地西泮联合心理干预治疗焦虑所致突发性耳聋的效果分析

Effect of diazepam combined with psychological intervention on sudden deafness caused by anxiety

目的评价地西泮联合心理干预治疗焦虑所致突发性耳聋的临床效果.方法选取2017年10月至2018年9月在山东省胶州市人民医院耳鼻喉科治疗的136例突发性耳聋患者.根据随机数字表法将患者分为联合组与对照组,每组68例.对照组根据中华医学会耳鼻喉头颈外科分会在2015年制定的突发性聋诊断和治疗标准进行治疗.联合组在对照组治疗的基础上应用地西泮片,2.5 mg/次,2次/d,并对患者辅以心理疗法.评价地西泮联合心理干预治疗焦虑所致突发性耳聋的临床疗效.结果与对照组比较,联合组总有效率(86.7%)高于对照组(53.0%,χ^2=18.471,P<0.01);联合组,低中频听力患者与全聋和平坦患者有效率较对照组提高(38.2%比22.1%,χ^2=4.225,P=0.040).治疗前后联合组与对照组低中频听力、高频听力及全聋和平坦患者的听力提高绝对值比较,差异有统计学意义(F=215.363,P<0.01).治疗前后联合组与对照组总听力提高绝对值比较,差异有统计学意义(t=4.653,P=0.007).联合组与对照组SAS评分与HAMA评分均较治疗前降低(P均<0.05),联合组治疗前后SAS评分与HAMA评分变化差值均提高(P均<0.05).结论地西泮联合心理干预治疗突发性耳聋,可以改善患者临床预后,延缓疾病进展,值得临床推广应用.

Objective To evaluate the clinical efficacy of diazepam combined with psychological intervention in the treatment of sudden deafness caused by anxiety.Methods A total of 136 patients with sudden deafness who were treated in Jiaozhou People's Hospital from October 2017 to September 2018 were enrolled.According to the random number table method,patients were divided into the combined psychological intervention group and the control group,with 68 cases in each group.The control group was treated according to the criteria for the diagnosis and treatment of sudden deafness developed by the Chinese Medical Association's Otolaryngology Head and Neck Surgery Branch in 2015.The combined group was treated with diazepam tablets,2.5 mg each time,twice a day,and the patients were supplemented with psychotherapy.The clinical efficacy of diazepam combined with psychological intervention in the treatment of sudden deafness caused by anxiety was evaluated.Results Compared with the control group,the total effective rate of the combined group was significantly improved(86.7%vs.53.0%,χ^2=18.471,P<0.01).In the combined group,the low-intermediate frequency hearing patients(38.2%vs.22.1%,χ^2=4.225,P=0.040)and the total sputum and flat patients(38.2%vs.22.1%,χ^2=4.225,P=0.040)were significantly more effective compared with the control group.Before and after treatment,the absolute values of hearing improvement in low-and medium-frequency hearing,high-frequency hearing,and total sacral and flat patients in the combined group and the control group were statistically significant(F=215.363,P<0.01).The absolute values of total hearing improvement in the combined group and the control group before and after treatment were statistically significant(t=4.653,P=0.007).The HAMA score and SAS score of the combined group and the control group were significantly lower than those before the treatment(P all<0.05).Compared with the control group,the difference of HAMA score and SAS scores before and after treatment was significantly increased(P<0.05).Conclusions Diazepam combined with psychological intervention for sudden deafness can significantly improve the clinical prognosis of patients and delay the progression of the disease,which is worthy of clinical application.