Bauer Carol A, Brozoski Thomas J
Division of Otolaryngology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9662, USA.
Laryngoscope. 2006 May;116(5):675-81. doi: 10.1097/01.MLG.0000216812.65206.CD.
OBJECTIVES/HYPOTHESIS: This study evaluated the effectiveness of gabapentin in treating chronic tinnitus in two populations: participants with tinnitus with associated acoustic trauma and participants with tinnitus without associated acoustic trauma. The hypothesis was that gabapentin would decrease both subjective and objective features of tinnitus in the trauma group but would be less effective in the nontrauma group.
Prospective, placebo-controlled, single-blind clinical trial.
Pure-tone audiograms and personal histories were used to categorize tinnitus etiology as either secondary to acoustic trauma or not associated with acoustic trauma. Participants were restricted to those with moderate to severe tinnitus for at least 1 year. All participants received gabapentin in a graduated ascending-descending dose series extending over 20 weeks (peak dose of 2,400 mg/d).
There was a significant improvement in tinnitus annoyance for the trauma group (P = .05). Other subjective aspects of tinnitus were not significantly affected in either group. Between-subject variability of therapeutic response was considerable. Nevertheless, in consideration of subjective loudness ratings, 4 of 19 nontrauma participants and 6 of 20 trauma participants showed an improvement of 20% or better. In consideration of psychoacoustic loudness estimates, 3 of 19 nontrauma and 6 of 20 trauma participants showed an improvement of 20 dB HL or greater. Evenly dividing each group into high and low responders revealed significant improvement in loudness at 1,800 and 2,400 mg/day for the trauma high-response subgroup (P = .007). No significant improvement was obtained for other subgroups.
Gabapentin is effective in reducing subjective and objective aspects of tinnitus in some individuals, with the best therapeutic response obtained in individuals with associated acoustic trauma.
目的/假设：本研究评估了加巴喷丁在治疗两类人群慢性耳鸣中的有效性：伴有听觉创伤的耳鸣参与者和不伴有听觉创伤的耳鸣参与者。假设是加巴喷丁会降低创伤组耳鸣的主观和客观特征，但在非创伤组中效果较差。
前瞻性、安慰剂对照、单盲临床试验。
使用纯音听力图和个人病史将耳鸣病因分类为继发于听觉创伤或与听觉创伤无关。参与者仅限于患有中度至重度耳鸣至少1年的人。所有参与者接受加巴喷丁，剂量在20周内逐渐递增和递减（峰值剂量为2400毫克/天）。
创伤组耳鸣烦恼度有显著改善（P = 0.05）。两组中耳鸣的其他主观方面均未受到显著影响。治疗反应的个体间变异性相当大。然而，考虑主观响度评分，19名非创伤参与者中有4名和20名创伤参与者中有6名显示改善了20%或更好。考虑心理声学响度估计，19名非创伤参与者中有3名和20名创伤参与者中有6名显示改善了20分贝听力水平或更高。将每组均匀分为高反应者和低反应者，创伤高反应亚组在每天1800毫克和2400毫克时响度有显著改善（P = 0.007）。其他亚组未获得显著改善。
加巴喷丁对某些个体的耳鸣主观和客观方面有效，在伴有听觉创伤的个体中获得最佳治疗反应。
