Lei G X, Deng Z, Tan D H, Zhang D, Zhao Z Q
Xiangnan University，Chenzhou，Hunan，423000，China.
Affiliated Hospital of Xiangnan University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Sep;33(9):858-861. doi: 10.13201/j.issn.1001-1781.2019.09.015.
The purpose of this study was to explore the efficacy of tetanus stimulation in tinnitus treatment and the correlation between the mainstream questionnaires of tinnitus and tinnitus-matching in order to find a more convenient and accurate method for tinnitus evaluation. Ten patients with chronic tinnitus and normal or mild hearing impairment were enrolled in this study, totaling 13 ears. Their age ranged from 23 to 53 years old. The stimulus sound（white noise, frequency modulation 14.1 Hz, repetitive amplitude modulation, duty cycle 0.5） was selected and the sound intensity was 50 dB SL. Experimental procedure: （4 minutes sound stimulation+4 minutes rest） ×4 times, totaling 32 minutes. The patients were treated three times a week for 5 weeks. The loudness of tinnitus was matched before and after each treatment, and tinnitus handicap inventory（THI）, tinnitus handicap questionnaire（THQ） and visual analog scales（VAS） were also used for assessment before the first treatment each week. The loudness matching and the above scales were performed once more at follow-up for one week after end-of-treatment. ①Single treatment: the matched loudness value decreased by 1.000（0.000, 3.000） dB（=7.553, <0.01） after each single treatment. ②After five weeks' treatment: the matched loudness value decreased（9.692±8.038） dB（=4.348, <0.01）; VAS value decreased by 2.000（1.000, 3.000）（=2.890, <0.01）; total score of THQ decreased（7.389%±8.847%）（=2.641, <0.05）. ③Correlation analysis: there was positive correlation between total scores of THI and THQ（=0.747, <0.01）; the matched loudness values have positive correlation with VAS value（=0.593, <0.01）, THI-F（=0.346, <0.01） and THQ-factor 3 score（=0.294, <0.05）; there was positive correlation between the VAS value and THI-F（=0.326, <0.05）, the total score of THI（=0.466, <0.01）, THQ-factor 3 score（=0.291, <0.05）, the total score of THQ（=0.497, <0.01）. The loudness of tinnitus declined with significant fluctuation during tetanus sound therapy. THQ scale is recommended as a sensitive indicator for evaluating the efficacy of tinnitus treatment; VAS is recommended for rapid assessment of tinnitus. Tetanus stimulation is expected to become an important direction in tinnitus sound therapy.
本研究旨在探讨破伤风刺激在耳鸣治疗中的疗效以及耳鸣主流问卷与耳鸣匹配之间的相关性，以便找到一种更便捷、准确的耳鸣评估方法。本研究纳入了10例慢性耳鸣且听力正常或轻度受损的患者，共13耳。他们的年龄在23至53岁之间。选择刺激声（白噪声，频率调制14.1Hz，重复幅度调制，占空比0.5），声强为50dB SL。实验程序：（4分钟声音刺激 + 4分钟休息）×4次，共32分钟。患者每周治疗3次，共5周。每次治疗前后进行耳鸣响度匹配，每周第一次治疗前还使用耳鸣障碍量表（THI）、耳鸣障碍问卷（THQ）和视觉模拟量表（VAS）进行评估。治疗结束后随访1周时再次进行响度匹配和上述量表评估。①单次治疗：每次单次治疗后，匹配响度值降低1.000（0.000，3.000）dB（=7.553，<0.01）。②治疗5周后：匹配响度值降低（9.692±8.038）dB（=4.348，<0.01）；VAS值降低2.000（1.000，3.000）（=2.890，<0.01）；THQ总分降低（7.389%±8.847%）（=2.641，<0.05）。③相关性分析：THI总分与THQ总分之间存在正相关（=0.747，<0.01）；匹配响度值与VAS值（=0.593，<0.01）、THI-F（=0.346，<0.01）和THQ因子3得分（=0.294，<0.05）存在正相关；VAS值与THI-F（=0.326，<0.05）、THI总分（=0.466，<0.01）、THQ因子3得分（=0.291，<0.05）、THQ总分（=0.497，<0.01）存在正相关。在破伤风声治疗期间，耳鸣响度显著波动下降。建议将THQ量表作为评估耳鸣治疗疗效的敏感指标；建议使用VAS进行耳鸣的快速评估。破伤风刺激有望成为耳鸣声治疗的一个重要方向。
