耳鸣掩蔽结合心理咨询治疗耳鸣的疗效评价

Evaluating the Effect of Masking Therapy Combined with Psychological Counseling in Tinnitus Treatment

目的评价耳鸣掩蔽结合心理咨询治疗耳鸣的疗效。方法对35例（48耳）耳鸣患者进行耳呜掩蔽结合心理咨询治疗，分别于治疗前、治疗结束后以及半年后填写耳鸣残疾评估量表（tinnitus handicap inventory，THI），根据THI量表得分变化分析疗效。治疗后THI得分比治疗前减少≥20分认为治疗有效。结果所有耳鸣患者均完成一个疗程的治疗，20例完成半年随访。耳呜掩蔽结合心理咨询前后THI评分减少≥20分者15例，有效率为43％（15／35），半年后有效率为45％。男女之间耳呜严重程度有统计学差异。40～49岁和50～80岁组治疗效果最好，20～29岁和10～19岁组治疗效果最差，但各年龄段疗效无统计学差异。治疗前后及半年后THI、E项（感情评价）、F项（功能性评价）、C项（严重性评价）差异有统计学意义，治疗有效。不同耳鸣持续时间的治疗效果差异没有统计学意义（P＝0．551）。结论耳鸣掩蔽结合心理咨询治疗耳鸣能够取得一定疗效，并且效果稳定。有高频听力损失患者治疗效果好。

Objective To evaluate the effects of masking therapy combined with counseling. Methods Tinnitus handicap inventory （THI） was filled out 6 months before and after tinnitus therapy. The patients were treated with tinnitus masking combined with psychological counseling. The results were analyzed by comparing the score of THI. Tinnitus therapy was considered effective if the THI score reduced more than or equal to 20. Results Thirty -five subjects（forty-eight ears） were included. Only twenty completed the study. The effective rate was 43 % and 45 %, separately after therapy and six months follow-up. Tinnitus severity between male and female was statistically different. The best result was found both in age of 40～49 group and age of 50～80 one. Data from 20～29 years and 10～ 19 years showed few therapeutic effect. No statistic difference was found among different age groups. There was statistic difference about the value of THI, item E, item F and item C before and after therapy and half a year later. The therapy was effective. There was no statistic difference between the therapy effect of duration of tinnitus （P=0. 551）. Conclusfon Tinnitus masking therapy combined with counseling is effective and stable in some cases, much better especially for those with high frequency hearing loss.