从听皮层可塑性阐述耳鸣的发生和治疗机制  

The developing mechanism and its therapeutic impact on tinnitus base on the theory of auditory cortex plasticity

作　　者：郑家旺 姚敬心 范冰彬 张欣雨 殷淑婷 吴琪[3] ZHENG Jiawang;YAO Jingxin;FAN Bingbin;ZHANG Xinyu;YIN Shuting;WU Qi(Hunan University of Chinese Medicine,College of Traditional Chinese Medicine,Hunan,410208,China)

机构地区：[1]湖南中医药大学中医学院,长沙410208 [2]湖南中医药大学医学院,长沙 [3]湖南中医药大学第一附属医院耳鼻咽喉科,长沙

出　　处：《中国中西医结合耳鼻咽喉科杂志》2025年第1期71-76,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：湖南省中医药科研课题(No:E2022031);湖南省大学生创新创业训练计划项目(No:S202310541025)。

摘　　要：耳鸣的发生机制与中枢听皮层的可塑性密切相关。长期的异常信号输入或不适当的刺激引发的听觉通路病变,可破坏听皮层神经远的兴奋-抑制平衡,致使突触间的传递效率改变,继而触发听皮层的稳态重塑。这种稳态重塑可能会增强听皮层与其他区域大脑皮质中与听觉相关区域的联系,可能是形成和维持耳鸣的重要原因。对于耳鸣的治疗,西医、中医以及中西医结合方法都能干预听皮层神经兴奋性,调整其与相关大脑皮质区域的联系,通过改善听皮层的不良可塑性以减轻耳鸣的症状。The onset of tinnitus may be closely related with the plasticity of the auditory cortex.Disorders in auditory pathway induced by persistent abnormal signal inputs or inappropriate stimuli could disrupt the excitatory-inhibitory balance of neurons in auditory cortex to cause alterations in synaptic transmission efficiency at first,then,a state of homeostatic remodeling within the auditory cortex might be prompted.Such a homeostatic restructurings would be believed to strengthen this kind of abnormal connections between the auditory cortex and related auditory regions within the cerebral cortex subsequently,a key factor contributing to the genesis and sustenance of tinnitus.In terms of tinnitus treatment,a combination of approaches from Western medicine,traditional Chinese medicine,and integration of both could be used to intervene with the excitability of neurons within the auditory cortex and modulate its connections with relevant cerebral cortical regions.Through these interventions and modifications,the malfunctioning plasticity of the auditory cortex should be realistically improved to alleviate the troubled state of tinnitus.

关 键 词：耳鸣 听皮层 可塑性 发生机制 治疗 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]