Mazurek B, Seydel C, Haupt H, Szczepek A, Klapp B F, Schrom T
Klinik für Hals-Nasen-Ohren-Heilkunde, Tinnituszentrum, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, Berlin.
Gesundheitswesen. 2009 Jan;71(1):35-40. doi: 10.1055/s-0028-1082303. Epub 2009 Jan 27.
The therapy of the chronic tinnitus is aimed at improving the way patients cope with their tinnitus and at reducing the tinnitus-related distress. The present study investigated the changes of psychometric parameters that occurred in patients with chronic tinnitus after 7-days outpatient multidisciplinary therapy. The changes were monitored for up to 1 year in order to evaluate the long-term efficiency.
Main emphasis of the intensive tinnitus therapy applied was placed on tinnitus habituation and on teaching the patients how to apply coping strategies. The main elements of the multimodal concept included progressive muscle relaxation according to Jacobson, physiotherapy, educative seminars, training of selective attention and, lastly, the change of judgment, attitude and behaviour towards tinnitus. Psychometric parameters and tinnitus-related distress were assessed prior to and after the therapy (at 3, 6 and 12 months) using the tinnitus questionnaire (TQ) according to Goebel and Hiller. Furthermore, subjects waiting for therapy (waiting list) were recruited to the control group and compared with the therapy group which had received therapy 3 months earlier.
The therapy group showed a significant reduction of the TQ total score after 3 months as compared to the control group. Moreover, we observed a long-term, progressive positive outcome during the one-year follow-up. The TQ total score was reduced by 10.9 points. There was an obvious decrease of the emotional and cognitive distress as well as of the intrusiveness of tinnitus, as per evaluation of TQ subscales.
The outpatient intensive multidisciplinary tinnitus therapy with long-term aftercare has proved to be an effective method in the treatment of patients with chronic tinnitus. The outpatient setting enables the instant implementation of strategies learned during therapy in the patients' everyday life.
慢性耳鸣的治疗旨在改善患者应对耳鸣的方式，并减轻与耳鸣相关的痛苦。本研究调查了慢性耳鸣患者在接受7天门诊多学科治疗后心理测量参数的变化。对这些变化进行了长达1年的监测，以评估长期疗效。
所应用的强化耳鸣治疗主要侧重于耳鸣习服以及教导患者如何应用应对策略。多模式概念的主要要素包括根据雅各布森法进行渐进性肌肉松弛、物理治疗、教育研讨会、选择性注意力训练，最后是对耳鸣的判断、态度和行为的改变。在治疗前以及治疗后（3、6和12个月），使用根据戈贝尔和希勒编制的耳鸣问卷（TQ）评估心理测量参数和与耳鸣相关的痛苦。此外，招募等待治疗的受试者（等待名单）作为对照组，并与3个月前接受治疗的治疗组进行比较。
与对照组相比，治疗组在3个月后TQ总分显著降低。此外，在1年的随访期间，我们观察到了长期的、渐进性的积极结果。TQ总分降低了10.9分。根据TQ子量表的评估，情绪和认知痛苦以及耳鸣的侵扰性明显降低。
长期随访的门诊强化多学科耳鸣治疗已被证明是治疗慢性耳鸣患者的有效方法。门诊治疗环境使患者能够在日常生活中即时实施在治疗期间学到的策略。
