摘要
目的应用定制音乐对慢性特发性耳鸣患者进行个体化干预,与现有耳鸣训练疗法进行比较,分析两种声治疗策略的治疗效果并探讨其作用机理。方法研究对象为就医于耳科广]诊,不明原因伴或不伴有感音神经性聋,病程≥6个月的耳鸣患者。采用前瞻性设计,随机将经过严格入选及排除标准纳入的患者分为A组(定制音乐组)和B组(耳鸣训练组),进行为期3个月的声治疗。治疗前及治疗后逐月对人选对象进行耳鸣残疾量表(tinnitus handicap inventory,THI)、响度视觉模拟量表(visual analogue scale,VAS)及听力学评估。结果经过3个月的声治疗,分析两组THI和IVAS改变。发现A组治疗有效率明显高于B组(77.8%vs 52.9%),两组比较差异有统计学意义(P<0.05)。随治疗时间延长,A组内疗效比较,呈上升趋势且差异有统计学意义(χ2=6.406.P<0.05);B组内疗效比较,治疗1个月时也有一定疗效,随后疗效基本保持稳定(χ2=0.628,P=0.713)。随聆听时间的累加,A组耳鸣响度明显减轻(χ2=29.493.P<0.05).B组未见显著变化(χ2=4.171.P=0.244)。结论本研究表明,长时程.规范化聆听个体化定制音乐用于治疗慢性特发性耳鸣具有积极意义。经特殊声学处理的音乐可以显著减轻患者耳鸣响度,不同程度改善耳鸣对患者生活质量影响。
OBJECTIVE The individualized intervention of patients with chronic idiopathic tinnitus was carried out by custom music therapy.Compared with the existing tinnitus training therapy,the therapeutic effects of the two acoustic therapy strategies were analyzed and their mechanisms were discussed.METHODS The subjects were recruited from the otological clinic.These patients had chronic(longer than 6 months)and idiopathic tinnitus,with or not significant sensorineural hearing loss.In the prospective design,the patients were randomly divided into group A(custom music group)and group B(innitus training group)to receive the treatment for 3 months.The tinnitus scale,tinnitus questionnaire and audiological findings were evaluated before and after treatment started.RESULTS After 3 months of regular treatment,we analyzed the changes of tinnitus handicap inventory(THI)and loudness visual analog scale(VAS).It was found that the effective rate of custom music group was significantly higher than that of tinnitus training grou(77.8%vs 52.9%),and there was significant difference between the two groups(P<0.05).With the accumulation of treatment time,the efficacy in group A showed an upward trend and the difference was statistically significant(x=6.406,P<0.05).Compared with the curative effect in group B,it also had a certain curative effect after one month of treatment,and then the curative effct remained basically stable(χ2=0.628,P=0.713).With the accumulation of listening time,the tinnitus loudness of the customized music group was significantly reduced(χ2=29.493,P<0.05),but there is no significant change in training group(x=4.171,P=0.244).CONCLUSION The results of this study show that the long-term and standardized listening to individual custom-made music is of positive significance in the treatment of chronic idiopathic tinnitus.The musie with special acoustic treatment can significantly reduce the tinnitus loudness of the patient and improve the effect of the tinnitus on the quality of the patient's life in different degrees.
作者
田如如
刁明芳
孙建军
TIAN Ruru;DIAO Mingfang;SUN Jianjun(Department of Otolaryngology,A filiated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang,310000,China;Department of Otolaryngology,Sixth Medical Center of PLA General Hospital,Bejing,100048,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2020年第2期98-101,114,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
耳鸣
前瞻性研究
音乐疗法
定制音乐
Tinnitus
Prospective Studies
Music Therapy
tailor-made notched music
作者简介
第一作者及通讯:田如如,女,安徽人,医学硕士。主要专业方向为耳科学,Email:tianra11@yeah.net;通讯作者:孙建军,Email:jjsun85@sina.com。
