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定制音乐疗法联合随访系统治疗慢性耳鸣患者的疗效及影响因素分析。

Efficacy and factors influencing outcomes of customized music therapy combined with a follow-up system in chronic tinnitus patients.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China.

出版信息

J Otolaryngol Head Neck Surg. 2023 Apr 24;52(1):29. doi: 10.1186/s40463-023-00631-y.

Abstract

BACKGROUNDS

Tinnitus is a meaningless sound signal perceived by the patients in the absence of auditory stimuli. Due to the complex etiology and unclear mechanism, specific therapies for tinnitus are still in the exploratory stage. In recent years, personalized and customized music therapy has been proposed as an effective method for tinnitus treatment. The aim of this study was to explore the efficacy of customized therapy with a well-designed follow-up system in the treatment of tinnitus through a large sample one arm study and to identify the relevant factors affecting the treatment outcome.

METHODS

The study investigated a total of 615 patients with unilateral or bilateral chronic tinnitus who received personalized and customized music therapy for 3 months. A complete follow-up system was designed by the professionals. Questionnaires of Tinnitus Handicap Inventory (THI), Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) were used to evaluate the therapeutic effects and relevant factors affecting the efficacy of therapy.

RESULTS

The results showed a decreasing trend in THI and VAS scores after 3 months of therapy, with statistically significant differences between pre- and post-therapy time points (P < 0.001). All patients were divided into 5 groups according to THI scores, and the mean reduction score in catastrophic, severe, moderate, mild and slight group was 28, 19, 11, 5, 0 respectively. The proportion of tinnitus patients with anxiety was higher than that with depression (70.57% and 40.65%, respectively), and there were statistically significant differences between HADS-A/D scores pre- and post-therapy. Binary logistic regression showed that the baseline of THI, VAS scores, the duration of tinnitus and the state of anxiety prior to therapy were significant influencing factors of therapeutic efficacy.

CONCLUSIONS

The magnitude of reduction in THI scores after music therapy depended on the severity of the patients' tinnitus, the higher the initial THI scores, the greater the potential for improvement in tinnitus disorders. Music therapy also reduced the anxiety and depression levels of tinnitus patients. Therefore, personalized and customized music therapy with a comprehensive follow-up system may be an effective treatment option for chronic tinnitus patients.

摘要

背景

耳鸣是指患者在没有听觉刺激的情况下感知到无意义的声音信号。由于病因复杂,发病机制尚不清楚,目前针对耳鸣的特异性治疗仍处于探索阶段。近年来,个性化定制音乐疗法已被提出作为治疗耳鸣的有效方法。本研究旨在通过大样本单臂研究探讨设计完善的随访系统下个性化定制音乐疗法治疗耳鸣的疗效,并确定影响治疗效果的相关因素。

方法

本研究共纳入 615 例单侧或双侧慢性耳鸣患者,接受个性化定制音乐治疗 3 个月。专业人员设计了完整的随访系统。采用耳鸣残疾量表(THI)、医院焦虑抑郁量表(HADS)和视觉模拟评分(VAS)问卷评估治疗效果和影响疗效的相关因素。

结果

治疗 3 个月后 THI 和 VAS 评分呈下降趋势,治疗前后时间点比较差异有统计学意义(P < 0.001)。所有患者根据 THI 评分分为 5 组,灾难性、严重、中度、轻度和轻微组的平均降低分数分别为 28、19、11、5、0。耳鸣患者焦虑比例高于抑郁(分别为 70.57%和 40.65%),HADS-A/D 评分治疗前后比较差异有统计学意义。二分类 Logistic 回归分析显示,THI、VAS 基线评分、耳鸣持续时间和治疗前焦虑状态是疗效的显著影响因素。

结论

音乐疗法治疗后 THI 评分降低幅度与患者耳鸣严重程度有关,初始 THI 评分越高,耳鸣障碍改善的潜力越大。音乐疗法还降低了耳鸣患者的焦虑和抑郁水平。因此,个性化定制音乐疗法结合全面的随访系统可能是慢性耳鸣患者的一种有效治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dfe/10124025/91a8a17a0567/40463_2023_631_Fig1_HTML.jpg

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