基于神经生理模式的多元复合声治疗主观性耳鸣的疗效分析

目的 评价多元复合声治疗(T-MIST)主观性耳鸣患者的疗效,并分析其影响因素。方法 回顾性分析接受T-MIST的870例主观性耳鸣患者的临床资料,并对治疗>6个月的27例患者进行随访。在治疗前、治疗后1、3、6个月时,采用耳鸣残障量表(THI)评估耳鸣严重程度,并记录得分。结果 初次治疗的有效率为66.2%。不同频率段耳鸣患者初次治疗的有效率差异有统计学意义(P<0.05):4~6kHz频段的有效率最高(81.8%),1~2 kHz频段的有效率最低(51.9%)。性别、年龄、病程、听力损失程度对初次治疗的有效率无明显影响(P>0.05),残余抑制试验(RIT)结果部分阳性患者有效率最高(76.9%)。结果与初次治疗的有效率存在相关性(P<0.05)。随着治疗时间的延长,T-MIST的有效率逐渐提高。治疗前后各时间点THI评分比较差异均有统计学意义(P<0.05)。结论 T-MIST主观性耳鸣患者具有较好的疗效,高频耳鸣患者更易获益,RIT可作为预测其疗效的参考指标。

Objective To evaluate the multivariate composite acoustic treatment in patients with subjective tinnitus in the short term and long term curative effect,and to analyze its influencing factors.Methods 870 patients with subjective tinnitus received multivariate composite acoustic treatment between April 2018 and May 2020 were retrospectively analyzed.Results Initial treatment effective rate was 66.2%.There was an initial treatment difference(P<0.05)for the effectiveness of different frequency of tinnitus patients.The efficient of 4 to 6 kHz frequency was highest(81.8%),and the 1~2 kHz frequency efficient was the lowest(51.9%).Gender,age,course of the disease,degree of hearing loss for initial treatment had no significant effect of efficient(P>0.05).The residual inhibition test results showed that some positive patients had the highest effective rate(76.9%),and the results were correlated with the effective rate of the initial treatment(P<0.05).With the extension of treatment time,the multivariate composite acoustic treatment efficiently improve gradually.THI at each time point before and after the treatment scale comparative differences are statistically.Conclusion Multivariate composite acoustic treatment in patients with subjective tinnitus has good short-term and long-term curative effect.High frequency tinnitus patients are more likely to benefit,and residual inhibition test can be used as a prediction index of its curative effect.