声治疗对不同频率主观性耳鸣的疗效观察-现代医学

声治疗对不同频率主观性耳鸣的疗效观察

单位：1. 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科, 江苏省医学重点学科, 江苏南京 210008;
2. 南京大学医学院附属鼓楼医院耳鼻咽喉研究所, 江苏南京 210008

分类号：R764.5

出版年·卷·期（页码）：2017·36·第六期（803-806）

摘要：

目的：观察主观性耳鸣临床特点及声治疗对不同频率主观性耳鸣的疗效。方法：对104例主观性耳鸣患者（病程大于3个月，或用药治疗大于3个月耳鸣无明显改善）进行问卷调查（THI量表、PSQI量表、PHQ-9量表、GAD-7量表）、耳科专科检查、听力学检查、耳鸣心理声学测试及声治疗。结果：男性50例（48.08%）；女性54例（51.92%）。耳鸣患者在年龄段分布情况如下：<20岁1例（0.96%），20～29岁10例（9.62%），30～39岁15例（14.42%），40～49岁23例（22.11%），50～59岁25例（24.04%），60～69岁18例（17.31%）；70～79岁12例（11.54%）。中年段（40～59岁）耳鸣人数最多，48例（46.15%）。不同年龄段耳鸣患者男女分布无统计学差异，P>0.05。3.85%耳鸣患者存在严重的睡眠障碍，58.65%耳鸣患者存在不同程度的抑郁，46.15%耳鸣患者存在不同程度的焦虑。主观性耳鸣频率分布情况如下：低频（<1 kHz）33例（31.73%），中频（1 kHz～4 kHz）17例（16.35%），高频（≥4 kHz）54例（51.92%）。声治疗对104例主观性耳鸣患者总有效率为96.15%，其中低频有效率为96.97%，中频有效率为94.12%，高频有效率为96.30%。声治疗对三组不同频率段耳鸣的疗效无统计学差异，P>0.05。结论：主观性耳鸣患者男女分布比例相当。耳鸣与年龄有相关性，中年人出现耳鸣的可能性高于其他年龄段。耳鸣患者普遍存在非听觉问题。主观性耳鸣以高频耳鸣最多见，其次低频，最后中频。声治疗适用于不同频率主观性耳鸣的治疗。

Objective: To investigate the clinical characteristics of subjective tinnitus and the curative effect of sound therapy on subjective tinnitus with different frequency. Methods: A total of 104 patients with subjective tinnitus (disease lasting for more than 3 months or not reponsive to drug treatment for more than 3 months) were recruited for the study. Each patient received questionaire, including detailed medical historty, completed questionnaires (THI, PSQI, PHQ-9 and GAD-7), special examination, audiological examination,psychoacoustic characteristics of tinnitus inspection and sound therapy. Results: 50 cases were male (48.08%) and 54 cases female (51.92%). The age distribution of patients with subjective tinnitus was as follows:<20 years old 1 cases (0.96%),20-29 years old 10 cases (9.62%), 30-39 years old 15 cases (14.42%), 40-49 years old 23 cases (22.11%), 50-59 years old 25 cases (24.04%), 60-69 years old 18 cases (17.31%), 70-79 years old 12 cases (11.54%). Most of the case were middle-aged (40 to 59 years old), accounting for 46.15%. There was no significant difference in the distribution of male and female between different age groups (P>0.05). 3.85% of the patients had serious sleep disorder, 58.65% of the patients had different degrees of depression and 46.15% of the patients had different degrees of anxiety. The distribution of different frequency of tinnitus was as follows:low frequency (<1 kHz) 33 cases (31.73%), intermediate frequency (1 kHz-4 kHz) 17 cases (16.35%), high frequency (≥ 4 kHz) 54 cases (51.92%). The total effective rate of sound therapy was 96.15% in 104 patients with subjective tinnitus. The ffective rate for subjective tinnitus with low frequency was 96.97%, that with intermediate frequency 94.12% and that with high frequency 96.30%. There was no statistical significance in the curative effect of the three groups of subjective tinnitus (P>0.05). Conclusion: There was a roughly equal proporition of male and female patients with subjective tinnitus.There was a correlation between tinnitus and age, namely a high possibility of tinnitus was found in middle-aged people. Non auditory problems were common in patients with tinnitus. High frequency tinnitus was the most common in subjective tinnitus, secondly low frequency tinnitus, lastly intermediate frequency. Sound therapy can be applied to subjective tinnitus with different frequency.

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