Kusatz Martin, Ostermann Thomas, Aldridge David
Tinnitus Therapy Center, Krefeld and Dusseldorf, University of Witten Herdecke, Germany.
Int Tinnitus J. 2005;11(2):163-9.
Tinnitus is a noise, a ringing, or a roaring sound in the affected ear and is becoming an increasingly serious problem for health care systems. Integrative treatment concepts are currently regarded as promising therapeutic approaches for managing tinnitus. The aim of this study was to present the results of auditive stimulation therapy, a program of music therapy developed specifically for tinnitus treatment. We collected data on outpatient treatment results from 155 tinnitus patients and evaluated them in a prospective observational study with three defined times of measurement (start, end, and 6 months after the end of treatment). Apart from anamnestic data and subjective evaluation of treatment, the major outcome parameter was the score of the tinnitus questionnaire. To evaluate effectiveness of the therapy, we calculated effect sizes (according to Cohen). Fifty-one percent of the patients were male, and the mean patient age was 49 years. Of the 155 patients, 137 (88%) were capable of gainful employment, which means that they fell in the age range between 18 and 65 years. The duration of tinnitus was more than 6 months for 80% of patients, and 43% had been suffering from tinnitus for more than 3 years. In general, all subscales of the tinnitus questionnaire showed highly significant changes (t-test, p < .01) between the measurement points "start of therapy" and "end of therapy," whereas no significant difference was found between the measurement points "end of therapy" and "follow-up". At follow-up, the values of the subscales were stabilized at a level recorded at the end of the therapy; we did not observe a reduction to the level prior to treatment. The values for the effect sizes mostly ranged between medium (> 0.5) and high (> 0.8). Closer investigations indicated that a combination of music therapy and psychological training rendered the best effect sizes. This study demonstrated that music therapy is an effective integrated treatment approach and offers a way to make progress in tinnitus treatment.
耳鸣是患耳中出现的一种噪音、铃声或轰鸣声,对医疗保健系统来说正成为一个日益严重的问题。综合治疗理念目前被视为管理耳鸣的有前景的治疗方法。本研究的目的是呈现听觉刺激疗法的结果,这是一种专门为耳鸣治疗开发的音乐治疗方案。我们收集了155名耳鸣患者门诊治疗结果的数据,并在一项前瞻性观察研究中对其进行评估,该研究有三个确定的测量时间点(治疗开始、结束以及治疗结束后6个月)。除了既往病史数据和治疗的主观评估外,主要结局参数是耳鸣问卷的得分。为了评估治疗效果,我们计算了效应量(根据科恩方法)。51%的患者为男性,患者平均年龄为49岁。在这155名患者中,137名(88%)有工作能力,这意味着他们年龄在18至65岁之间。80%的患者耳鸣持续时间超过6个月,43%的患者耳鸣已持续3年以上。总体而言,耳鸣问卷的所有子量表在“治疗开始”和“治疗结束”测量点之间显示出高度显著的变化(t检验,p < 0.01),而在“治疗结束”和“随访”测量点之间未发现显著差异。在随访时,子量表的值稳定在治疗结束时记录的水平;我们没有观察到其降至治疗前的水平。效应量的值大多在中等(> 0.5)和高(> 0.8)之间。进一步调查表明,音乐治疗与心理训练相结合产生了最佳的效应量。本研究表明,音乐治疗是一种有效的综合治疗方法,为耳鸣治疗取得进展提供了一条途径。