【摘要】 目的针对不同匹配频率的耳鸣患者,采用声治疗并联合基于网络的行为认知治疗,通过量表评分来探讨它们的疗效。方法选取就诊于我院耳鼻咽喉科门诊,主要诊断为主观性耳鸣且病程超过半年的患者。完善常规耳科检查及听力学检查。经过耳鸣频率匹配后根据患者耳鸣频率不同将其分为三组:①低频组(耳鸣频率≤500Hz);②中频组(501Hz-2000Hz);③高频组(耳鸣频率>2000Hz)。再随机分为复合声治疗组,定制音乐治疗组,进行为期3个月的声治疗并联合基于互联网的行为认知治疗(Internet-based cognitive behavioural therapy, i CBT)。在治疗前,治疗后1个月、3个月分别对其进行THI、SAS两个量表评估。结果低频组在复合声联合i CBT治疗3个月时THI与中、高频组比较显著下降,SAS评分与高频组比较显著下降(P均<0.05),与定制音乐联合i CBT治疗组比较其THI评分也显著下降(P<0.05)。低、中频组在定制音乐联合i CBT治疗3个月时SAS评分与高频组比较显著下降(P均<0.05)。中频和高频组,其SAS评分在定制音乐联合i CBT治疗1个月时与复合声联合i CBT治疗比较明显下降(P<0.05),特别是中频组在3个月时SAS评分也有明显下降(P<0.05)。结论低频耳鸣患者使用复合声联合i CBT效果较好,而中频耳鸣患者则是定制音乐联合i CBT效果较好,高频耳鸣患者效果不及低中频耳鸣,定制音乐联合i CBT对高频耳鸣患者短期内缓解焦虑效果较好。更多还原

【Abstract】 Objective To investigate the efficacy of acoustic therapy combined with internet-based behavioral cognitive therapy for tinnitus patients with different matching frequencies. Methods Patients who were diagnosed as subjective tinnitus with course of half a year were selected. After routine otology, audiology examination and the tinnitus frequency match, the patients were divided into three groups including low-frequency group(≤ 500 Hz), intermediate-frequency group(501 hz-2000 hz) and high-frequency group(>2000 Hz) according to their tinnitus frequency. They were randomly divided into a compound acoustic therapy group and a customized music therapy group. They received a three-month acoustic therapy combined with Internet-based cognitive behavioural therapy(i CBT).The effects were evaluated with THI and SAS scales before treatment, one month and three months after treatment. Results The THI score of the low-frequency group was significantly lower than that of the medium and high-frequency groups when the composite sound combined with i CBT was treated for 3 months, the SAS score was significantly lower than that of the high-frequency group(P<0.05),and the THI score of low frequency group was also significantly lower than that of customized music combined with ICBT treatment group(P<0.05). The SAS scores of the low-frequency and intermediate-frequency groups were significantly lower than that of the high-frequency group when customized music therapy combined with i CBT were treated for 3 months(P<0.05). In the intermediate-frequency and high-frequency groups, the SAS scores of the customized music therapy combined with i CBT for 1 months were significantly lower than that of the compound acoustic therapy combined with i CBT(P<0.05). In particular, the SAS scores of the intermediate-frequency group also decreased significantly at 3 months(P<0.05). Conclusion Low-frequency tinnitus patients using compound acoustic therapy combined with i CBT have better results, while those with intermediate-frequency tinnitus have better effects with customized music therapy combined with i CBT. The effect of high-frequency tinnitus patients is not as good as that of low-and intermediate-frequency tinnitus patients. Customized music combined with i CBT can relieve anxiety in high-frequency tinnitus patients in the short term.更多还原