艾灸配合电针治疗感音神经性耳鸣疗效观察

目的观察赵氏雷火灸（简称雷火灸）配合电针治疗感音神经性耳鸣的临床疗效。方法将90例患者随机分为两组,治疗组45例采用雷火灸配合电针治疗,对照组45例单纯用电针治疗。结果治疗组总有效率为93.3%,对照组为84.4%,两组总有效率比较差异有统计学意义（P〈0.05）。结论赵氏雷火灸配合电针治疗感音神经性耳鸣有较好疗效。     

金纳多联合针灸治疗感音性耳鸣的疗效观察

目的：观察金纳多联合针灸治疗感音性耳鸣的临床疗效。方法将81例患者随机单盲法分成两组,观察组（A组）41人,采用金纳多联合针灸耳穴治疗;对照组（B组）40人,血栓通联合针灸耳穴治疗,均以2周为1疗程,效差时连续下1疗程,共3个疗程,每疗程间隔3~4d。结果 A组：痊愈22例,显效7例,有效6例,显效率70.7%,总有效率87.5%;B组：治愈16例,显效6例,有效5例,显效率55.0%,总有效率为67.5%. A组总有效率明显高于B组（P〈0.01）。结论 A组治疗感音性耳鸣疗效优于B组,金纳多联合针灸治疗感音性耳鸣能有效提高有效率,值得推广应用。     

耳鸣对老年患者心理及生活质量影响的调查研究

目的分析60岁以上老年耳鸣患者的心理状态及耳鸣症状对其生活质量的影响因素。方法回顾性分析我院自2010年6月至2012年6月间治疗的178例60岁以上的老年耳鸣患者的临床诊治资料,应用SCL-90症状自评量表对患者疾病状况进行评测,并与国内常模比较,分析耳鸣患者的心理状态及耳鸣症状对其生活质量的影响因素。结果 （1）调查结果显示118例患者不同程度表现出猜疑、厌烦、忧虑、坐立、抑郁和高度紧张等不良情绪,影响患者治疗效果,占研究对象的66.3%,SCL-90量表结果表明老年耳鸣患者抑郁、躯体化、恐惧、焦虑等各项指标得分和总均分均显著高于国内常模,差异有统计学意义（P〈0.05）;（2）生活质量满意度评定量表LSR结果显示统计量表LSR总得分和两个因子的得分情况,并与国内常模比较。老年耳鸣患者LSR综合得分明显低于国内常模,差异有统计学意义（P〈0.05）。结论耳鸣会影响老年患者的身心健康,其生活满意度低于正常人群,严重干扰患者的心理健康和生活质量,需提高对患者的心理和社会支持,提高其生活质量。     

全参数生物反馈指标在主观性耳鸣患者中的应用

目的研究全参数生物反馈在治疗主观性耳鸣患者中的效果。方法对20例主观性耳鸣患者行全参数生物反馈治疗10次,观察治疗前后耳鸣残疾评估量表（Tinnitus Handicap Inventory,THI）得分及全参数生物反馈指标的变化。结果耳鸣患者治疗前后THI总分分别为44．9±22．3和28．0±14．8,差异达到极显著性水平（P〈0．01）;冶疗前后生物反馈指标肌电分别为6．7±1．6和5．1±1．2,差异达到显著性水平（P〈0．05）、治疗前后仪波分别为13．3±6．4和16．4±6．2,差异极显著（P〈0．01）、治疗前后SMR波分别为5．4±1．6和6．2±2．2,差异显著（P〈0．05）。结论主观性耳鸣患者进行生物反馈治疗有效,可明显降低THI总分,改善耳鸣症状,随着耳鸣患者症状减轻,其对应生物反馈指标也发生相应改变。     

DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值

目的 观察分析听力正常的耳鸣患者畸变产物耳声发射(DPOAE)与高刺激率听性脑干反应(ABR)检测的特征,探讨其在耳鸣评估中的应用价值。 方法 选取耳鼻咽喉科门诊听力正常的青年耳鸣患者31例(46耳)为耳鸣组,另外选取听力结果正常的青年无耳鸣者25例(50耳)为正常对照组,分别进行纯音听阈测定、声导抗测听、DPOAE和高低刺激率ABR的检测,对比两组受试者DPOAE各频检出率和信噪比以及高低刺激率ABR各波潜伏期(PL)、波间期(IPL)、波幅以及两种刺激速率下的潜伏期和波间期差值(△PL和△IPL)。 结果 DPOAE各频检出率两组无显著性差异;信噪比在8 kHz,耳鸣组较对照组降低,差异有统计学意义(P<0.05);高低刺激率ABR结果中,不同刺激速率下两组Ⅰ、Ⅲ、Ⅴ波波幅差异均无统计学意义;高刺激速率下,耳鸣组Ⅰ~Ⅴ IPL较对照组延长,差异有统计学意义(P<0.05),两种刺激速率下,耳鸣组Ⅰ△PL较对照组缩短,差异有统计学意义(P<0.05),耳鸣组Ⅴ△PL、Ⅰ~Ⅴ△IPL较对照组延长,差异有统计学意义(P<0.05)。 结论 DPOAE与高刺激率ABR可作为诊断耳鸣的一种客观检查方法,其对耳鸣的早期评估有重要的应用价值;增加ABR刺激速率,可提高耳鸣检测的敏感性。     

家庭化个体多元复合声治疗对耳鸣伴听力损失患者的疗效及影响因素分析

目的 探究家庭化个体多元复合声治疗对耳鸣伴听力损失患者的有效性,并分析耳鸣伴听力损失患者疗效的影响因素。 方法 利用四川省4家三甲医院的既往电子病历记录,回顾性分析2019年3月至2022年3月期间接受家庭化个体多元复合声治疗的212例耳鸣患者临床资料,收集耳鸣患者的人口学特征、听力损失相关和治疗前后的耳鸣障碍量表评分等资料。采用多因素二元逻辑回归分析疗效相关影响因素。 结果 家庭化个体多元复合声治疗对耳鸣伴听力损失患者的总有效率为43.87%,治疗周期长于12个月的耳鸣患者的有效改善率(57.43%)显著高于治疗周期短于12个月的耳鸣患者(31.53%),单因素逻辑回归分析比值比(OR)值为2.93(95%CI: 1.67~5.14)。多因素逻辑回归分析提示治疗周期为影响家庭化个体多元复合声治疗效果的独立风险因素,OR值为2.23(95%CI: 1.09~5.00),患者年龄与声治疗疗效的OR值为1.03(95%CI: 1.01~1.05)。 结论 研究表明家庭化个体多元复合声治疗可有效改善部分耳鸣患者的临床症状及恼人程度。其中,治疗周期是影响家庭化个体多元复合声治疗疗效的独立危险因素。临床医生应针对不同听力损失和耳鸣特征的耳鸣患者采用家庭化个体多元复合声治疗方案。     

Tinnitus characteristics and associated variables on Tinnitus Handicap Inventory among a Hungarian population

BackgroundTinnitus is a sound precepted without an external sound stimulus. Its background can be categorised into primary and secondary cases. The secondary cases include pathologies of the external, middle and inner ear. Tinnitus can be objective or subjective; the latter can only identified by the sufferer. Previous research results have shown that tinnitus significantly affects the quality of life and daily functioning.ObjectivesTo analyse the impact of tinnitus on the daily functioning and the possible influence of demographical data and tinnitus duration on it.Methods630 patients (265 males and 365 females, 25–85 years of age) suffering from primary tinnitus were enrolled. In the Hungarian language, these patients completed the Tinnitus Handicap Inventory (THI) questionnaire and underwent a complete otorhinolaryngological examination. IBM SPSS V24 software was used for data processing; correlation tests, the Mann-Whitney U and Kruskal-Wallis non-parametric tests were used.ResultsAccording to the THI questionnaires outcomes, most patients (62.5%) were presented with a mild handicap. Based on statistical analysis, no significant correlation was observed between the total THI points and the age of the patients, along with the duration and localisation of the symptoms. However, the total THI scores of male and female patients significantly differed, indicating higher THI values in the female group (p = 0.000521).ConclusionsThe tinnitus severity was not affected by the duration, localisation of the symptoms and age but by gender, indicating higher values in the case of females.     

国医大师干祖望治疗耳鸣的学术经验及用药规律

目的:基于数据挖掘技术探究国医大师干祖望治疗耳鸣的学术特色及用药规律。方法:整理筛选干祖望治疗耳鸣的临床病案,根据《中华人民共和国药典》进行药物名称规范化处理,运用Microsoft Excel 2010构建干祖望治疗耳鸣临床医案数据库,并使用中医传承辅助系统(V3.0)软件数据挖掘,总结其对辨治耳鸣的治则治法、用药规律。结果:干祖望治疗耳鸣的处方共324首,药物186味; 高频药物为茯苓、石菖蒲、当归、山药、甘草、熟地黄; 常用药物中药性多寒、温,药味多偏甘、苦、辛,归经多属脾、肝、肺经; 聚类分析得到三组药物组合。结论:通过数据挖掘客观展示干祖望治疗耳鸣的用药特色,对干祖望治疗耳鸣学术思想的继承以及耳鸣临床用药指导具有重要意义。     

Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients

Objective: Test of dose–response relationship for Ginkgo biloba extract EGb 761 (oral) in outpatients with acute idiopathic sudden sensorineural hearing loss (ISSHL) of at least 15 dB at one frequency within the speech range occurring less than 10 days before study inclusion. Design: Multicentre, randomized, double-blind phase III study comparing dosages of 120 mg twice daily and 12 mg twice daily over 8 weeks. Main endpoint: Recovery (in dB) of the auditory threshold from the initial measurement to the value on the last day of treatment, averaged over those frequencies from 0.25, 0.5, 1, 2, and 3 kHz for which the initial hearing loss amounted to 15 dB or more compared to the level on the opposite side. Patients: 106 patients with an average age of 44 ± 16 years and with hearing loss at affected frequencies 26 dB ± 9 dB included between December 1995 and July 1997. Results: Large majorities of both treatment groups recovered completely. In exploratory analyses of the 96 patients included according to the protocol, patients given the higher dose had less risk of not recovering well (≤10 dB residual hearing loss) (one-sided Fisher test: P = 0.0061), especially if they had no tinnitus (n = 44, P = 0.00702). Conclusion: A higher dosage of EGb 761 (oral) appears to speed up and secure the recovery of ISSHL patients, with a good chance that they will recover completely, even with little treatment. This was already observed after one week of treatment. We find it justified to treat patients who have unilateral ISSHL of less than 75 dB and neither tinnitus nor vertigo with 120 mg oral EGb 761 twice daily. Received: 20 November 2000 / Accepted: 10 April 2001