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上呼吸道感染后嗅觉丧失患者的嗅觉训练。

Olfactory training for patients with olfactory loss after upper respiratory tract infections.

机构信息

Department of Otorhinolaryngology, University Hospital Jena, Lessingstrasse 2, 07740, Jena, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2014 Jun;271(6):1557-62. doi: 10.1007/s00405-013-2747-y. Epub 2013 Oct 6.

Abstract

Olfactory training consisting of daily suprathreshold odor exposure over 12 weeks seems to improve olfactory function. It is unknown if a longer period of training might be more effective. A prospective non-randomized clinical study was performed including 39 patients with olfactory loss after an upper respiratory tract infection (URTI) of less than 24 months duration. Patients exposed themselves with suprathreshold concentrations of four odors (rose, eucalyptus, lemon, cloves) applied in ''Sniffin' Sticks'' felt-tip pens over 32 weeks. Olfactory function was performed before (T1), after 16 weeks (T2), and 32 weeks of training (T3) using the 'the Sniffin' Sticks test kit calculating the TDI score (Threshold, Discrimination, Identification). The mean TDI score showed a non-significant trend of improvement at T2, and was significantly increased at T3 (p = 0.021). Overall, 31 patients (79%) showed an increased TDI score at T3. The increase of TDI from T1 to T3 was 4.6 ± 5.1. Age, gender, duration and initial severity of olfactory loss had no influence on the improvement (all p > 0.05). Only patients with a D score lower than the median value of 8 showed a significantly higher increase of the D score at T3 (p = 0.004). The present study confirmed that olfactory training improves olfactory function in patients with olfactory loss after URTI. A longer duration of training over 32 weeks seems to increase the effectiveness in comparison to a 12-week period. This was tested in a completed German multicenter trial to be published soon containing a control group to include the effect of a spontaneous recovery after URTI.

摘要

嗅觉训练包括每天暴露于阈上浓度的气味超过 12 周,似乎可以改善嗅觉功能。目前尚不清楚更长时间的训练是否会更有效。进行了一项前瞻性非随机临床研究,纳入了 39 例上呼吸道感染(URTI)后嗅觉丧失时间小于 24 个月的患者。患者使用“Sniffin' Sticks” 一次性嗅棒以阈上浓度暴露于四种气味(玫瑰、桉树、柠檬、丁香),持续 32 周。在训练前(T1)、16 周后(T2)和 32 周后(T3)使用“Sniffin' Sticks”嗅觉测试套件计算 TDI 评分(阈值、辨别、识别)进行嗅觉功能检查。TDI 评分的平均值在 T2 时呈非显著趋势改善,在 T3 时显著增加(p = 0.021)。总体而言,31 例患者(79%)在 T3 时 TDI 评分增加。从 T1 到 T3,TDI 增加了 4.6 ± 5.1。年龄、性别、URTI 持续时间和嗅觉丧失的初始严重程度对改善均无影响(均 p > 0.05)。只有 D 评分低于 8 的中位数的患者在 T3 时 D 评分的增加具有显著统计学意义(p = 0.004)。本研究证实,URTI 后嗅觉丧失患者的嗅觉训练可改善嗅觉功能。与 12 周相比,32 周以上的训练时间似乎会增加疗效。这在一项即将发表的包含 URTI 后自发恢复效应的对照组的德国多中心试验中进行了测试。

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