声敏感与耳鸣的病因病机初探

Preliminary study of the etiology and pathogenesis of acoustic hypersensitivity and tinnitus

目的探讨声敏感与耳鸣的病因病机.方法以符合声敏感和/或耳鸣诊断标准并愿意配合调查的272例患者作为研究对象,指导患者填写生活方式调查表、抑郁自评量表（SDS）、焦虑自评量表（SAS）、脾胃功能量表,有耳鸣的患者填写耳鸣评价量表（TEQ）以评估严重程度,有声敏感的患者,用VAS评分评估严重程度.结果①所有入组患者中,有睡眠不足者占86.8%,嗜食肥甘厚腻者占93.8%,嗜食生冷寒凉者占81.3%,心情不好者占88.6%,有压力者占97.8%,以上各项指标在有声敏感组及无声敏感组（即单纯耳鸣组）之间无统计学差异（P〉0.05）.②有声敏感组的抑郁、焦虑发生率以及SDS、SAS得分均值较无声敏感组高（P〈0.05）,说明有声敏感的患者焦虑、抑郁情况较单纯耳鸣患者更严重.③所有入组患者的脾胃功能评分均值显著高于健康人,明确患有脾胃系疾病者占38.97%,但在有声敏感与无声敏感两组之间无显著性差异（P〉0.05）.结论睡眠不足、饮食不节、心情不好及压力大可能是声敏感与耳鸣的共同病因,脾胃失调可能是声敏感与耳鸣共同的主要病机之一,提示治疗大方向宜以调理脾胃为中心,并注重心理疏导.

Objective To investigate the etiology and pathogenesis of acoutic hypersensitivity and tinnitus. Methods A total of 272 eligible cases were collected in this study as an object. The patient was instructed to complete the Self Rating Depression Scale SDS,the Self rating Anxiety Scale （SAS）, Spleen and Stomach Function Scores. Patients with tinnitus filled the Tinnitus Questionnaire （including TEQ） to assess severity, and patients with hyperacusis were assessed by VAS score. Results ①Of all the patients, 86.76 had insufficient sleep, 93. 75% were fat, 81. 25% were cold, 88. 60% had bad mood, 97. 79% had psychological pressure, and there was no statistical difference between the sound sensitive group and the silent sensitive group （P〉0. 05）. ② The incidence of depression and anxiety in the sound sensitive group were greater than that in the non sound sensitive group（P〈0. 05）. It indicates that patients with sound sensitive are more anxious and depressed than those with simple tinnitus. ③The mean value of spleen and stomach function score of all patients was far higher than that of healthy people,and 38.97% of the patients with spleen and stomach diseases were identified. There was no statistical difference between the sound sensitive group and the non sensitivity group （P〉0. 05）. Conclusion Insufficient sleep, bad mood （high social pressure） , improper diet, ete may be the common cause of Hyperacusis and tinnitus. Spleen and stomach dysfunction may be one of the main pathogenesis of them. It suggesting that the general treatment direction should be centered on the spleen and stomach and psychological counseling treatment is indeed recommmended for those who suffers hyperacusis or/and tinnitus.