声刺激联合认知行为治疗慢性耳鸣的初步探讨

目的 探讨声刺激联合认知行为治疗(CBT)对慢性耳鸣的临床疗效。方法 本研究将49例慢性耳鸣患者按照随机数字表法分为干预组(25例)和对照组(24例)，所有患者均行声音刺激1个月。干预组患者同时接受持续1个月的个体化的CBT，对照组患者不接受个体化CBT。所有患者在治疗前和治疗后30 d均需填写问卷，包括耳鸣残疾评估量表(THI)、焦虑自评量表(SAS)及匹兹堡睡眠质量指数(PSQI)。结果 两组患者均完成临床试验。治疗1个月后观察，对照组患者THI、SAS、PSQI的平均值分别下降15.58、15.46、4.96，干预组患者THI、SAS、PSQI的平均值分别下降40.52、41.76、7.72， 差异具有统计学意义(P＜0.05)；且干预组患者THI、SAS、PSQI的得分均明显低于对照组。结论 声音刺激和CBT可以预测治疗效果，声音刺激联合CBT的治疗效果优于单独的声音刺激。性别、年龄和听力障碍是耳鸣最相关的危险因素。

Preliminary study of sound stimulation combined with cognitive behavior therapy on chronic tinnitus

Objective To investigate the therapeutic effectiveness of sound stimulation combined with cognitive behavior therapy (CBT) on chronic tinnitus.Methods A total of 49 patients with chronic tinnitus were randomly divided into intervention group (n=25) and control group (n=24),. All the patients underwent sound stimulation for one month, and those in the intervention group also received personalized CBT for one month, while the patients from control group did not receive such treatment. Additionally, all patients were required to fill out the questionnaires including tinnitus handicap inventory (THI), self-rating anxiety scale (SAS),and Pittsburgh sleep quality index (PSQI) before treatment and 30 days of treatment.Results All the 49 cases completed the trial. The follow-up after one month of treatment revealed that the mean values of THI, SAS and PSQI were decreased by 15.58, 15.46 and 4.96 in the control group, and 40.52, 41.76 and 7.72 in the intervention group, respectively. The differences of decreases in THI, PSQI and SAS between the two groups were statistically significant (P < 0.05). After intervention, the THI, PSQI and SAS scores of the intervention group were significantly lower than those of the control group.Conclusion Both sound stimulation and CBT can predict the therapeutic effect, and the therapeutic effect of sound stimulation combined with CBT is superior to sound stimulation alone. Gender, age and the hearing impairment are the most relevant risk factors for tinnitus.