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摘要: 目的 探讨经皮耳迷走神经刺激(taVNS)治疗慢性耳鸣的疗效。方法 采用taVNS治疗慢性失代偿耳鸣, 10 d为一疗程。记录分析患者在治疗期间主观症状的改善情况, 并于治疗结束时(治疗10 d)、治疗后3个月及6个月进行THI、PSQI、DASS-21评分, 比较taVNS组和对照组的耳鸣改善情况, 并对taVNS组THI评分进行治疗前后的比较。结果 ① taVNS治疗期间, 93.65%的患者获得主观症状改善, 28.6%的患者自愿接受第二疗程taVNS治疗; ②睡眠改善以治疗10 d时最理想, 3、6个月后部分患者睡眠状况不稳定; ③ taVNS组在治疗期间及治疗后均获得焦虑情绪的改善, 以治疗后3个月及6个月时最理想; ④THI评分在组间未呈现显著差异, 但taVNS组治疗后3个月及6个月随访时较治疗前明显改善。结论 taVNS治疗可明显改善耳鸣患者的睡眠障碍、焦虑障碍及耳鸣困扰。Abstract: Objective The aim of this study is to investigate the efficacy of transcutaneous vagus nerve stimulation(taVNS) in the treatment of chronic tinnitus.Methods taVNS was used to treat chronic decompensated tinnitus, 10 days as a course of treatment. Record and analyze the improvement of the patient's subjective symptoms during treatment. The THI, PSQI and DASS-21 scores were performed at 10 days, 3 months and 6 months after treatment. The improvement of tinnitus in taVNS group and control group at the above recorded time points was compared, and the THI score of taVNS group was compared before and after treatment.Results ① During the taVNS treatment, 93.65% of the patients achieved improvement in subjective symptoms, and 28.6% of the patients voluntarily accepted the second course of taVNS treatment; ② The sleep improvement was optimal when the treatment was 10 days, and some patients had poor sleep status after 3 or 6 months; ③ The anxiety of taVNS group was improved during and after treatment, and the best effect time was 3 months and 6 months after treatment; ④ There was no significant difference in THI score between the two groups, but there was significant improvement in taVNS group at 3 months and 6 months after treatment.Conclusion taVNS treatment can significantly improve the sleep disorder, anxiety disorder and tinnitus disturbance of tinnitus patients, and the curative effect is good after 3 months and 6 months of prevention.
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表 1 治疗期间两组主观症状的改善情况比较
例(%) 主观症状 taVNS组(n=63) 对照组(n=63) 耳鸣困扰 25(39.68) 11(17.46) 睡眠质量 33(52.38)2) 3(4.76) 耳鸣响度 6(9.52) 2(3.17) 与对照组比较，1)P < 0.05，2)P < 0.01。 
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表 2 治疗前后两组PSQI评分比较
x±s 时间 taVNS组 对照组 治疗前 15±3.32 15±4.23 治疗结束时 10±2.242) 14±3.39 治疗后3个月 12±4.161) 13±4.15 治疗后6个月 13±2.14 13±4.20 与治疗前比较，1)P < 0.05，2)P < 0.01。
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表 3 治疗前后两组DASS-21评分比较
x±s 时间 焦虑 抑郁 压力 taVNS组 对照组 taVNS组 对照组 taVNS组 对照组 治疗前 9.22±7.05 8.82±5.21 7.05±6.55 6.88±6.22 14.02±6.21 13.58±7.83 治疗结束时 7.21±6.121) 8.36±6.12 6.66±6.13 6.33±4.32 13.35±5.67 13.56±6.78 治疗后3个月 5.33±4.222) 6.56±4.24 6.11±4.13 6.21±5.39 12.58±5.35 12.68±7.22 治疗后6个月 5.22±3.02) 6.58±4.34 7.00±6.03 6.28±6.32 13.55±5.68 13.76±6.26 与治疗前比较，1)P < 0.05，2)P < 0.01。
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表 4 治疗前后两组THI评分比较
x±s 时间 taVNS组 对照组 P(组间) 治疗前 46.06±7.01 46.50±5.47 0.459 治疗结束时 45.06±6.53 45.00±5.25 0.343 治疗后3个月 42.50±5.931) 43.31±4.53 0.231 治疗后6个月 42.04±6.021) 43.56±5.88 0.206 与治疗前比较，1)P < 0.05。
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| 引用本文: |
曾祥丽, 郑可, 岑锦添, 等. 经皮耳迷走神经刺激治疗慢性耳鸣的疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(2): 105-108. doi: 10.13201/j.issn.2096-7993.2021.02.003
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| Citation: |
ZENG Xiangli, ZHENG Ke, CEN Jintian, et al. Efficacy of percutaneous vagal stimulation in the treatment of chronic tinnitus[J]. J Clin Otorhinolaryngol Head Neck Surg, 2021, 35(2): 105-108. doi: 10.13201/j.issn.2096-7993.2021.02.003
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