低频重复经颅磁刺激联合高压氧治疗老年患者神经性耳鸣的疗效

The effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with hyperbaric oxygen therapy on the elderly patients with neurogenic tinnitus

目的观察低频重复经颅磁刺激(rTMS)联合高压氧治疗对老年神经性耳鸣患者相关症状的治疗效果。方法选取老年神经性耳鸣患者58例,随机分为两组,均进行常规药物治疗,治疗组29例,给予低频rTMS联合高压氧治疗,对照组29例,给予高压氧治疗,低频rTMS患者行耳鸣同侧颞顶叶皮质1HzrTMS磁刺激,每天40次×40次,共20d。两组患者均于治疗前、治疗20d后,采用耳鸣致残(THI)量表、阿森斯失眠(AIS)量表及目测类比法(VAS)进行评估。对治疗前后两组患者的THI评分、AIS评分和VAS评分进行比较。结果治疗前,两组THI评分、AIS评分和VAS评分比较差异无统计学意义(P>0.05)。治疗20d后,治疗组的THI、AIS评分和VAS评分显著低于治疗前和对照组(P<0.05)。治疗20d后,治疗组中有19例患者THI评分降幅≥20分,有效达65.5%;对照组有12例患者THI评分降幅≥20分,有效率为41.4%,组间比较,差异有统计学意义(P<0.05)。结论rTMS联合高压氧治疗可以显著改善老年神经性耳鸣患者临床症状。

Objective To observe the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with hyperbaric oxygen therapy on the elderly patients with neurogenic tinnitus. Methods 58 elderly patients with neurogenic tinnitus were randomly divided into treatment and control groups.The treatment group was given rTMS combined with hyperbaric oxygen therapy,and the control group was given hyperbaric oxygen therapy.Before and after treatment for 20 d,tinnitus handicap inventory(THI),Hamilton anxiety(HAMA) scale and visual analogue scale(VAS) of two groups were assessed and compared. Results Before treatment,the scores of THI,AIS and VAS had no significant differences between the two groups( P >0.05).After treatment,the scores of THI,AIS and VAS were significantly different between the two groups( P <0.05).After treatment,the THI score of 19 patients in treatment group was decreased by 20 points,with an effective rate of 65.5%;the THI score of 12 patients in control group was decreased by 20 points,and the effective rate was 41.4%;the difference between the two groups was statistically significant ( P <0.05). Conclusions The rTMS with hyperbaric oxygen therapy could significantly improve the clinical symptoms in elderly patients with neurogenic tinnitus.