掩蔽声治疗慢性主观性耳鸣的焦虑抑郁状态分析  

Analysis of anxiety and depression states in the treatment of chronic subjective tinnitus with masking sound therapy

作　　者：董雪林 张治军[1] DONG Xuelin;ZHANG Zhijun(Department of Otorhinolaryngology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院耳鼻咽喉科,上海200021

出　　处：《山东大学耳鼻喉眼学报》2025年第2期18-24,共7页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：上海中医药大学附属曙光医院四明临床基金项目(SGZXY-202203)。

摘　　要：目的 探究掩蔽声治疗对慢性主观性耳鸣患者的焦虑抑郁状态的改善情况及影响因素。方法 将256例慢性主观性耳鸣患者按照掩蔽声治疗时间分为观察组和对照组。收集两组治疗前后的耳鸣障碍量表(tinnitus handicap inventory, THI)、汉密顿抑郁量表(hamilton depression scale, HAMD)及汉密顿焦虑量表(hamilton anxiety scale, HAMA)评分。比较治疗前后耳鸣程度、焦虑抑郁状态的变化,并分析影响焦虑抑郁状态的因素。结果 观察组患者的THI、HAMA和HAMD量表评分等级改善的有效率明显高于对照组(P均<0.001)。多因素二元Logistic回归分析显示观察组患者耳鸣响度(OR=31.57,P=0.003)和治疗前THI等级(OR=0.11,P=0.002)是HAMA量表有效改善的独立因素,残余抑制结果(OR=0.12,P=0.003)和治疗前THI等级(OR=0.20,P=0.016)是HAMD量表有效改善的独立因素。结论 本研究发现掩蔽声治疗在降低耳鸣严重程度的同时,也能改善焦虑、抑郁情况。治疗前THI等级、耳鸣响度和残余抑制结果对有效改善慢性主观性耳鸣患者的焦虑、抑郁有明显影响。Objective To explore the improvement of anxiety and depression status in patients with chronic subjective tinnitus after masked sound therapy and its influencing factors.Methods 256 patients with chronic subjective tinnitus were divided into observation group and control group according to the duration of masked sound therapy.The Tinnitus handicap inventory(THI),Hamilton depression scale(HAMD),and Hamilton anxiety scale(HAMA)scores of the two groups were collected before and after treatment.The changes of tinnitus degree,anxiety and depression status before and after treatment were compared,and the factors affecting anxiety and depression status were analysed.Results The efficacy rates of THI,HAMA,and HAMD scores in the observation group were significantly higher than those in the control group(P<0.001,P<0.001,P<0.001).In the observation group,multivariate binary logistic regression analysis showed that tinnitus loudness(OR=31.57,P=0.003)and pre-treatment THI level(OR=0.11,P=0.002)were independent factors for effective improvement of HAMA score,while residual inhibition result(OR=0.12,P=0.003)and pre-treatment THI level(OR=0.20,P=0.016)were independent factors for effective improvement of HAMD score.Conclusion This study found that masked sound therapy can reduce the severity of tinnitus and improve anxiety and depression.Pre-treatment THI level,tinnitus loudness,and residual inhibition results have significant effects on the effective improvement of anxiety and depression in patients with chronic subjective tinnitus.

关 键 词：慢性主观性耳鸣 掩蔽声治疗 焦虑 抑郁 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]