声治疗联合心理咨询对耳鸣伴高频听力下降的疗效观察

Effect of acoustic therapy combined with counseling on tinnitus with high frequency hearing loss

目的 探讨声治疗联合心理咨询在治疗耳鸣伴高频听力下降的疗效.方法 选取2021年11月至2022年5月就诊于惠州市中心人民医院耳鼻咽喉科门诊的60例听力正常的耳鸣患者和60例高频听力下降的耳鸣患者为研究对象,每组患者再次分为对照组(声治疗组,30例),实验组(声治疗+心理咨询组,30例),分别采用不同的治疗方案;于治疗1个月和3个月后,用视觉模拟量表(visual analogue scale,VAS)、耳鸣致残量表(tinnitus handicap inventory,THI)、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)和匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评估听力正常耳鸣患者和高频听力下降耳鸣患者的疗效.结果 听力正常耳鸣患者治疗3个月后,实验组和对照组均较治疗前VAS、THI、HADS和PSQI评分降低(P均<0.05);且治疗3个月后,实验组较对照组,VAS、THI、HADS和PSQI评分降低(P均<0.05).高频听力下降耳鸣患者治疗1个月后,实验组和对照组均与治疗前VAS、THI、HADS和PSQI评分相比,未见明显差异(P均>0.05),治疗3个月后,仅实验组较治疗前VAS、THI、HADS和PSQI评分降低(P均<0.01);且治疗3个月后,实验组较对照组,VAS、THI、HADS和PSQI评分降低(P均<0.05).结论 与单纯声治疗相比,声治疗联合心理咨询较能有效地减轻高频听力下降耳鸣患者的耳鸣症状,改善其精神心理状况.

Objective To explore the effect of acoustic therapy combined with counseling on tinnitus with high frequency hearing loss.Methods A total of 120 patients treated at Huizhou Central People's Hospital from November 2021 to May 2022 were enrolled in this study,including 60 tinnitus patients with normal hearing and 60 tinnitus patients with high frequency hearing loss.The patients in each group were divided into control group treated with acoustic therapy and experimental group treated with acoustic therapy combined with counseling again,30 cases in each group.Visual analogue scale(VAS),tinnitus handicap inventory(THI),hospital anxiety and depression scale(HADS)and pittsburgh sleep quality index(PSQI)were used to evaluate the efficacy of the treatment for all tinnitus patients after 1 month and 3 months.Results For tinnitus patients with normal hearing,after 3 months of treatment,the scores of VAS,THI,HADS and PSQI in the experimental group and the control group were lower than those before treatment(P<0.05),and the scores of the experimental group were lower than those in the control group(P<0.05).For tinnitus patients with high frequency hearing loss,after 1 month of treatment,there was no significant difference in VAS,THI,HADS and PSQI scores in the experimental group and the control group(P>0.05).After 3 months of treatment,only the VAS,THI,HADS and PSQI scores of the experimental group were lower than those before treatment(P<0.01).After 3 months of treatment,the scores of above scales in the experimental group were lower than those in the control group(P<0.05).Conclusions Acoustic therapy combined with counseling can more effectively relieve the tinnitus symptoms and improve the psychological status of patients with high frequency hearing loss compared with acoustic therapy alone.