耳鸣治疗:一项实验研究

Sujoy Kumar Makar
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摘要

本研究的目的是根据四个实验组在接受不同治疗方案后在社会心理变量、生活质量和耳鸣严重程度方面的得分,比较实验组所选耳鸣治疗方案的有效性。研究人员随机抽取了 200 名年龄介于 20 至 55 岁(平均年龄 44.14 岁,标准差 = 6.16 岁)、患有轻度至中度感音神经性听力损失且无耳鸣的成年人作为对照组,而实验组则由 200 名患有轻度至中度感音神经性听力损失且有耳鸣且无其他相关疾病的成年人组成。对照组和实验组的参与者都接受了听力测试和 QoL 问卷调查。此外,实验组还进行了 PSQ、TSI 和 THI 问卷调查以及心理声学测试,即测量耳鸣的音高、响度和 MML。实验组的参与者被随机分配到 4 组,每组 50 人,治疗方法如下:第 1 组:只进行耳鸣掩蔽,第 2 组:只进行心理辅导,第 3 组:进行掩蔽和心理辅导,第 4 组:进行耳鸣掩蔽和心理辅导以及注意力转移任务疗法。与耳鸣患者相比,无耳鸣患者的生活质量明显提高。治疗组的前后比较显示,"掩蔽+咨询+注意力转移任务 "组在社会心理方面、生活质量和耳鸣严重程度方面的差异非常显著。此外,基于平均得分差异的配对比较显示,与 "掩蔽+咨询+注意力转移任务 "组合(如 "掩蔽+咨询")或单独(即单独掩蔽或咨询)相比,"掩蔽+咨询+注意力转移任务 "组具有显著影响。由此看来,综合干预方案(掩蔽 + 辅导 + 注意力转移任务)可能更适合通过改变神经可塑性(音调变位)来降低耳鸣的响度和音调,从而通过掩蔽立即缓解耳鸣;从长远来看,它可以通过辅导治疗的积极思维来减少耳鸣的影响,还可以通过注意力训练将注意力转移到日常活动中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tinnitus treatment: an experimental study
The objective of the present study was to compare the effectiveness of the selected tinnitus management protocols for the experimental groups, based on the scores obtained for psychosocial variables, quality of life and severity of tinnitus between the four experimental groups following the various treatment protocols. Two-hundred adults ages ranged from 20 to 55 years (mean age 44.14, SD = 6.16) with mild-to-moderate sensorineural hearing loss without tinnitus were randomly selected for the control group, whereas the experimental group comprised 200 adults with mild-to-moderate sensorineural hearing loss with tinnitus without any other associated medical problems. Participants of both control and experimental groups underwent audiological tests and were administered the QoL questionnaire. The experimental group, in addition, was also administered the PSQ, TSI and THI questionnaire and psychoacoustic tests, i.e. measuring pitch, loudness and MML of tinnitus. Participants of experimental group were randomly assigned to 4 groups, each of 50 participants, and treatment was given as below: Group 1: only tinnitus masking sound was administered, Group 2: only counselling was given, Group 3: masking with counselling was given and Group 4: tinnitus masking combined with counselling and attention diversion task therapy was given. The patients without tinnitus had significantly better quality of life in comparison to the patients with tinnitus. Pre-post comparisons of the treatment groups revealed that “masking + counselling + attention diversion task” group showed highly significant differences for psychosocial aspects, QoL and severity of tinnitus. Further, pairwise comparison based on differences in mean scores indicated significant impact of “masking + counselling + attention diversion task” as compared to both in combination like “masking + counselling” or independently, i.e. masking or counselling alone. It appears that an integrated package of intervention (masking + counselling + attention diversion task) might be preferable for providing immediate tinnitus relief by masking through reducing tinnitus loudness and pitch by altering neuroplasticity (tonotopicity); in the long term, it reduces tinnitus impact through positive thinking by counselling treatment and also diverts attention to daily activity through attention training.
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