Yan X G, Gao X, Sun Z F, Guo Y C, Yao L Y, Liu J, Xiao W, Lyu Q W, Wei Y X
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Department of Otorhinolaryngology Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Nov 7;53(11):815-819. doi: 10.3760/cma.j.issn.1673-0860.2018.11.004.
To explore the clinical effects and the influence factors of olfactory training in the treatment of olfactory dysfunction. A total of 86 patients with olfactory dysfunction (49 post-infectious and 37 post-traumatic) in Beijing Anzhen Hospital during Dec 2016 to May 2017 were recruited in this prospective study. The clinical data of patients were analyzed, including gender, age, body mass index (BMI), course of disease, smoking history, drinking history, diabetes history, hypertension history, hyperlipidemia history, and anxiety visual analogue score (VAS). All patients were treated with olfactory training for 16 weeks, and all of them underwent Sniffin' Sticks olfactory test before and after treatment, which was evaluated by composite threshold-discrimination-identification score (TDI). SPSS 23.0 software, paired test and univariate and multivariate regression analysis were used to analyze the data. Eighty patients received treatment, including 46 post-infectious olfactory dysfunction and 34 post-traumatic olfactory dysfunction. After olfactory training, the total scores of TDI increased with statistically significant (18.3±8.6 13.6±7.4, =-6.158, <0.05). The overall efficacy was 40% (32/80). The effective rate were 45.7% (21/46) in post-infectious olfactory dysfunction and 32.4% (11/34) in post-traumatic olfactory dysfunction respectively, with no statistically significant difference (χ(2)=1.441, =0.230). regression analysis showed that the course of disease was an influence factor in the clinical curative effect (=0.881, 95%: 0.799-0.973, =0.012). In patients with less than a year of olfactory dysfunction, the olfactory function improved obviously with the efficiency of 50.9% (29/57). Sixteen weeks of olfactory training provides a significant therapeutic effect on the post-infectious and post-traumatic olfactory dysfunction, and the olfactory training can achieve better therapeutic effects at the early stage.
探讨嗅觉训练治疗嗅觉功能障碍的临床效果及影响因素。本前瞻性研究纳入了2016年12月至2017年5月在北京安贞医院就诊的86例嗅觉功能障碍患者（49例感染后嗅觉功能障碍和37例创伤后嗅觉功能障碍）。分析患者的临床资料，包括性别、年龄、体重指数（BMI）、病程、吸烟史、饮酒史、糖尿病史、高血压史、高脂血症史以及焦虑视觉模拟评分（VAS）。所有患者均接受16周的嗅觉训练，治疗前后均进行嗅棒嗅觉测试，通过综合阈值-辨别-识别评分（TDI）进行评估。采用SPSS 23.0软件，配对检验以及单因素和多因素回归分析对数据进行分析。80例患者接受了治疗，其中46例感染后嗅觉功能障碍，34例创伤后嗅觉功能障碍。嗅觉训练后，TDI总分升高，差异有统计学意义（18.3±8.6比13.6±7.4，t=-6.158，P<0.05）。总有效率为40%（32/80）。感染后嗅觉功能障碍的有效率为45.7%（21/46），创伤后嗅觉功能障碍的有效率为32.4%（11/34），差异无统计学意义（χ²=1.441，P=0.230）。回归分析显示病程是临床疗效的影响因素（β=0.881，95%CI：0.799-0.973，P=0.012）。嗅觉功能障碍病程小于1年的患者，嗅觉功能改善明显，有效率为50.9%（29/57）。16周的嗅觉训练对感染后和创伤后嗅觉功能障碍有显著治疗效果，且嗅觉训练在早期可取得更好的治疗效果。
