耳鸣患者发病前的睡眠情况及脾胃功能研究

Study on Sleep Quality and Function of Spleen and Stomach in Tinnitus Patients before Onset

【目的】研究睡眠不足(包括睡眠障碍及熬夜)及脾胃虚弱与耳鸣发病的关系,为从中医整体观角度探讨耳鸣的病因和发病机制提供临床依据。【方法】收集443例耳鸣患者的临床资料,记录患者发病前1个月的常规入睡时间,采用匹兹堡睡眠质量指数(PSQI)对耳鸣患者发病前的睡眠质量进行评价,采用耳鸣评价量表(TEQ)评估耳鸣严重程度,同时应用脾胃功能量表评估患者的脾胃功能。将PSQI评分与TEQ评分进行Pearson相关分析,并对比研究有无听力障碍的耳鸣患者发病前的睡眠障碍及熬夜情况有无差异。【结果】(1)443例耳鸣患者发病前的PSQI评分平均为(9.09±3.66)分,与国内常模比较,差异均有统计学意义(P<0.01),表明耳鸣患者普遍存在睡眠障碍。(2)发病前存在睡眠障碍和/或熬夜的患者耳鸣严重程度均显著高于睡眠正常者,睡眠障碍的患者耳鸣严重程度又显著高于熬夜者,差异均有统计学意义(P<0.05)。(3)443例耳鸣患者发病前的脾胃功能评分为(39.80±9.92)分,与国内常模比较,差异均有统计学意义(P<0.01),表明耳鸣患者普遍存在脾胃虚弱表现。(4)Pearson相关性分析结果显示,耳鸣患者发病前的睡眠质量PSQI评分与耳鸣严重程度TEQ评分呈正相关,相关系数为0.879(95%置信区间为0.827~0.931,P<0.01)。(5)听力下降和听力正常两组睡眠障碍和熬夜的比例以及PSQI得分比较,差异均无统计学意义(P>0.05)。【结论】无论是否存在听力下降,睡眠障碍和/或熬夜均可能是耳鸣发病的主要原因之一,其机理可能与睡眠不足导致脾胃虚弱有关。

Objective The relationship of insufficient sleep(including sleep disturbance and staying up late)and spleen and stomach deficiency with the onset of tinnitus was studied,so as to provide clinical evidence for investigating the etiology and pathogenesis of tinnitus from the holistic viewpoint of traditional Chinese medicine(TCM).Methods The clinical data of 443 tinnitus patients were collected.The regular time for falling asleep one month before the onset of tinnitus was recorded,and the Pittsburgh sleep quality index(PSQI)was used to evaluate the sleep quality of the patients before the onset of tinnitus.The tinnitus evaluation questionnaire(TEQ)was used to assess the severity of tinnitus,and the spleen and stomach function scale was applied to assess the function of spleen and stomach of the patients.Pearson correlation analysis was performed between the PSQI scores and the TEQ scores,and the differences in sleep disturbance and staying up late before the onset of tinnitus in the patients with or without hearing impairment were compared and studied.Results(1)The average PSQI scores of 443tinnitus patients before onset were(9.09±3.66),which differed from those of the national norm(P<0.01),indicating that sleep disturbance was common in tinnitus patients.(2)The severity of tinnitus in patients with sleep disturbance and/or staying up late before onset was significantly higher than that in the normal sleep patients,and the severity of tinnitus in patients with sleep disturbance was significantly higher than that in the patients with staying up late,the difference being statistically significant(P<0.05).(3)The spleen and stomach function scores of 443 tinnitus patients before onset were(39.80±9.92),which differed from those of the national norm(P<0.01),indicating that tinnitus patients generally had the manifestations of spleen and stomach deficiency.(4)Pearson correlation analysis showed that PSQI scores of sleep quality before onset was positively correlated with TEQ scores of tinnitus severity,with a correlation coefficient of 0.879(95%confidence interval being 0.827-0.931,P<0.01).(5)There was no significant difference in the proportion of sleep disturbance and staying up late and PSQI scores between the patients with hearing loss and the patients with normal hearing(P>0.05).Conclusion Whether the hearing loss exists or not,sleep disturbance and/or staying up late contributes to one of the main causes of tinnitus onset,and the mechanism may be related to the spleen and stomach deficiency induced by sleep insufficiency.