多位点经颅随机噪声刺激治疗慢性耳鸣40例的疗效及安全性研究

Efficacy and safety of multiple⁃site transcranial random noise stimulation for chronic tinnitus:a study of 40 cases

目的探讨多位点经颅随机噪声刺激(transcranial Random Noise Stimulation,tRNS)对慢性耳鸣的疗效及安全性。方法将海口市第三人民医院自2017年1月至2019年1月就诊的80例慢性耳鸣病人按随机数字表法分为两组(每组各40例):单位点刺激组和多位点刺激组。先进行耳鸣心理声学检测和耳鸣活动问卷填写,记录相关数据;随后分别进行单位点tRNS和多位点tRNS,治疗4周后,对两组再进行耳鸣心理声学检测并填写耳鸣活动问卷,记录相关数据并进行分析。每次治疗后,从5个方面询问病人的不良反应情况并记录分析。结果两组病人的耳鸣心理声学检测值及耳鸣活动问卷得分在tRNS治疗后均显著降低(P<0.05);耳鸣心理声学检测值多位点组[(LM:11.52±2.24)dB HL,PM:(167.59±10.92)Hz]分同单位点组[LM:(23.12±1.06)dB HL,PM:(253.17±14.38)Hz]分比较明显下降、耳鸣活动问卷得分多位点组(16.45±2.49)分同单位点组(24.13±2.77)分比较明显下降(P<0.05),多位点组的治疗效果更优。两组的不良反应率均较低,均为7.5%(3/40),且两组间差异无统计学意义(P>0.05)。结论多位点tRNS对慢性耳鸣具有治疗作用,效果明显;并且其不良反应发生率低,安全性较强。

Objective To investigate the efficacy and safety of multi⁃site transcranial random noise stimulation(tRNS)for chronic tinnitus.Methods Eighty cases of chronic tinnitus patients treated in The Third People’s Hospital of Haikou from January 2017 to January 2019 were randomly assigned into two groups by random number table(40 cases in each group):single⁃point stimula⁃tion group and multi⁃site stimulation group.Both groups had the tinnitus psychoacoustic assessment and tinnitus activity question⁃naire,and the relevant data were recorded;then the single⁃point tRNS and multi⁃site tRNS were performed respectively.After 4 weeks of treatment,the two groups underwent tinnitus psychoacoustic assessment and filled in the tinnitus activity questionnaire,and the relevant data were recorded and analyzed.After each treatment,the patients’adverse reactions were asked from 5 aspects and recorded and analyzed.Results The tinnitus psychoacoustic measurement values and the scores of tinnitus activity question⁃naire in the two groups of patients were all significantly reduced after tRNS treatment(P<0.05).The tinnitus psychoacoustic mea⁃surement value and the score of the tinnitus activity questionnaire in multi⁃site stimulation group were significantly lower than those in single⁃point stimulation group[LM:(11.52±2.24)dB HL vs.(23.12±1.06)dB HL,PM:(167.59±10.92)Hz vs.(253.17±14.38)Hz;(16.45±2.49)vs.(24.13±2.77),respectively;P<0.05],and the treatment effect of the multi⁃site stimulation group was better.The adverse reaction rates of the two groups were low,both were 7.5%(3/40)and the difference between the two groups was not statistically significant(P<0.05).Conclusion Multiple⁃site transcranial random noise stimulation has a therapeutic effect on chronic tinnitus,and the efficacy is obvious.What’s more,the incidence of adverse reactions is lower and the treatment safety is stronger.