山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (4): 38-45.doi: 10.6040/j.issn.1673-3770.0.2022.161

• • 上一篇    

多元复合声治疗对突聋患者耳鸣的疗效分析

许海艳,曹卫,范大川   

  1. 安徽医科大学第二附属医院 耳鼻咽喉头颈外科, 安徽 合肥 230601
  • 发布日期:2023-07-27
  • 通讯作者: 范大川. E-mail:entfdc@163.com
  • 基金资助:
    安徽高校自然科学研究重点项目(KJ2021A0315)

Efficacy of compound sound therapy for patients with tinnitus and sudden deafness

XU Haiyan, CAO Wei, FAN Dachuan   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China
  • Published:2023-07-27

摘要: 目的 探讨多元复合声治疗在突聋患者耳鸣的疗效,为突聋患者的耳鸣治疗提供参考。 方法 回顾性分析2017年1月至2020年8月收治的112例单侧突聋伴耳鸣患者的临床资料,其中58例采用多元复合声联合药物治疗为观察组,54例采用单独药物治疗为对照组。详细收集患者病例资料,并行纯音听阈测定、耳鸣测试,以及耳鸣残疾评估量表、视觉模拟量表和焦虑自评量表评分。对比两组患者治疗前后听力水平、耳鸣严重程度及负性情绪评分。 结果 治疗后两组患者听力总有效率显著提高,2周、1个月、3个月后听力总有效率观察组分别为55.2%、75.9%、77.6%,对照组为53.7%、77.8%、80.3%,组间差异无统计学意义(P>0.05)。治疗1个月、3个月后观察组耳鸣疗效(62.1%、81.1%)优于对照组(53.7%、59.3%),组间差异有统计学意义(P<0.05)。观察组耳鸣疗效在治疗3个月后(81.1%)优于治疗1个月后(62.1%),差异有统计学意义(P<0.05)。 结论 多元复合声治疗对突聋患者的耳鸣疗效显著,延长治疗时间可提高耳鸣疗效。

关键词: 多元复合声治疗, 耳鸣, 突发性耳聋, 纯音听阈, 耳鸣残疾评估量表, 视觉模拟量表, 焦虑自评量表

Abstract: Objective The objectives of this study were to evaluate the efficacy of compound sound therapy and provide guidance for clinical practice for patients with tinnitus and sudden deafness. Methods We retrospectively analyzed clinical data from 112 patients with tinnitus and unilateral sudden deafness who were treated in our department between January 2017 and August 2020. Patients were randomly divided into two groups according to the treatment: 54 patients in the control group were treated with medical therapy, and 58 patients in the observation group were treated with medical therapy in addition to compound sound therapy. Clinical data were collected for age, sex, laterality, and duration. All patients received the pure-tone audiometry and tinnitus tests, including loudness and residual inhibition. The Tinnitus Handicap Inventory, Visual Analogue Scale and Self-Rating Anxiety Scale scores were measured pre-and post-therapy. The compound sounds were remixed with noise/pure tone, natural sound, and music clips. The masking frequency of background sound was consistent with the tinnitus frequency of patients, and the main frequency of music clips covered the tinnitus frequency. Results The means of the pure tone hearing thresholds of the two groups after treatment were significantly lower at 2 weeks, 1 month, and 3 months after treatment. The total effective rates of hearing in the control group were 53.7%, 77.8%, and 80.3%, and the rates in the observation group were 55.2%、75.9%、and 77.6% at 2 weeks, 1 month, and 3 months, respectively. No significant difference was found between the two groups(P>0.05). The THI, VAS, and SAS scores significantly decreased after treatment in both groups, The total effective rates of tinnitus in the observation group were 62.1% and 81.1%, which were significantly better than those in the control group, which were 53.7% and 59.3% at 1 month and 3 months after treatment, respectively. The highest effect was observed in the observation group at 3 months after the compound sound therapy. This effect was better than at 1 month post-treatment, and the difference was statistically significant(all P<0.05). Conclusion Patients with tinnitus and sudden deafness showed adaptations with compound sound therapy and acquired more benefits from extension of treatment duration.

Key words: Compound sound therapy, Tinnitus, Sudden deafness, Pure tone hearing thresholds, Tinnitus handicap inventory, Visual analogue scale, Self-Rating anxiety scale

中图分类号: 

  • R764.43+7
[1] Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice guideline: sudden hearing loss[J]. Otolaryngol Head Neck Surg, 2012, 146(3 suppl): S1-35. doi:10.1177/0194599812436449
[2] Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical practice guideline: sudden hearing loss(update)[J]. Otolaryngol Head Neck Surg, 2019, 161(1_suppl): S1-S45. doi:10.1177/0194599819859885
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 突发性聋诊断和治疗指南(2015)[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(6): 443-447. doi:10.3760/cma.j.issn.1673-0860.2015.06.002
[4] 周腊梅, 蒋雯, 刘稳, 等. 持续性特发性耳鸣严重程度的相关因素分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 70-76. doi:10.6040/j.issn.1673-3770.0.2021.009 ZHOU Lamei, JIANG Wen, LIU Wen, et al. Analysis of factors related to the severity of persistent idiopathic tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 70-76. doi:10.6040/j.issn.1673-3770.0.2021.009
[5] 钟晓声, 杨海弟, 郑亿庆. 突发性聋伴耳鸣的治疗与转归[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 43-46. doi:10.6040/j.issn.1673-3770.0.2018.393 ZHONG Xiaosheng, YANG Haidi, ZHENG Yiqing. Treatment and outcome of tinnitus in sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 43-46. doi:10.6040/j.issn.1673-3770.0.2018.393
[6] Tunkel DE, Bauer CA, Sun GH, et al. American academy of otolaryngology—head and neck foundation clinical practice guideline: tinnitus[J]. Otolaryngol Head Neck Surg, 2014, 151(1_suppl): 20. doi:10.1177/0194599814538403a56
[7] 中华耳鼻咽喉头颈外科杂志编辑委员会耳科专业组.2012耳鸣专家共识及解读[J].中华耳鼻咽喉头颈外科杂志,2012(9):709-712. doi:10.3760/cma.j.issn.1673-0860.2012.09.002
[8] Sereda M, Xia J, El Refaie A, et al. Sound therapy(using amplification devices and/or sound generators)for tinnitus[J]. Cochrane Database Syst Rev, 2018, 12(12): CD013094. doi:10.1002/14651858.CD013094.pub2
[9] 石青霞, 马群, 赵晶晶, 等. 耳鸣的个性化声治疗[J]. 中华耳科学杂志, 2021, 19(4): 679-682. doi:10.3969/j.issn.1672-2922.2021.04.027 SHI Qingxia, MA Qun, ZHAO Jingjing, et al. Advances in individualized sound therapy for tinnitus[J]. Chinese Journal of Otology, 2021, 19(4): 679-682. doi:10.3969/j.issn.1672-2922.2021.04.027
[10] 李刚, 李明, 张剑宁. 个性化音乐治疗耳鸣的机制及研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(1): 91-95. doi:10.13201/j.issn.2096-7993.2021.01.024 LI Gang, LI Ming, ZHANG Jianning. Mechanism and research progresses of personalized music in the treatment of tinnitus[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2021, 35(1): 91-95. doi:10.13201/j.issn.2096-7993.2021.01.024
[11] Cima RFF, Mazurek B, Haider H, et al. A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment[J]. HNO, 2019, 67(Suppl 1): 10-42. doi:10.1007/s00106-019-0633-7
[12] 叶毅良, 卢标清. 704例突发性耳聋疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 44-47. doi:10.6040/j.issn.1673-3770.0.2019.052 YE Yiliang, LU Biaoqing. Therapeutic outcome analysis of 704 cases of sudden deafness[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 44-47. doi:10.6040/j.issn.1673-3770.0.2019.052
[13] 何颖贤, 刘蓬, 戴如璋, 等. 突发性聋的耳鸣发生率及与听力恢复的同步性观察[J]. 中国听力语言康复科学杂志, 2020, 18(5): 347-350. doi:10.3969/j.issn.1672-4933.2020.05.007 HE Yingxian, LIU Peng, DAI Ruzhang, et al. Incidence and synchronization with hearing recovery of tinitus in sudden deafness patients[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2020, 18(5): 347-350. doi:10.3969/j.issn.1672-4933.2020.05.007
[14] Liu H, Zhang J, Yang SY, et al. Efficacy of sound therapy interventions for tinnitus management: a protocol for systematic review and network meta-analysis[J]. Medicine, 2021, 100(41): e27509. doi:10.1097/MD.0000000000027509
[15] 李昌武,熊观霞,王仙仁,等.复合声治疗对不同类型听阈正常耳鸣患者的疗效观察[J].中山大学学报(医学科学版), 2018, 39(3):356-362. doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2018.0055 LI Changwu, XIONG Guanxia, WANG Xianren, et al. Tailor-made complex sound alleviates both residual-inhibition positive and negative tinnitus patients with normal hearing audiogram[J]. Journal of Sun Yat-sen University(Medical Sciences), 2018, 39(3): 356-362. doi:10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2018.0055
[16] Searchfield GD, Linford T, Durai M. Sound therapy and aural rehabilitation for tinnitus: a person centred therapy framework based on an ecological model of tinnitus[J]. Disabil Rehabil, 2019, 41(16): 1966-1973. doi:10.1080/09638288.2018.1451928
[17] Jeong S, Heo S, Oh H, et al. Methods and application of sound therapy for tinnitus rehabilitation[J]. Audiol Speech Res, 2019, 15(1): 1-10. doi:10.21848/asr.2019.15.1.1
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