中老年慢性主观性耳鸣患者焦虑和抑郁及睡眠障碍的临床治疗分析

Clinical efficacy on anxiety, depression and chronic subjective tinnitus

目的探讨慢性主观性耳鸣的治疗方法，评价其对患者焦虑、抑郁及睡眠障碍症状的疗效影响。方法收集2016年1月至2017年12月我院耳鼻喉科符合慢性主观性耳鸣诊断标准的80例患者，用随机数字方法分为观察组和对照组，对照组单用药物治疗，观察组采取药物治疗＋习服的方案，以耳鸣残障量表（THI）、匹兹堡睡眠质量指数（PSQI）及汉密尔抑郁量表（SDS）和汉密尔顿焦虑量表（SAS）评定治疗前后变化，并评价其总体疗效。结果观察组治疗后3个月THI后PSQI、SAS和SDS评分均低于对照组（均P〈0.05）。治疗后6个月随访，观察组有效率82.5%（33例），高于对照组的55.0%（22例）（χ^2＝7.040，P〈0.01）。结论常规药物方案联合习服疗法有助于改善慢性主观性耳鸣患者残障状况，改善焦虑抑郁等负性情绪，提高睡眠质量，具有研究推广价值。

ObjectiveTo evaluate the efficacy of tinnitus retraining therapy （TRT） on anxiety, depression, and symptoms of sleep disorders in patients with chronic subjective tinnitus.MethodsEighty patients with chronic subjective tinnitus visiting The Affiliated Hospital of Hangzhou Normal University from January 2016 to December 2017 were recruited, and were divided into an observation group and a control group through computer generated random numbers. Patients in the control group were given drug treatment only, while those in the observation group received TRT in addition to drug treatment. Clinical efficacy was evaluated using Tinnitus Handicap Inventory （THI）, Pittsburgh Sleep Quality Index （PSQI）, Hamilton Depression Scale （SDS）, and Hamilton Anxiety Scale （SAS） for both groups.ResultsPatients in the observation group were associated with significantly lower scores of THI, PSQI, SAS and SDS, compared with those in the control group 3 months after treatment （each P〈0.05）. Furthermore, the effectiveness rate was markedly higher （82.5% or 33 cases vs. 55.0% or 22 cases, χ^2=7.040, P〈0.01） in the observation group than in the control group 6 months after treatment.ConclusionTinnitus retraining therapy combined with conventional therapy can help to reduce the severity of tinnitus handicap, ameliorate negative emotions such as anxiety and depression, and improve sleep quality in patients with chronic subjective tinnitus.