声音疗法联合药物治疗慢性主观性耳鸣的临床随机对照研究

A randomized controlled clinical trial of sound therapy combined with medication in the treatment of chro⁃nic subjective tinnitus

目的探讨声音联合药物治疗与药物治疗对慢性主观性耳鸣患者的短期疗效及其差异。方法纳入慢性耳鸣(>6个月)患者共64例,采用随机对照方法,分为声音联合药物组(联合组)和药物组各32例。在耳鸣咨询基础上,药物组予口服银杏叶提取物片,联合组在药物治疗基础上行个性化多元复合声治疗,比较两组治疗1个月前后耳鸣残疾量表(tinnitus handicap inventory,THI)、耳鸣严重程度视觉模拟量表(visual analogue scale,VAS)及焦虑自评量表(self-rating anxiety scale,SAS)评分变化,对比两组耳鸣治疗有效率,分析影响耳鸣治疗疗效的可能因素。结果药物组及联合组治疗后的THI、VAS及SAS评分均较前下降(P=0.001);联合组较药物组治疗前后THI(P=0.003)、VAS(P=0.002)评分差值变化更大;短期治疗前后两组SAS评分差值无明显统计学差异;联合组治疗总有效率较药物组高(P=0.002);性别(P=0.366)、年龄(P=0.062)、耳鸣频率(P=0.142)、耳鸣侧别(P=0.891)、耳鸣音与听力下降频段是否匹配(P=0.302)等因素均与耳鸣疗效无明显相关性。结论在耳鸣咨询基础上,声音疗法联合药物及单独药物治疗耳鸣皆有一定疗效,联合组较药物组能更有效缓解耳鸣对患者生活影响的主观严重程度,并具有更高治疗总有效率。性别、年龄、耳鸣频率、耳鸣侧别、耳鸣音与听力下降频段是否匹配等因素对耳鸣疗效无明显影响。

Objective To investigate the short-term efficacy and difference between sound therapy combined with medication and medication alone in patients with chronic subjective tinnitus.Methods A total of 64 patients with chronic tinnitus(>6 months)were included in the study.Using a randomized controlled method,patients were divided into two groups(n=32 each):combined sound and drug(combined treatment);and drug alone.Based on tinnitus counseling,the drug group was administered oral ginkgo biloba extract tablet,while the combined group was administered personalized multiple compound sound therapy based on drug therapy.The Tinnitus Handicap Inventory(THI),visual analog scale(VAS),and Self-rating Anxiety Scale(SAS)scores were compared between the two groups before and after 1 month of treatment.The effectiveness rate of tinnitus treatment was compared between the two groups and possible factors affecting treatment efficacy were analyzed.Results THI,VAS,and SAS scores in the drug and combined groups were decreased after treatment(P<0.05).Differences in THI and VAS scores in the combination treatment group were greater than those in the drug group before and after treatment(P<0.05).There was no statistical difference in SAS score between the two groups before and after shortterm treatment.The total treatment effectiveness rate in the combined treatment group was higher than that of the drug group(P<0.05).Sex,age,tinnitus frequency,tinnitus side,tinnitus tone,and hearing loss frequency band were not significantly correlated with tinnitus treatment efficacy(P>0.05).Conclusion Based on tinnitus consultation,both sound therapy combined with medication and drug alone have certain efficacy in the treatment of tinnitus.Compared with drug alone,however,combined treatment more effectively alleviated subjective severity of the impact of tinnitus on patient life,and yielded a higher total effectiveness rate.Sex,age,tinnitus frequency,tinnitus side,tinnitus tone,and hearing loss frequency band matching and other factors did not exert significant influence on the efficacy of tinnitus treatment.