强直声治疗慢性耳鸣及耳鸣评估方法研究

雷冠雄; 邓忠; 谭东辉; 张铎; 赵泽祺

doi:10.13201/j.issn.1001-1781.2019.09.015

强直声治疗慢性耳鸣及耳鸣评估方法研究

- 1 湘南学院(湖南郴州, 423000);
- 2 湘南学院附属医院;
- 3 徐州医科大学
基金项目:
湖南省自然科学基金项目(No:2016JJ6144,2018JJ3479)

湖南省临床医疗技术创新引导项目(No:2018SK52003)

湖南省卫生计生委计划课题项目(No:B20180707)

江苏省研究生科研创新计划项目(No:KYCX19_2227)

郴州市科技局科研项目(No:zdyf2018054,CZ2014052)

详细信息

通讯作者: 赵泽祺,E-mail:529805335@qq.com

中图分类号: R764.45

收稿日期: 2019-03-19

Study on treatment of chronic tinnitus by tetanus stimulation and evaluation methods of tinnitus

- 1 Xiangnan University, Chenzhou, Hunan, 423000, China;
- 2 Affiliated Hospital of Xiangnan University;
- 3 Xuzhou Medical University

More Information

Corresponding author: ZHAO Zeqi, E-mail: 529805335@qq.com

Received Date: 19 March 2019

摘要

摘要: 目的:探索强直声治疗耳鸣的疗效,以及耳鸣响度匹配与耳鸣主流量表、问卷之间的相关性,以寻求更为简便准确的耳鸣评估方法。方法:入组10例(13耳)听力正常或轻度听力损失的慢性耳鸣患者,年龄23~53岁。选用强直声(以白噪声为载波,调频14.1 Hz,重复振幅调制,占空比0.5),给声强度50 dB SL。给声方案:(4 min给声+4 min休息)×4次,总时长32 min。每周3次强直声治疗,连续治疗5周。每次治疗前、后行耳鸣响度匹配,每周第1次治疗前进行耳鸣致残量表(THI)、耳鸣障碍问卷(THQ)以及耳鸣响度视觉模拟量表(VAS)评估,治疗结束后1周随访,予以响度匹配及上述量表、问卷跟踪评估。结果:①单次治疗后响度匹配值下降1.000(0.000,3.000) dB(Z=7.553,P<0.01)。②治疗5周后响度匹配值下降(9.692±8.038) dB(t=4.348,P<0.01);VAS值下降2.000(1.000,3.000)(Z=2.890,P<0.01);THQ总分下降(7.389%±8.847%)(t=2.641,P<0.05)。③相关性分析:THI与THQ总分之间呈正相关(r=0.747,P<0.01);响度匹配值与VAS值(r=0.593,P<0.01)、THI-F(r=0.346,P<0.01)及THQ-因子3分值(r=0.294,P<0.05)之间呈正相关;VAS值与THI-F(r=0.326,P<0.05)、THI总分(r=0.466,P<0.01)、THQ-因子3分值(r=0.291,P<0.05)、THQ总分(r=0.497,P<0.01)之间呈正相关。结论:强直声治疗过程中,耳鸣响度呈显著的波动性下降。推荐使用THQ作为耳鸣疗效评估的敏感指标;推荐使用VAS进行耳鸣的快速评估。强直声治疗有望成为耳鸣声治疗一个值得重视的方向。
- 耳鸣 /
- 声治疗 /
- 强直声 /
- 耳鸣致残量表 /
- 耳鸣障碍问卷 /
- 视觉模拟量表
Abstract: Objective: The purpose of this study was to explore the efficacy of tetanus stimulation in tinnitus treatment and the correlation between the mainstream questionnaires of tinnitus and tinnitus-matching in order to find a more convenient and accurate method for tinnitus evaluation. Method: Ten patients with chronic tinnitus and normal or mild hearing impairment were enrolled in this study, totaling 13 ears. Their age ranged from 23 to 53 years old. The stimulus sound(white noise, frequency modulation 14.1 Hz, repetitive amplitude modulation, duty cycle 0.5) was selected and the sound intensity was 50 dB SL. Experimental procedure: (4 minutes sound stimulation+4 minutes rest) ×4 times, totaling 32 minutes. The patients were treated three times a week for 5 weeks. The loudness of tinnitus was matched before and after each treatment, and tinnitus handicap inventory(THI), tinnitus handicap questionnaire(THQ) and visual analog scales(VAS) were also used for assessment before the first treatment each week. The loudness matching and the above scales were performed once more at follow-up for one week after end-of-treatment. Result: ①Single treatment: the matched loudness value decreased by 1.000(0.000, 3.000) dB(Z=7.553, P<0.01) after each single treatment. ②After five weeks' treatment: the matched loudness value decreased(9.692±8.038) dB(t=4.348, P<0.01); VAS value decreased by 2.000(1.000, 3.000)(Z=2.890, P<0.01); total score of THQ decreased(7.389%±8.847%)(t=2.641, P<0.05). ③Correlation analysis: there was positive correlation between total scores of THI and THQ(r=0.747, P<0.01); the matched loudness values have positive correlation with VAS value(r=0.593, P<0.01), THI-F(r=0.346, P<0.01) and THQ-factor 3 score(r=0.294, P<0.05); there was positive correlation between the VAS value and THI-F(r=0.326, P<0.05), the total score of THI(r=0.466, P<0.01), THQ-factor 3 score(r=0.291, P<0.05), the total score of THQ(r=0.497, P<0.01). Conclusion: The loudness of tinnitus declined with significant fluctuation during tetanus sound therapy. THQ scale is recommended as a sensitive indicator for evaluating the efficacy of tinnitus treatment; VAS is recommended for rapid assessment of tinnitus. Tetanus stimulation is expected to become an important direction in tinnitus sound therapy.
- tinnitus /
- sound therapy /
- tetanus stimulation /
- tinnitus handicap inventory /
- tinnitus handicap questionnaire /
- visual analog scales

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