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[耳鸣治疗中的经颅磁刺激(TRT)与心理治疗]

[TRT and psychotherapy in the treatment of tinnitus].

作者信息

Schaaf H, Gieler U

机构信息

Tinnitus-Klinik Dr Hesse im Krankenhaus Arolsen, Große Allee 50, 34454 Bad Arolsen.

出版信息

HNO. 2010 Oct;58(10):999-1003. doi: 10.1007/s00106-010-2180-0.

Abstract

Basic requirements and results of tinnitus retraining therapy (TRT) as well as other habituation therapies with psychotherapeutic approaches in the treatment of tinnitus are examined closely in this literature review. In German-speaking countries experts generally aim for involvement of psychotherapists beyond the classic TRT developed by Jastreboff and Hazell. On the basis of a validated diagnostic test such as the Tinnitus Questionnaire according to Hiller and Goebel (1998), such a therapy regime is more effective than the "classic" procedure. Under different treatment approaches, cognitive behavioural therapy elements have been proven to be effective-even as a component of the TRT-as well as integrated variants in psychodynamic therapies. We have to give consideration to the fact that in all studies about the selection and inclusion criteria selective test conditions were established which suggest that in each case diverse patient groups were studied. In the overall picture it becomes apparent that depending on the severity of the tinnitus and accompanying hearing problems a dysfunction-oriented and staged approach makes sense.

摘要

本文献综述深入研究了耳鸣再训练疗法(TRT)的基本要求和结果,以及其他采用心理治疗方法的习惯化疗法在耳鸣治疗中的应用。在德语国家,专家们普遍希望心理治疗师参与到由贾斯特雷博夫和黑兹尔开发的经典TRT之外的治疗中。基于经过验证的诊断测试,如希勒和戈贝尔(1998年)的耳鸣问卷,这样的治疗方案比“经典”程序更有效。在不同的治疗方法中,认知行为疗法元素已被证明是有效的——即使作为TRT的一个组成部分——以及心理动力疗法中的综合变体。我们必须考虑到这样一个事实,即在所有关于选择和纳入标准的研究中,都建立了选择性测试条件,这表明在每种情况下都研究了不同的患者群体。从总体情况来看,很明显,根据耳鸣的严重程度和伴随的听力问题,采用以功能障碍为导向的分阶段方法是有意义的。

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