Yang Ting, Zhang Jin, Wang Bing, Zhang Wen, Xu Min, Yang Shuangyuan, Liu Hui
Xi'an Medical University, Xi'an, China.
Department of Otolaryngology, Shaanxi Provincial People's Hospital, Xi'an, China.
Ther Adv Chronic Dis. 2021 Sep 13;12:20406223211041069. doi: 10.1177/20406223211041069. eCollection 2021.
Tinnitus is one of the most common otological symptoms that patients experience, and it can be debilitating. No effective drug treatments are available for tinnitus, although considerable research investigating its mechanisms and possible treatments is underway. Electrical stimulation has been considered a promising and well-tolerated therapeutic strategy for tinnitus. This meta-analysis study was aimed to investigate the efficacy, safety and tolerability of electrical stimulation in patients with tinnitus.
Relevant studies were retrieved from the Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang and Weipu databases. The Tinnitus Handicap Inventory (THI) and the visual analogue scale (VAS) which focus on loudness and distress evaluation (0-10 points) were used to assess perceived tinnitus suppression after treatment. Subgroup analysis was also performed based on different stimulating areas and methods, follow-up times, tinnitus duration and electrical current intensity. Review Manager 5.4 software was used for data synthesis, and Stata 15.1 software was used for analyses of publication bias and sensitivity.
Our meta-analysis included 11 studies involving a total of 447 patients with tinnitus. The results showed that electrical stimulation significantly reduced THI scores [mean difference (MD) = -9.69; 95% confidence interval (CI) = -14.25, -5.13; < 0.0001; = 80%] and VAS scores between the two groups (VAS loudness scores, MD = -0.72; 95% CI = -1.20, -0.25; VAS distress scores, MD = -0.90; 95% CI = -1.17, -0.63). In addition, subgroup analysis showed that THI scores in electrical stimulation group of different stimulating areas and methods follow-up times, tinnitus duration and electrical current intensity were generally reduced, regardless of the acute or subacute tinnitus group or left temporoparietal area (LTA) group with no statistical significance between two groups.
Overall, electrical stimulation may be an effective and well-tolerated treatment option for tinnitus.
耳鸣是患者最常经历的耳科症状之一，可能使人衰弱。尽管针对耳鸣机制和可能治疗方法的研究正在大量开展，但目前尚无有效的药物治疗方法。电刺激已被认为是一种有前景且耐受性良好的耳鸣治疗策略。本荟萃分析旨在研究电刺激对耳鸣患者的疗效、安全性和耐受性。
从Embase、PubMed、科学网、考克兰图书馆、中国知网、中国生物医学文献数据库、万方和维普数据库中检索相关研究。使用耳鸣障碍量表（THI）以及专注于响度和痛苦评估（0至10分）的视觉模拟量表（VAS）来评估治疗后耳鸣减轻的情况。还根据不同的刺激区域和方法、随访时间、耳鸣持续时间和电流强度进行亚组分析。使用Review Manager 5.4软件进行数据合成，使用Stata 15.1软件分析发表偏倚和敏感性。
我们的荟萃分析纳入了11项研究，共涉及447例耳鸣患者。结果显示，电刺激显著降低了两组之间的THI评分[平均差（MD）=-9.69；95%置信区间（CI）=-14.25，-5.13；P<0.0001；I²=80%]和VAS评分（VAS响度评分，MD=-0.72；95%CI=-1.20，-0.25；VAS痛苦评分，MD=-0.90；95%CI=-1.17，-0.63）。此外，亚组分析表明，不同刺激区域和方法、随访时间、耳鸣持续时间和电流强度的电刺激组的THI评分总体上有所降低，无论急性或亚急性耳鸣组还是左颞顶区（LTA）组，两组之间均无统计学意义。
总体而言，电刺激可能是一种有效且耐受性良好的耳鸣治疗选择。
