Li Y, Feng G D, Wu H Y, Gao Z Q
Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 May 7;54(5):355-361. doi: 10.3760/cma.j.issn.1673-0860.2019.05.008.
The effectiveness of two different sound therapies in chronic subjective tinnitus was compared. The effectiveness of different degrees of hearing loss patients on two different sound therapies were analyzed preliminarily and the possible mechanisms were discussed. This clinical trial was conducted in the Peking Union Medical College Hospital, China from January 2018 to April 2018. Patients were received sound therapy when they were diagnosed as subjective tinnitus. This was a double-blinded randomized controlled trial. In our clinical trial, we included 56 participants who were randomly divided into Groups A and B with different sound therapies by using a computer allocation sequence. Pure tone audiometry, tympanometry and tinnitus matching were performed. The patients were followed up for 2 weeks, 1 month, 2 months and 3 months. Tinnitus handicap inventory (THI) and visual analog scales (VAS) measuring were used to evaluate the handicap, loudness and anxiety of tinnitus. An analysis of variance (ANOVA) of 2×5 repeated-measures was conducted. With the prolongation of the treatment time, both groups showed significantly lower scores after 3 months training compared with baseline which were measured by THI scores. While there was no effect between the two groups. According to the degree of hearing loss, Group A and B were divided into normal to mild hearing loss group (26-40 dB HL, Group A1, Group B1), moderate to profound hearing loss group (41 dB HL group and above, Group A2, Group B2). In the patients with normal hearing and mild hearing loss, the THI (0.013), VAS loudness and annoyance scores (0.01) after 3 months in Group B1 was significantly lower than those at baseline and the sound therapy in Group B1 was effective. In patients with moderate to profound hearing loss, the THI, VAS loudness and annoyance scores (0.01) after 3 months in Group A2 was significantly lower than those at baseline and the sound therapy in Group A2 was effective. Sound therapy may be effective for some patients. Sound therapy for patients with different degrees of hearing loss are different. The tinnitus of most patients could not disappear completely, but reduce or eliminate. Doctors should use appropriate and individualized acoustic parameters for different characteristics of tinnitus. Doing so would provide effective and specific sound therapy for patients and reduce or eliminate tinnitus.
比较了两种不同声音疗法对慢性主观性耳鸣的疗效。初步分析了不同程度听力损失患者对两种不同声音疗法的疗效，并探讨了可能的机制。本临床试验于2018年1月至2018年4月在中国北京协和医院进行。患者被诊断为主观性耳鸣时接受声音疗法。这是一项双盲随机对照试验。在我们的临床试验中，纳入了56名参与者，通过计算机分配序列将他们随机分为A组和B组，采用不同的声音疗法。进行了纯音听力测试、鼓室图测试和耳鸣匹配。对患者进行了2周、1个月、2个月和3个月的随访。使用耳鸣障碍量表（THI）和视觉模拟量表（VAS）测量来评估耳鸣的障碍、响度和焦虑。进行了2×5重复测量的方差分析（ANOVA）。随着治疗时间延长，两组在3个月训练后的THI评分与基线相比均显著降低。但两组之间没有差异。根据听力损失程度，A组和B组分为听力正常至轻度听力损失组（26 - 40 dB HL，A1组和B1组）、中度至重度听力损失组（41 dB HL及以上，A2组和B2组）。在听力正常和轻度听力损失的患者中，B1组3个月后的THI（0.013）、VAS响度和烦恼评分（0.01）显著低于基线水平，B1组的声音疗法有效。在中度至重度听力损失的患者中，A2组3个月后的THI、VAS响度和烦恼评分（0.01）显著低于基线水平，A2组的声音疗法有效。声音疗法可能对部分患者有效。不同程度听力损失患者的声音疗法有所不同。大多数患者的耳鸣无法完全消失，但可减轻或消除。医生应针对不同耳鸣特征使用合适的个体化声学参数。这样可为患者提供有效且针对性的声音疗法，并减轻或消除耳鸣。
