复合声治疗突发性聋患者耳鸣的临床对照研究

刘钊; 梁勇; 杨衬; 刘友利; 李衍菲; 韩晓燕; 曾林燕; 何萍香

doi:10.13201/j.issn.1001-1781.2015.04.010

复合声治疗突发性聋患者耳鸣的临床对照研究

- 南方医科大学南方医院耳鼻咽喉头颈外科(广州, 510515)

详细信息

通讯作者: 梁勇,E-mail:yliang@smu.edu.cn

中图分类号: R764.45

收稿日期: 2014-09-11

The clinical efficacy of composite acoustic therapy in patients of sudden deafness with tinnitus

- Department of Otolaryngology Head and Neck Surgery, Nanfang Hospital of Nanfang Medical University, Guangzhou, 510515, China

More Information

Corresponding author: LIANG Yong, E-mail: yliang@smu.edu.cn

Received Date: 11 September 2014

摘要

摘要: 目的: 观察复合声治疗突发性聋患者耳鸣的临床疗效,并探讨作用机制。方法: 将96例(96耳)突发性聋伴耳鸣患者分为试验组和对照组,进行14 d的药物治疗,试验组前30天加入个性化复合声治疗,31~90 d改音乐治疗,对照组不加声治疗。在治疗前、第30天、第90天对两组患者进行纯音测听、耳鸣匹配、残余抑制等听力学检查,填写耳鸣响度VAS量表、THI量表、SAS量表,比较结果。结果: 89例(试验组47例、对照组42例)完成本试验。两组第30天比较:VAS评分、听力恢复率差异均无统计学意义(P>0.05),THI评分、SAS评分差异均有统计学意义(P<0.01)。第90天比较:VAS评分、THI评分、SAS评分差异均有统计学意义(P<0.05或P<0.01),听力恢复率差异无统计学意义(P>0.05)。两组VAS评分有显著差异出现在治疗前30天。两组听力恢复率、试验组耳鸣VAS评分,前30天疗效好于31~90 d(P<0.01)。结论: 复合声联合药物治疗可以改善突发性聋患者的耳鸣和焦虑,其对耳聋的疗效仍有待观察。
- 复合声 /
- 听觉丧失 /
- 突发性 /
- 耳鸣 /
- 焦虑
Abstract: Objective: To determine whether the composite acoustic therapy is effective to treat tinnitus in patients with sudden deafness and to explore the mechanisms.Method: Ninety-six cases (96 ears) were divided into experimental group and control group, and all the patients underwent drug treatment.The patients in experimental group were given personalized composite acoustic therapy in the first 30 days, music therapy in next 31-90 days, however, the patients in control group were not given sound therapy.Additionally, pure tone audiogram, tinnitus pitch and loudness as well as questionnaires (including THI, VAS, and SAS) were conducted for each patient before treatment, at day 30 and day 90 posttreatment.Result: Eighty-nine patients (n=47 for experimental group and n=42 for control group) completed the trial.The results of day 30 posttreatment showed there were no significant differences in VAS and hearing recovery rate between these two groups, but THI and SAS showed significant differences.The results of day 90 posttreatment showed significant differences in VAS(P<0.05),THI (P<0.01) and SAS (P<0.01), and no significant difference of hearing recovery rate was detected.The most significant changes of VAS appeared in the first 30 days of treatment.The hearing and tinnitus recovery in experimental group were better for the first 30 days of treatment than for the next 31-90 days, and similar results were obtaind in control group.(P<0.01).Conclusion: Composite acoustic treatment combined with drug therapy can improve the tinnitus and anxiety symptoms of patients with sudden deafness, and the effect on hearing recovery still need to be confirmed in further studies.
- composite acoustic therapy /
- hearing loss /
- sudden /
- tinnitus /
- anxiety

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参考文献(22)

[1]	OH J H,PARK K,LEE S J,et al.Bilateral versus unilateral sudden sensorineural hearing loss[J].Otolaryngol Head Neck Surg,2007,136:87-91.
[2]	中国突发性聋多中心临床研究协作组.中国突发性聋分型治疗的多中心临床研究[J].中华耳鼻咽喉头颈外科杂志,2013,48(5):355-361.
[3]	ROMAN S,ALADIO P,PARIS J,et al.Prognostic factors of sudden hearing loss in children[J].Int J Pediatr Otorhinolaryngol,2001,61:17-21.
[4]	HESSER H,ANDERSSON G.The role of anxiety sensitivity and behavioral avoidance in tinnitus disability[J].Int J Audiol,2009,48:295-299.
[5]	DAVIS P.Music and the acoustic desensitization protocol for tinnitus[M].New York:Thieme Medical Publishers,2005:146-160.
[6]	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.突发性聋的诊断和治疗指南(2005年,济南)[J].中华耳鼻咽喉头颈外科杂志,2006,41(8):569-569.
[7]	黄治物,常伟,陈桂芳.耳鸣掩蔽疗法[J].听力学及言语疾病杂志,2004,12(6):376-377.
[8]	COLES R.Some aspects of evaluation of treatment effects[M].New York/Amsterdam:Kugler Publications,1991:563-568.
[9]	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.
[10]	SVANBORG P,ASBERG M.A new self-rating scale for depression and anxiety states based on the Comprehensive Psychopathological Rating Scale[J].Acta Psychiatr Scand,1994,89:21-28.
[11]	JASTREBOFF P J,HAZELL J W,GRAHAM R L.Neurophysiological model of tinnitus:dependence of the minimal masking level on treatment outcome[J].Hear Res,1994,80:216-232.
[12]	MIRZ F,GJEDDE A,SODKILDE-JRGENSEN H,et al.Functional brain imaging of tinnitus-like perception induced by aversive auditory stimuli[J].Neuroreport,2000,11:633-637.
[13]	杨剑,刘博,韩德民.突发性耳聋的循环病因机制[J].国际耳鼻咽喉头颈外科杂志,2006,30(3):175-177.
[14]	HOKE E S,MUHLNICKEL W,ROSS B,et al.Tinnitus and event-related activity of the auditory cortex[J].Audiol Neurootol,1998,3:300-331.
[15]	黄治物,吴皓.耳鸣中枢化机制与临床诊疗[J].临床耳鼻咽喉头颈外科杂志,2014,28(4):222-225.
[16]	王洪田,梁勇.耳鸣诊疗新进展[M].北京:人民卫生出版社,2004:124,293.
[17]	ROBERTS L E.Residual inhibition[J].Prog Brain Res,2007,166:487-495.
[18]	LOPEZ-GONZALEZ M A,CAMBIL E,ABRANTE A,et al.[Sound therapy in sudden deafness] [J].Acta Otorrinolaringol Esp,2012,63:165-172.
[19]	李永贺,黄以乐.声波对离体耳蜗外毛细胞内游离Ca²⁺浓度的影响[J].临床耳鼻咽喉科杂志,1999,13(8):359-360.
[20]	NORENA A J,EGGERMONT J J.Enriched acoustic environment after noise trauma abolishes neural signs of tinnitus[J].Neuroreport,2006,17:559-563.
[21]	NIU X,TAHERA Y,CANLON B.Protection against acoustic trauma by forward and backward sound conditioning[J].Audiol Neurootol,2004,9:265-273.
[22]	JASTREBOFF P J,GRAY W C,GOLD S L.Neurophysiological approach to tinnitus patients[J].Am J Otol,1996,17:236-240.