primary tinnitus completed follow-ups successfully,and the total Tinni⁃tus Evaluation Questionnaire(TEQ)at follow-up was significantly lower than that before treatment(P<0.001).Among the 496 cases,101(20.36%)cases cured,189(38.10%)cases showed significant improvement,116(23.39%)cases were effective,90(18.15%)cases were ineffective,and the overall effect rate was 81.85%(406/496).At follow-up,the score of lifestyle was higher than that before treatment(P<0.001).Grouped by the score of lifestyle at follow-up,the effective rates of better lifestyle group and poor lifestyle group were 97.53%(237/243)and 66.80%(169/253),respectively,with statistical significance(P<0.001).Grouped by the mean value of the differ⁃ence in lifestyle scores before and after treatment,the effective rates of the group with greater lifestyle adjustment and the group with smaller adjustment were 97.55%(239/245)and 66.53%(167/251),respectively,and the differenc⁃es were statistically significant(P<0.001).Binary logistic regression showed that the better lifestyle,the greater lifestyle adjustment and the severity of tinnitus were positively correlated with the total effective rate of tinnitus(P<0.001),while older and

关 键 词：原发性耳鸣 医师疗法 生活方式 临床疗效 远期随访 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]