MacKenzie K, Millar A, Wilson J A, Sellars C, Deary I J
Department of Otorhinolaryngology and Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER. kmk2x@clinm,ed.gla.ac.uk
BMJ. 2001 Sep 22;323(7314):658-61. doi: 10.1136/bmj.323.7314.658.
To assess the overall efficacy of voice therapy for dysphonia.
Single blind randomised controlled trial.
Outpatient clinic in a teaching hospital.
204 outpatients aged 17-87 with a primary symptom of persistent hoarseness for at least two months.
After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to this stage and at 12-14 weeks on the 133 (65%) patients who completed the study. The assessments at the three time points for the 70 patients who completed treatment and the 63 patients in the group given no treatment were compared.
Ratings of laryngeal features, Buffalo voice profile, amplitude and pitch perturbation, voice profile questionnaire, hospital anxiety and depression scale, clinical interview schedule, SF-36.
Voice therapy improved voice quality as assessed by rating by patients (P=0.001) and rating by observer (P<0.001). The treatment effects for these two outcomes were 4.1 (95% confidence interval 1.7 to 6.6) points and 0.82 (0.50 to 1.13) points. Amplitude perturbation showed improvement at six weeks (P=0.005) but not on completion of the study. Patients with dysphonia had appreciable psychological distress and lower quality of life than controls, but voice therapy had no significant impact on either of these variables.
Voice therapy is effective in improving voice quality as assessed by self rated and observer rated methods.
评估嗓音治疗对发声障碍的总体疗效。
单盲随机对照试验。
一家教学医院的门诊诊所。
204名年龄在17 - 87岁之间、主要症状为持续声音嘶哑至少两个月的门诊患者。
在进行基线评估后，患者被随机分为两组，一组接受为期六周的嗓音治疗，另一组不接受治疗。对继续进入该阶段的145名（71%）患者在六周时进行重复评估，对完成研究的133名（65%）患者在12 - 14周时进行重复评估。比较了完成治疗的70名患者和未接受治疗组的63名患者在三个时间点的评估结果。
喉部特征评分、布法罗嗓音剖面图、振幅和音高微扰、嗓音剖面图问卷、医院焦虑抑郁量表、临床访谈时间表、SF - 36。
通过患者自评（P = 0.001）和观察者评分（P < 0.001）评估，嗓音治疗改善了嗓音质量。这两个结果的治疗效果分别为4.1（95%置信区间1.7至6.6）分和0.82（0.50至1.13）分。振幅微扰在六周时有所改善（P = 0.005），但在研究结束时没有改善。发声障碍患者比对照组有明显的心理困扰和较低的生活质量，但嗓音治疗对这两个变量均无显著影响。
通过自评和观察者评分方法评估，嗓音治疗在改善嗓音质量方面是有效的。
