言语测听体系评价中医药治疗耳聋耳鸣疗效研究

Evaluation of Therapeutic Effect of Chinese Medicine for Treatment of Deafness and Tinnitus with Speech Detection System

【目的】通过比较言语测听及现有的纯音听阈测听与患者主观听力、耳鸣之间的相关程度,研究言语测听的特点,以期寻找中医自身规律和特点的耳聋耳鸣临床疗效评价模式。【方法】收集20例耳聋患者(40耳)治疗前后主观自觉听力损失程度、耳鸣致残量表(THI)的评分情况,并进行言语识别阈(SRT)、言语平均纯音听阈(PTA)等的主客观测试,评价主观自觉听力损失程度、THI量表评分情况与SRT、PTA的关联程度。【结果】患耳治疗前后主观听力损失与SRT、PTA的Spearman相关系数较高(P<0.05),而治疗前后THI量表评分与两种测试的Spearman相关系数均较低(P>0.05)。就言语测听的SRT而言,其与治疗前后主观听力损失的Spearman相关系数比PTA更高(P<0.01)。说明两种测试方式均可较好地评定患者的听力损失情况,但是对耳鸣情况的变化不能较好地评定。可见言语测听与患者主观的听力损失程度的相关性更好,高于PTA及纯音听阈听力损失程度,更能评定患者主观的听力损失程度的变化。【结论】言语测听检测本身比现有纯音听阈测听更符合中医的思维模式,符合中医自身规律和特点的耳聋耳鸣临床疗效评价模式,可为治疗耳聋耳鸣提供一套中西医认可的评价临床疗效的新手段和工具。

Objective To study the correlation of the speech audiometry and pure tone threshold audiometry with subjective hearing and tinnitus of the patients, thus to explore the speech audiometry characteristics and to evaluate the clinical curative effect of traditional Chinese medicine for deafness and tinnitus. Methods Twenty deafness patients（involving 40 ears）were enrolled into the study. The subjective hearing loss degree and tinnitus handicap inventory（THI） scores were investigated,and the speech recognition threshold（SRT） and pure tone average（PTA） were tested. And then we analyzed the correlation of the subjective hearing loss degree and THI scores with SRT and PTA. Results Spearman correlation coefficient was high between the subjective hearing loss degree and SRT as well as PTA（P 0.05）,while was low between pre- and post- treatment THI scores and SRT as well as PTA（P 0.05）. The Spearman correlation coefficient of SRT with subjective hearing loss degree was higher than that of PTA with subjective hearing loss degree（P 0.01）. Both of the speech audiometry and pure tone threshold audiometry were suitable for the evaluation of hearing loss of the patients,but not suitable for the changes of tinnitus. The speech audiometry was highly correlated with subjective hearing loss,better than PTA and pure tone threshold audiometry for the evaluation of subjective hearing loss. Conclusion Speech audiometry is more suitable for traditional Chinese medical mode than the existing pure tone audiometry,and is feasible for the evaluation of the clinical curative effect of Chine se medicine for deafness and tinnitus, which can provide a set of new methods and tools for clinical effectiveness evaluation by the practitioners of Chinese medicine and western medicine.