山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (6): 70-76.doi: 10.6040/j.issn.1673-3770.0.2022.327

• 论著 • 上一篇    

家庭化个体多元复合声治疗对耳鸣伴听力损失患者的疗效及影响因素分析

王欣怡1,杨文杰2,余文兴3,徐艳红4,胡纯红5,母晓松6,蒲晓兵6,任建君1,赵宇1   

  1. 1.四川大学华西医院 耳鼻喉头颈外科, 四川 成都 610041;
    2.四川大学华西医院 临床研究方案设计与统计办公室, 四川 成都 610041;
    3.遂宁市中心医院 耳鼻咽喉科, 四川 遂宁 629000;
    4.雅安市人民医院 耳鼻咽喉科, 四川 雅安 625000;
    5.成都市第二人民医院 耳鼻咽喉科, 四川 成都 610017;
    6.阆中市人民医院 耳鼻咽喉科, 四川 阆中 637400
  • 发布日期:2022-12-07
  • 通讯作者: 赵宇. E-mail:yutzhao@vip.163.com
  • 基金资助:
    四川大学华西医院临床孵化项目(2019HXFH003)

Effects and influencing factors of family-oriented customized sound therapy on patients with tinnitus and hearing loss

WANG Xinyi1, YANG Wenjie2, YU Wenxing3, XU Yanhong4, HU Chunhong5, MU Xiaosong6, PU Xiaobing6, REN Jianjun1, ZHAO Yu1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China;
    2. Center of Biostatistics, Design, Measurement and Evaluation(CBDME), West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China;
    3. Department of Otorhinolaryngology, Suining Central Hospital, Suining 629000, Sichuan, China;
    4. Department of Otorhinolaryngology, Yaan People's Hospital, Yaan 625000, Sichuan, China;
    5. Department of Otorhinolaryngology, Chengdu Second People's Hospital, Chengdu 610041, Sichuan, China;
    6. Department of Otorhinolaryngology, Langzhong People's Hospital, Langzhong 637400, Sichuan, China
  • Published:2022-12-07

PDF (PC)

89

摘要： 目的 探究家庭化个体多元复合声治疗对耳鸣伴听力损失患者的有效性,并分析耳鸣伴听力损失患者疗效的影响因素。 方法 利用四川省4家三甲医院的既往电子病历记录,回顾性分析2019年3月至2022年3月期间接受家庭化个体多元复合声治疗的212例耳鸣患者临床资料,收集耳鸣患者的人口学特征、听力损失相关和治疗前后的耳鸣障碍量表评分等资料。采用多因素二元逻辑回归分析疗效相关影响因素。 结果 家庭化个体多元复合声治疗对耳鸣伴听力损失患者的总有效率为43.87%,治疗周期长于12个月的耳鸣患者的有效改善率(57.43%)显著高于治疗周期短于12个月的耳鸣患者(31.53%),单因素逻辑回归分析比值比(OR)值为2.93(95%CI: 1.67~5.14)。多因素逻辑回归分析提示治疗周期为影响家庭化个体多元复合声治疗效果的独立风险因素,OR值为2.23(95%CI: 1.09~5.00),患者年龄与声治疗疗效的OR值为1.03(95%CI: 1.01~1.05)。 结论 研究表明家庭化个体多元复合声治疗可有效改善部分耳鸣患者的临床症状及恼人程度。其中,治疗周期是影响家庭化个体多元复合声治疗疗效的独立危险因素。临床医生应针对不同听力损失和耳鸣特征的耳鸣患者采用家庭化个体多元复合声治疗方案。

关键词: 耳鸣, 听力损失, 家庭化个体多元复合声治疗, 疗效

Abstract: Objective To evaluate the efficacy of family-oriented customized sound therapy in patients with tinnitus in the absence or presence of hearing loss, and analyze the effects of related factors by sound therapy. Methods We retrieved electronic medical records from March 2019 to March 2022 from four hospitals in Sichuan province, and conducted a retrospective cohort study to analyze data on 212 patients with tinnitus who received family-oriented customized sound therapy. The demographic, hearing loss characteristics, and the tinnitus handicap inventory scores before and after treatments were extracted. Binary logistic regression was used to analyze the factors associated with efficacy. Results The effectiveness of family-oriented customized sound therapy for all patients with tinnitus and hearing loss was 43.87%. Patients treated for more than 12 months(57.4%)had a significantly higher percentage of improvement than those treated for less than 12 months(31.5%)with the odds ratio(OR)of 2.93(95%CI: 1.67-5.14). The multivariable regression analysis showed that there was significant difference in treatment cycles with an OR of 2.23(95%CI: 1.09-5.00)and the association of age with an OR of 1.03(95%CI: 1.01-1.09). Conclusion Family-oriented customized sound therapy can effectively improve the clinical symptoms and annoyance in patients with tinnitus. Treatment period is the main factor associated with the efficacy of family-oriented customized sound therapy. Clinicians are thus advised to adopt family-oriented customized sound therapy for patients diagnosed with different types of hearing loss and tinnitus.

Key words: Tinnitus, Hearing loss, Family-oriented customized sound therapy, Therapeutic effects

中图分类号: 

  • R764.4
[1] Koops EA, Renken RJ, Lanting CP, et al. Cortical tonotopic map changes in humans are larger in hearing loss than in additional tinnitus[J]. J Neurosci, 2020, 40(16): 3178-3185. doi:10.1523/JNEUROSCI.2083-19.2020.
[2] Zhang D, Xu Q, Caimino C, et al. The prevalence of tinnitus in China: a systematic review of the literature[J]. J Laryngol Otol, 2021, 135(1): 3-9. doi:10.1017/S002221512000256X.
[3] McCormack A, Edmondson-Jones M, Somerset S, et al. A systematic review of the reporting of tinnitus prevalence and severity[J]. Hear Res, 2016, 337: 70-79. doi:10.1016/j.heares.2016.05.009.
[4] McFerran DJ, Stockdale D, Holme R, et al. Why is there no cure for tinnitus? [J]. Front Neurosci, 2019, 13: 802. doi:10.3389/fnins.2019.00802.
[5] Jarach CM, Lugo A, Scala M, et al. Global prevalence and incidence of tinnitus: a systematic review and meta-analysis[J]. JAMA Neurol, 2022, 79(9): 888-900. doi:10.1001/jamaneurol.2022.2189.
[6] Oosterloo BC, Croll PH, Baatenburg de Jong RJ, et al. Prevalence of tinnitus in an aging population and its relation to age and hearing loss[J]. Otolaryngol Head Neck Surg, 2021, 164(4): 859-868. doi:10.1177/0194599820957296.
[7] 段新艳, 宋忠义, 王宁, 等. DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2021.404. DUAN Xinyan, SONG Zhongyi, WANG Ning, et al. Application value of distortion product otoacoustic emission and high stimulation rate auditory brainstem response in patients with normal hearing tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2021.404.
[8] Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus[J]. Otolaryngol Head Neck Surg, 2014, 151(2 ): 1-40. doi:10.1177/0194599814545325.
[9] Shapiro SB, Noij KS, Naples JG, et al. Hearing loss and tinnitus[J]. Med Clin North Am, 2021, 105(5): 799-811. doi:10.1016/j.mcna.2021.05.003.
[10] Boecking B, Rausch L, Psatha S, et al. Hearing therapy improves tinnitus-related distress in mildly distressed patients with chronic tinnitus and mild-to-moderate hearing loss: a randomized-controlled cross-over design[J]. J Clin Med, 2022, 11(7): 1764. doi:10.3390/jcm11071764.
[11] Cederroth CR, Gallus S, Hall DA, et al. Editorial: towards an understanding of tinnitus heterogeneity[J]. Front Aging Neurosci, 2019, 19(11): 53. doi:10.3389/fnagi.2019.00053.
[12] 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.
[13] Hébert S. Individual reliability of the standard clinical method vs patient-centered tinnitus likeness rating for assessment of tinnitus pitch and loudness matching[J]. JAMA Otolaryngol Head Neck Surg, 2018, 144(12): 1136-1144. doi:10.1001/jamaoto.2018.2416.
[14] Jin IK, Choi SJ, Ku M, et al. The impact of daily hours of sound therapy on tinnitus relief for people with chronic tinnitus: a randomized controlled study[J]. J Speech Lang Hear Res, 2022, 65(8): 3079-3099. doi:10.1044/2022_JSLHR-21-00651.
[15] Kutyba JJ, Jdrzejczak WW, Gos E, et al. Chronic tinnitus and the positive effects of sound treatment via a smartphone app: mixed-design study[J]. JMIR Mhealth Uhealth, 2022, 10(4): e33543. doi:10.2196/33543.
[16] Beukes EW, Lourenco MPCG, Biot L, et al. Suggestions for shaping tinnitus service provision in Western Europe: lessons from the COVID-19 pandemic[J]. Int J Clin Pract, 2021, 75(7): e14196. doi:10.1111/ijcp.14196.
[17] 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.
[18] Boecking B, Brueggemann P, Kleinjung T, et al. All for one and one for all? - examining convergent validity and responsiveness of the German versions of the tinnitus questionnaire(TQ), tinnitus handicap inventory(THI), and tinnitus functional index(TFI)[J]. Front Psychol, 2021, 12: 596037. doi:10.3389/fpsyg.2021.596037.
[19] Zeman F, Koller M, Figueiredo R, et al. Tinnitus handicap inventory for evaluating treatment effects: which changes are clinically relevant? [J]. Otolaryngol Head Neck Surg, 2011, 145(2): 282-287. doi:10.1177/0194599811403882.
[20] Dauman N, Dauman R. An empowerment model for individuals with chronic tinnitus[J]. Ear Hear, 2021, 42(2): 425-442. doi:10.1097/AUD.0000000000000946.
[21] 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: CD013094. doi:10.1002/14651858.CD013094.pub2.
[22] Wang HY, Tang DM, Wu YZ, et al. The state of the art of sound therapy for subjective tinnitus in adults[J]. Ther Adv Chronic Dis, 2020,14(11): 2040622320956426. doi:10.1177/2040622320956426.
[23] Nolan DR, Gupta R, Huber CG, et al. An effective treatment for tinnitus and hyperacusis based on cognitive behavioral therapy in an inpatient setting: a 10-year retrospective outcome analysis[J]. Front Psychiatry, 2020, 11: 25. doi:10.3389/fpsyt.2020.00025.
[24] Bauer CA, Berry JL, Brozoski TJ. The effect of tinnitus retraining therapy on chronic tinnitus: a controlled trial[J]. Laryngoscope Investig Otolaryngol, 2017, 2(4): 166-177. doi:10.1002/lio2.76.
[25] 罗彬, 熊彬彬, 孙伟, 等. 个性化多元复合声对慢性主观性耳鸣临床疗效的初步分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(11): 819-822, 826. doi:10.13201/j.issn.1001-1781.2018.11.005. LUO Bin, XIONG Binbin, SUN Wei, et al. Preliminary analysis of the effects of individualized sound therapy on chronic subjective tinnitus[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(11): 819-822, 826. doi:10.13201/j.issn.1001-1781.2018.11.005.
[26] 徐飘, 杨静雅, 林琼萍, 等. 精细化声治疗耳鸣的疗效分析[J]. 听力学及言语疾病杂志, 2021, 29(6): 653-657. doi: 10.3969/j.issn.1006-7299.06.013. XU Piao, YANG Jingya, LIN Qiongping, et al. Factors affecting the efficacy of precision sound therapy in tinnitus treatment[J]. Journal of Audiology and Speech Pathology, 2021, 29(6): 653-657. doi: 10.3969/j.issn.1006-7299.06.013.
[27] Tutaj L, Hoare DJ, Sereda M. Combined amplification and sound generation for tinnitus: a scoping review[J]. Ear Hear, 2018, 39(3): 412-422. doi:10.1097/AUD.0000000000000516.
[28] 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.
[29] de Ridder D, Vanneste S. Targeting the parahippocampal area by auditory cortex stimulation in tinnitus[J]. Brain Stimul, 2014, 7(5): 709-717. doi:10.1016/j.brs.2014.04.004.
[30] Vanneste S, de Ridder D. Deafferentation-based pathophysiological differences in phantom sound: Tinnitus with and without hearing loss[J]. Neuroimage, 2016, 129: 80-94. doi:10.1016/j.neuroimage.2015.12.002.
[31] Chen JM, Zhao YX, Zou TM, et al. Sensorineural hearing loss affects functional connectivity of the auditory cortex, parahippocampal gyrus and inferior prefrontal gyrus in tinnitus patients[J]. Front Neurosci, 2022, 16: 816712. doi:10.3389/fnins.2022.816712.
[32] Schormans AL, Typlt M, Allman BL. Adult-onset hearing impairment induces layer-specific cortical reorganization: evidence of crossmodal plasticity and central gain enhancement[J]. Cereb Cortex, 2019, 29(5): 1875-1888. doi:10.1093/cercor/bhy067.
[33] Riga M, Komis A, Maragoudakis P, et al. Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise: effects of frequency, gender, tinnitus bilaterality and age[J]. Acta Otorhinolaryngol Ital, 2018, 38(2): 131-137. doi:10.14639/0392-100X-1465.
[34] 鲁丹, 陈晓平, 梁佳, 等. 耳鸣患者多元叠加整合声治疗的临床应用研究[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(2): 128-131. doi:10.13201/j.issn.1001-1781.2019.02.009. LU Dan, CHEN Xiaoping, LIANG Jia, et al. The application of accurate clinical diagnosis and treatment with T-MIST in tinnitus patients[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(2): 128-131. doi:10.13201/j.issn.1001-1781.2019.02.009.
[35] Mazurek B, Hesse G, Dobel C, et al. Chronic tinnitus[J]. Dtsch Arztebl Int, 2022, 119(13): 219-225. doi:10.3238/arztebl.m2022.0135.
[1] 段新艳,宋忠义,王宁,訾希存, 潘新良. DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 6-10.
[2] 李世金,唐昂藏,杨必,王将栏,刘陇黔. 虚拟现实视觉训练对集合不足长期疗效的观察[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 35-40.
[3] 黄岚,高伟陈钢钢. 内耳疾病继发BPPV的发病机制和临床特征的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 108-113.
[4] 姜雪莲, 张静月, 卫旭东. 基于Meta分析桥接网络药理学的鼻渊通窍颗粒治疗慢性鼻窦炎的疗效评价及潜在机制研究[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 226-236.
[5] 马宁, 陈敏, 刘薇, 杨扬, 邵剑波, 郝津生, 刘冰, 张晓, 段晓岷, 张祺丰, 张杰. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19.
[6] 胡春燕, 党攀红, 张睿, 樊孟耘. 儿童单侧感音性听力损失的听力学及影像学特征149例分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 31-36.
[7] 周腊梅, 蒋雯, 刘稳, 乔月华. 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.
[8] 金鑫,施磊,金梦园. 脱细胞真皮基质覆盖鼻腔鼻窦良性肿瘤切除术后术腔的临床疗效观察[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 17-22.
[9] 马亦飞,喻国冻,鲜志芃,何星辰,顾萍,陈自力. 嗓音训练应用于声带息肉术后的效果评价[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 54-58.
[10] 兰世鹏,陈智斌,曹新,邢光前. 一个新的X连锁耳聋综合征的表型特征[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 65-69.
[11] 林小燕,李静,马志祺,李依琳,高馨怡,李勇. 益生菌治疗变应性鼻炎的临床疗效及抗变态反应作用Meta分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 70-80.
[12] 周恩,肖禹,肖旭平. 等离子射频消融技术在早期声门型喉癌治疗中的应用进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 9-15.
[13] 林育珊,卢标清. 从心脾论治突发性耳聋的疗效观察[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 6-11.
[14] 刘宇鹏,吴文瑾,何景春,郑贵亮,张青,杨军. 迷路后径路前庭神经切断术治疗难治性梅尼埃病75例[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 46-50.
[15] 林宗通,沈翎,杨中婕. 腺样体大小及圆枕类型对儿童分泌性中耳炎的影响[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 121-126.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发