复合声治疗对不同类型听阈正常耳鸣患者的疗效观察（英文）

Tailor-made Complex Sound Alleviates both Residual-Inhibition Positive and Negative Tinnitus Patients with Normal Hearing Audiogram

【目的】探讨复合声对听阈正常耳鸣患者的疗效,为纯音听阈正常耳鸣患者治疗提供参考。【方法】收集2014年9月1日-2015年12月30日间中山大学附属第一医院门诊就诊的纯音测听听阈正常的46例耳鸣患者,耳鸣持续时间>3个月。详细收集患者病例资料如年龄、性别、耳鸣特点、伴随症状等,并行纯音测听、耳鸣测听检查,以及耳鸣致残量表(THI)评分和视觉模拟评分(VAS)评分。给予复合声治疗,选取主频与耳鸣频率一致的自然声,并挑选音乐主频覆盖耳鸣频率中心的音乐片段,以选出的掩蔽自然声与音乐材料片段进行叠加重合,对耳鸣患者进行声治疗并评估疗效。【结果】46例耳鸣患者中32例后效抑制阳性,其治疗前THI评分平均为(33.38±16.23)分,VAS评分平均为(4.38±1.62)分;经复合声治疗后THI评分为(21.75±11.67)分,VAS评分为(2.97±1.06)分;14例后效抑制阴性的患者,治疗前THI评分平均为(29.86±20.15)分,VAS评分平均为(3.93±1.69)分;复合声治疗后THI评分为(23.43±16.29)分,VAS评分为(3.36±1.2)分。后效抑制阳性组声治疗前后THI评分和VAS评分显著降低,后效抑制阴性组声治疗也有效,效果不如后效抑制阳性组。【结论】复合声对听力正常耳鸣患者有效,后效抑制阳性的患者复合声治疗效果较好,而后效抑制阴性的患者声治疗效果不明显。

【Objective】To evaluate the efficacy of sound therapy and provide a kind of treatment for tinnitus patients with normal audiogram.【Methods】From the database of the Audiometric Center of the First Affiliated Hospital,Sun Yatsen University,we identified 46 outpatients with normal hearing thresholds in the conventional pure-tone audiometry suffering subjective tinnitus over 3 months. The clinical information were collected with respect of age,gender,tinnitus severity,pitch,laterality and duration,comorbid symptoms. All the patients received the tinnitus test,including loudness and frequency of the tinnitus and residual inhibition,Tinnitus Handicap Inventory（THI）and Visual Analogue Scale（VAS）scores pre-and post-complex sound therapy. The complex sound were remixed with natural sounds and music materials,while the masking frequency of natural sounds is consistent with the tinnitus frequency of patients and the main frequency of music materials covers the tinnitus frequency.【Results】32 of the 46 patients showed residual inhibition（RI）positive. The average THI score before treatment was 33.38±16.23 and the VAS score was 4.38±1.62. The THI score decreased to 21.75±11.67 and the VAS score was 2.97±1.06 after sound therapy. The rest 14 patients were residual inhibition（RI）negative. The THI score were 29.86±20.15 and 23.43±16.29 pre-and post-complex sound therapy,while the VAS score were 3.93±1.69 and 3.36±1.2. The THI and VAS scores were significantly decreased after the treatment in both RI positive and negative patients. The RI positive group showed better results than RI negative group.【Conclusions】Both RI positive and negative tinnitus with normal audiometry shown adaptation with complex sound therapy,RI positive patients acquired more benefits from tailor-made complex sound therapy.