慢性主观性耳鸣应用音乐联合心理治疗的疗效评估

Evaluation of the efficacy of music therapy combined with psychotherapy for chronic subjective tinnitus

目的 探讨音乐联合心理治疗慢性主观性耳鸣患者的临床效果。方法 102例慢性主观性耳鸣患者,随机分为A组和B组,每组51例。A组采用音乐治疗, B组采用音乐+心理治疗。比较两组治疗效果,治疗前后耳鸣响度值及耳鸣残疾量表(THI)、视觉模拟评分法(VAS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、睡眠障碍量表(SDRS)评分。结果 治疗3个月后,两组耳鸣响度值及THI、VAS评分均低于治疗前,且B组耳鸣响度(36.69±10.47)dB HL、THI评分(37.14±11.55)分、VAS评分(3.67±1.49)分均低于A组的(41.75±13.73)dB HL、(43.80±13.94)分、(4.29±1.55)分,差异有统计学意义(P<0.05)。治疗3个月后,两组SAS、SDS、SDRS评分均低于治疗前,且B组SAS评分(32.55±7.44)分、SDRS评分(9.24±2.77)分均低于A组的(36.16±8.38)、(10.53±3.11)分,差异有统计学意义(P<0.05);两组治疗3个月后SDS评分组间比较无差异(P>0.05)。B组总有效率80.4%高于A组的66.7%,但无显著性差异(P>0.05)。结论 音乐联合心理治疗慢性主观性耳鸣患者疗效突出,可有效改善患者耳鸣及焦虑、抑郁、失眠状态,值得临床上推广。

Objective To investigate the clinical effect of music therapy combined with psychotherapy on patients with chronic subjective tinnitus.Methods A total of 102 patients with chronic subjective tinnitus were randomly divided into group A and group B,with 51 cases in each group.Group A was treated with music therapy,and group B was treated with music therapy and psychotherapy.The therapeutic effect,value of tinnitus loudness,tinnitus handicap inventory(THI),visual analogue scale(VAS),self-rating depression scale(SDS),self-rating anxiety scale(SAS)and sleep dysfunction rating scale(SDRS)before and after treatment were compared between the two groups.Results After 3 months of treatment,the value of tinnitus loudness,THI and VAS scores in both groups were lower than those before treatment;group B had value of tinnitus loudness of(36.69±10.47)dB HL and THI score of(37.14±11.55)points and VAS score of(3.67±1.49)points,which were lower than(41.75±13.73)dB HL,(43.80±13.94)points and(4.29±1.55)points in group A;the difference was statistically significant(P<0.05).After 3 months of treatment,the scores of SAS,SDS and SDRS in both groups were lower than those before treatment;group B had SAS score of(32.55±7.44)points and SDRS score of(9.24±2.77)points,which were lower than(36.16±8.38)and(10.53±3.11)points in group A;the difference was statistically significant(P<0.05).After 3 months of treatment,there was no difference in SDS scores between the two groups(P>0.05).The total effective rate of group B was 80.4%,which was higher than 66.7%of group A,but there was no significant difference(P>0.05).Conclusion The effect of music therapy combined with psychotherapy on chronic subjective tinnitus patients is outstanding,which can effectively improve the tinnitus and anxiety,depression,insomnia of patients,and is worthy of clinical promotion.