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    下一篇

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

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.
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