山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (1): 1-7.doi: 10.6040/j.issn.1673-3770.0.2023.384

• 论著 •    下一篇

慢性主观性耳鸣患者心理特征、睡眠质量调查及与临床效果相关性

郭振平1,2,3,李雪冰1,2   

  1. 1.中国科学院 心理研究所, 北京 100101;
    2.中国科学院大学 心理学系, 北京 100049 ;
    3.清华大学附属北京清华长庚医院/清华大学临床医学院 耳鼻咽喉头颈外科, 北京 102218
  • 发布日期:2025-01-17
  • 通讯作者: 李雪冰. E-mail: mufurong5452@163.com

A survey of the psychological characteristics, sleep quality, and correlation with clinical outcomes in patients with chronic subjective tinnitus

GUO Zhenping1,2,3, LI Xuebing1,2   

  1. 1. Institute of psychology, Chinese Academy of Sciences, Beijing 100101, China2. Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China3. Department of Otorhinolaryngology & Head and Neck Surgery, Beijing Tsinghua Changgung Hospital/School of Clinical Medicine, Tsinghua University, Beijing 102218, China
  • Published:2025-01-17

PDF (PC)

444

摘要： 目的 探讨慢性主观性耳鸣(chronic subjective tinnitus, CST)患者的心理特征及睡眠质量,并分析其与临床效果的相关性。 方法 选入CST患者80例,采用抑郁自评量表(self-rating depression scale, SDS)、焦虑自评量表(self-rating anxiety scale, SAS)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)评价患者的心理特征及睡眠质量,同时给予常规药物治疗,分析临床效果与心理特征及睡眠质量的相关性。 结果 随着听力下降程度加重,患者治疗前THI-C(F=28.255,P<0.001)、SDS(F=316.139,P<0.001)、SAS(F=204.933,P<0.001)、PSQI量表评分(F=220.602,P<0.001)均显著增加。正常听力与轻度聋(P=0.186),重度聋与极重度聋(P=0.09)患者中文版耳鸣残疾量表(Chinese version of the tinnitus handicap disability version, THI-C)评分比较无统计学意义,其他各听力程度组间均有统计学意义(P均<0.001)。高频耳鸣患者治疗前THI-C、SDS、SAS、PSQI量表评分显著高于低频和中频患者,中频患者则显著高于低频患者(F=48.950,P<0.001;F=225.048,P<0.001;F=230.489,P<0.001;F=332.730,P<0.001)。重度耳鸣患者治疗前SDS、SAS和PSQI量表评分显著高于轻度和中度患者,中度患者则显著高于轻度患者(P均<0.001)。治疗前THI-C评分与SDS、SAS和PSQI量表评分均有显著正相关性(r=0.649、0.681和0.657,P均<0.001)。80例患者治疗总有效率为63.75%,其中治愈21例、显效30例。患者治疗后THI-C(t=7.605,P<0.001)、SDS(t=25.344,P<0.001)、SAS(t=26.801,P<0.001)和PSQI量表评分(t=38.171,P<0.001)均显著低于治疗前,差异有统计学意义。治愈患者SDS(F=374.158,P<0.001)、SAS(F=577.547,P<0.001)和PSQI量表评分(F=570.382,P<0.001)显著低于显效和无效患者,显效患者则显著低于无效患者。 结论 CST患者存在普遍的抑郁、焦虑等负性情绪,睡眠质量较差,且其负性情绪和睡眠质量与耳鸣、听力程度有密切相关性,可对治疗效果造成不良影响。

关键词: 慢性主观性耳鸣, 心理特征, 睡眠质量, 临床效果, 相关性

Abstract: Objective This study aims to not only explore the psychological characteristics and sleep quality of patients with chronic subjective tinnitus(CST)but also analyze their correlation with clinical outcomes. Methods Eighty patients with CST were selected. The psychological characteristics and sleep quality of the patients were evaluated using the Self-Rating Depression Scale(SDS), Self-Rating Anxiety Scale(SAS), and pittsburgh sleep quality index(PSQI). Routine drug treatment was also given to analyze the correlation between clinical efficacy and psychological characteristics and sleep quality. Results As the degree of hearing loss worsens, the SDS, SAS, and PSQI scores of patients before treatment all significantly increase(F=28.255, P<0.001; F=31.613 9, P<0.001; F=204.933, P<0.001; F=220.602, P<0.001). There was no statistically significant differencein the scores of the Chinese version of the tinnitus handicap disability version(THI-C)between patients with normal hearing and mild hearing loss(P=0.186), as well as between patients with severe and extremely severe hearing loss(P=0.09). The THI-C, SDS, SAS, and PSQI scores of high-frequency tinnitus patients before treatment were significantly higher than those of low-frequency and intermediate frequency patients, while intermediate frequency patients were significantly higher than those of low-frequency patients(F=48.950, P<0.001; F=225.048, P<0.001; F=230.489, P<0.001; F=332.730, P<0.001). The SDS, SAS, and PSQI scores of patients with severe tinnitus before treatment were significantly higher than those of mild and moderate patients, while moderate patients were significantly higher than mild patients(P<0.001 for all). The THI-C score before treatment was significantly positively correlated with SDS, SAS, and PSQI scale scores(r=0.649, 0.681, and 0.657, respectively, P<0.001). The total effective rate of treatment for 80 patients was 63.75%, of which 21 were cured and 30 showed significant improvement. The THI-C, SDS, SAS, and PSQI scores of the patients after treatment were significantly lower than before treatment, and the differences were statistically significant(t=7.605, P<0.001; t=25.344, P<0.001; t=26.801, P<0.001; t=38.171, P<0.001). The SDS, SAS, and PSQI scores of cured patients were significantly lower than those of significantly improved and ineffective patients, while significantly improved patients were significantly lower than ineffective patients(F=374.158, P<0.001; F=577.547, P<0.001; F=570.382, P<0.001). Conclusion Patients with CST have common negative emotions such as depression and anxiety, and their sleep quality is poor. Their negative emotions and sleep quality are closely related to tinnitus and hearing levels, which can have adverse effects on the treatment effect.

Key words: Chronic subjective tinnitus, Psychological feature, Sleep quality, Clinical effects, Relevance

中图分类号: 

  • R764.45
[1] Tinnitus Retraining Therapy Trial Research Group, Scherer RW, Formby C. Effect of tinnitus retraining therapy vs standard of care on tinnitus-related quality of life: a randomized clinical trial[J]. JAMA Otolaryngol Head Neck Surg, 2019, 145(7): 597-608. doi:10.1001/jamaoto.2019.0821
[2] Kim HJ, Lee HJ, An SY, et al. Analysis of the prevalence and associated risk factors of tinnitus in adults[J]. PLoS One, 2015, 10(5): e0127578. doi:10.1371/journal.pone.0127578
[3] 仝悦, 蒋雯, 吴扬, 等. 慢性主观性耳鸣精细化检查及多元复合声治疗初探[J]. 临床与病理杂志, 2019, 39(6): 1266-1272. doi:10.3978/j.issn.2095-6959.2019.06.019 TONG Yue, JIANG Wen, WU Yang, et al. Precision tinnitus testing for chronic subjective tinnitus and preliminarily analyses for the effect of multiple complex acoustic therapy[J]. Journal of Clinical and Pathological Research, 2019, 39(6): 1266-1272. doi:10.3978/j.issn.2095-6959.2019.06.019
[4] 孙慧颖, 冯国栋, 高志强. 声治疗在慢性主观性耳鸣中的临床应用现状[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(3): 282-285. doi:10.13201/j.issn.2096-7993.2021.03.021 SUN Huiying, FENG Guodong, GAO Zhiqiang. Clinical application of sound therapy in chronic subjective tinnitus[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2021, 35(3): 282-285. doi:10.13201/j.issn.2096-7993.2021.03.021
[5] 李莉, 于文永. 慢性主观性耳鸣病人声治疗依从性影响因素的质性研究[J]. 全科护理, 2018, 16(13): 1593-1595. doi:10.12104/j.issn.1674-4748.2018.13.020
[6] 陈倬诣, 郑亿庆, 杨海弟. 慢性主观性耳鸣分类、发生发展机制及治疗新进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 1-12. doi:10.6040/j.issn.1673-3770.0.2023.137 CHEN Zhuoyi, ZHENG Yiqing, YANG Haidi. Classification, pathogenesis, and treatment advances of chronic subjective tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 1-12. doi:10.6040/j.issn.1673-3770.0.2023.137
[7] Park DH, Han SS, Han M, et al. A clinical trial of a patient-customized virtual reality intervention for tinnitus[J]. Sci Rep, 2022, 12(1): 12441. doi:10.1038/s41598-022-16764-5
[8] 石秋兰, 卜行宽, 王俊国, 等. 耳鸣致残量表中文版的研译与临床应用[J]. 南京医科大学学报(自然科学版), 2007, 27(5): 476-479. doi:10.3969/j.issn.1007-4368.2007.05.018 SHI Qiulan, BU Xingkuan, WANG Junguo, et al. Translation and application of tinnitus handicap inventory in Chinese version[J]. Journal of Nanjing Medical University(Natural Sciences), 2007, 27(5): 476-479. doi:10.3969/j.issn.1007-4368.2007.05.018
[9] 李斐然, 刘定, 徐红, 等. 耳鸣与脑源性神经营养因子关系的研究进展[J]. 中华耳科学杂志, 2020, 18(5): 967-971. doi:10.3969/j.issn.1672-2922.2020.05.031 LI Feiran, LIU Ding, XU Hong, et al. Progress in the study on relationship between tinnitus and brain-derived neurotrophic factor[J]. Chinese Journal of Otology, 2020, 18(5): 967-971. doi:10.3969/j.issn.1672-2922.2020.05.031
[10] Bhatt JM, Lin HW, Bhattacharyya N. Prevalence, severity, exposures, and treatment patterns of tinnitus in the United States[J]. JAMA Otolaryngol Head Neck Surg, 2016, 142(10): 959-965. doi:10.1001/jamaoto.2016.1700
[11] O'Brien DC, Robinson AD, Wang N, et al. Transdermal lidocaine as treatment for chronic subjective tinnitus: a pilot study[J]. Am J Otolaryngol, 2019, 40(3): 413-417. doi:10.1016/j.amjoto.2019.03.009
[12] 李青, 郭琳燕, 王维娜, 等. 慢性主观性耳鸣患者多元复合声治疗依从性的影响因素分析[J]. 中国医药导报, 2023, 20(15): 65-68. doi:10.20047/j.issn1673-7210.2023.15.13 LI Qing, GUO Linyan, WANG Weina, et al. Analysis of factors influencing compliance of patients with chronic subjective tinnitus treated with multiple complex sounds[J]. China Medical Herald, 2023, 20(15): 65-68. doi:10.20047/j.issn1673-7210.2023.15.13
[13] 王晓静, 董瑜新, 叶放蕾, 等. 认知行为疗法联合精细化护理对慢性主观性耳鸣患者的影响[J]. 深圳中西医结合杂志, 2022, 32(9): 127-130. doi:10.16458/j.cnki.1007-0893.2022.09.038 WANG Xiaojing, DONG Yuxin, YE Fanglei, et al. Effect of cognitive behavioral therapy combined with refined nursing on patients with chronic subjective tinnitus[J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2022, 32(9): 127-130. doi:10.16458/j.cnki.1007-0893.2022.09.038
[14] Monzani D, Genovese E, Pini LA, et al. Nimodipine in otolaryngology: from past evidence to clinical perspectives[J]. Acta Otorhinolaryngol Ital, 2015, 35(3): 135-145
[15] 董洪松, 王春丽, 俞艳萍, 等. 声音疗法联合药物治疗慢性主观性耳鸣的临床随机对照研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 30-37. doi:10.6040/j.issn.1673-3770.0.2023.210 DONG Hongsong, WANG Chunli, YU Yanping, et al. A randomized controlled clinical trial of sound therapy combined with medication in the treatment of chro-nic subjective tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 30-37. doi:10.6040/j.issn.1673-3770.0.2023.210
[16] 李颖, 冯国栋, 吴海燕, 等. 多个混合纯音频率声治疗对不同听力损失程度耳鸣患者有效性的双盲随机对照试验研究[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(5): 355-361. doi:10.3760/cma.j.issn.1673-0860.2019.05.008 LI Ying, FENG Guodong, WU Haiyan, et al. A double-blind randomized controlled trial on the efficacy of mixed pure tone sound therapy in chronic tinnitus patients with different hearing loss[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(5): 355-361. doi:10.3760/cma.j.issn.1673-0860.2019.05.008
[17] 朱晓月, 罗征, 孙越甲, 等. 主观性耳鸣患者心理人格特征研究[J]. 中国耳鼻咽喉头颈外科, 2022, 29(5): 301-303, 316. doi:10.16066/j.1672-7002.2022.05.007 ZHU Xiaoyue, LUO Zheng, SUN Yuejia, et al. Study on the psychologic status and personality traits of patients with tinnitus[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2022, 29(5): 301-303, 316. doi:10.16066/j.1672-7002.2022.05.007
[18] 郭岚宁, 齐音, 张艳利, 等. 影响慢性主观性耳鸣的心理学因素[J]. 心理学进展, 2022, 12(10): 3330-3335. doi:10.12677/ap.2022.1210404 GUO Lanning, QI Yin, ZHANG Yanli, et al. Psychological factors affecting chronic subjective tinnitus[J]. Advances in Psychology, 2022, 12(10): 3330-3335. doi:10.12677/ap.2022.1210404
[19] Weber FC, Schlee W, Langguth B, et al. Low sleep satisfaction is related to high disease burden in tinnitus[J]. Int J Environ Res Public Health, 2022, 19(17): 11005. doi:10.3390/ijerph191711005
[20] Wakabayashi S, Saito H, Oishi N, et al. Effects of tinnitus treatments on sleep disorders in patients with tinnitus[J]. Int J Audiol, 2018, 57(2): 110-114. doi:10.1080/14992027.2017.1374565
[21] 余力生, 马鑫. 耳鸣的代偿与失代偿[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(8): 630-633. doi:10.3760/cma.j.issn.1673-0860.2017.08.019 YU Lisheng, MA Xin. Compensation and decompensation of tinnitus[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(8): 630-633. doi:10.3760/cma.j.issn.1673-0860.2017.08.019
[22] LU Tao, LI Shuling, MA Ying, et al. Positive correlation between tinnitus severity and poor sleep quality prior to tinnitus onset: a retrospective study[J]. Psychiatr Q, 2020, 91(2): 379-388. doi:10.1007/s11126-019-09708-2
[23] 陈立萍, 黄超洋, 关志华, 等. 老年慢性主观性耳鸣严重程度与睡眠质量的相关性研究[J]. 华南国防医学杂志, 2016, 30(6): 376-378. doi:10.13730/j.issn.1009-2595.2016.06.006 CHEN Liping, HUANG Chaoyang, GUAN Zhihua, et al. Analysis of sleep quality in elderly patients with chronic subjective tinnitus[J]. Military Medical Journal of South China, 2016, 30(6): 376-378. doi:10.13730/j.issn.1009-2595.2016.06.006
[24] 齐柳, 宋勇莉, 白雪, 等. 慢性主观性耳鸣患者睡眠障碍及影响因素分析[J]. 中国眼耳鼻喉科杂志, 2022, 22(2): 119-123. doi:10.14166/j.issn.1671-2420.2022.02.003 QI Liu, SONG Yongli, BAI Xue, et al. Analysis of sleep disturbance and its influencing factors in patients with chronic subjective tinnitus[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2022, 22(2): 119-123. doi:10.14166/j.issn.1671-2420.2022.02.003
[25] 鹿艳丽. 探究认知行为疗法(CBT)结合精细化护理对慢性主观性耳鸣患者睡眠质量、心理状态及应对方式的影响[J].医药卫生, 2023,(1): 148-151
[1] 吕丹,李如珍,刘明秋,孟新宇,李俊义. 不同类型良性阵发性位置性眩晕患者焦虑、抑郁状态及睡眠障碍的发生率与相关性[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 62-67.
[2] 雷玉丹,方璐,陈健,彭昌福. 托珠单抗治疗激素抵抗或不耐受的中重度甲状腺相关性眼病临床疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 54-67.
[3] 陶朵朵,史彬,赵云舒,李勇刚,刘济生. 年龄相关性听力损失患者前扣带回神经递质水平及其与听力水平关系的初步研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 31-39.
[4] 黄焕,华红利,邓玉琴,江承洋,王雨薇,杨星海. 儿童过敏性鼻炎、扁桃体腺样体肥大和鼻窦炎之间相关性及其对临床指导价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 34-41.
[5] 刘欣,杜安石,王艳,谭青青,李俊萍,郭玉楠,兰长骏. 上睑下垂患者提上睑肌肌力与术后眼睑闭合的相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 70-75.
[6] 汪盛,黄旭东. 铁死亡与年龄相关性白内障的研究新进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 161-168.
[7] 董凌康,于栋祯. 1990—2021年中国年龄相关性听力下降负担变化趋势及预测[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 61-69.
[8] 张丽霞,李琳. 基于GEO数据库筛选年龄相关性听力损失关键基因的分析研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 104-114.
[9] 毛一恒,冯洁,何润田. 高血脂对视网膜损害与脉络膜厚度关系研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 162-167.
[10] 董雪林,张治军. 掩蔽声治疗慢性主观性耳鸣的焦虑抑郁状态分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 18-24.
[11] 孙鸿翔,曹娟. 老年白内障患者心理脆弱现状及其与希望水平和述情障碍的相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 89-95.
[12] 崔小缓,尹龙龙,张延平,蒋兴旺,李丽娜. 咽喉反流患者唾液菌群与反流症状相关性分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 78-84.
[13] 刘盼盼,赵赫,王琰,仇静静,刘大炜,孙岩. 基于百度指数的新型冠状病毒感染流行发生前后耳部症状健康问题网络关注度研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 7-14.
[14] 陈倬诣,郑亿庆,杨海弟. 慢性主观性耳鸣分类、发生发展机制及治疗新进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 1-12.
[15] 董洪松,王春丽,俞艳萍,陈涛,聂国辉. 声音疗法联合药物治疗慢性主观性耳鸣的临床随机对照研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 30-37.
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