习服疗法与掩蔽疗法对慢性耳鸣疗效的Meta分析

目的系统评价并比较习服疗法和掩蔽疗法对慢性耳鸣的疗效。方法从万方数据库、中国期刊全文数据库(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of science和Cochrane library等中英文数据库中检索自建库到2020年2月与慢性耳鸣治疗相关的文献,全面收集采用习服疗法和掩蔽疗法治疗慢性主观性耳鸣的随机对照实验(RCT),严格按照纳入及排除标准对文献进行筛选,提取文章相关数据并对文章进行质量评价,采用Revman5.3软件对纳入文献的耳鸣残疾量表(THI)评分、耳鸣烦躁度变化、耳鸣各项指标(耳鸣时间及环境、睡眠质量、情绪影响、生活质量、耳鸣自我评分)、总有效率进行Meta分析。结果最终纳入文献19篇,共计19个RCT实验2103例患者,其中习服疗法组1164例,掩蔽疗法组939例。Meta分析结果显示,习服疗法治疗后患者的THI评分明显低于治疗前,且较掩蔽疗法效果更明显(P<0.05);习服疗法组耳鸣烦躁度减轻率明显高于掩蔽疗法组(P<0.05);治疗后两组耳鸣各指标评分均明显低于治疗前,且习服疗法较掩蔽疗法效果更明显(P<0.05);治疗6、12个月组习服疗法总有效率分别为79.34%、83.60%;掩蔽疗法总有效率为48.76%(6个月组)、52.05%(12个月组),习服疗法组总有效率高于掩蔽疗法组,差异均有统计学意义(P<0.05)。结论与掩蔽疗法相比,习服疗法可以明显提高慢性耳鸣的治疗效果并获得较高的患者满意度。

Meta-analysis of the Efficacy of Tinnitus Retraining Therapy and Tinnitus Masking in the Treatment of Chronic Subjective Tinnitus

Objective To systematically evaluate the clinical efficacy of tinnitus masking(TM)and tinnitus retraining therapy(TRT)in the treatment of chronic subjective tinnitus.Methods We searched from Wanfang data,CNKI,VIP,CBM,PubMed,Web of science and Cochrane library to find articles related to the treatment of chronic subjective tinnitus.The retrieval was started from database set-up to February 2020.We selected randomized controlled trial(RCT)about TRT and TM for patients with chronic subjective tinnitus.The articles were screened according to the inclusion and exclusion criteria.We used Cochrane evaluation form to evaluate the quality of the articles and extracted the data.Meta—analysis was performed by Revman5.3 software.Results A total of 19 randomized controlled trials(RCT)with 2103 patients were included,including 1164 patients in the TRT group and 939 patients in the TM group.THI value was lower in TRT group than TM group,the difference was statistically significant(P<0.05).Anxious degree of tinnitus was much more released in TRT group than TM group(P<0.05).Tinnitus related indexes value were lower in TRT group than TM group,the difference was statistically significant(P<0.05).The total effective rate in the TRT group were 79.34%(6 months),83.60%(12 months).While in the TM group were 48.76%(6 months),52.05%(12 months),respectively(P<0.05).Conclusion Compared with TM,TRT can significantly improve the clinical efficacy of treating chronic subjective tinnitus,and can reduce adverse reactions brought by tinnitus.