认知行为疗法在爆震性耳鸣治疗中的应用

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摘要目的评估认知行为疗法（CBT）对爆震性耳鸣的治疗效果。方法选取2018年1月～2019年6月就诊于解放军第九八四医院耳鼻喉科的62例爆震性耳鸣患者作为研究对象，采用抛硬币法将其分为对照组（32例）和联合治疗组（30例）。对照组患者给予常规药物治疗，联合治疗组患者给予药物联合CBT治疗，疗程均为1个月。治疗前及疗程结束后，均采用耳鸣残疾评估量表（THI）和焦虑自评量表（SAS）对患者耳鸣严重程度及焦虑情绪进行评估，分别比较两组患者治疗前后的THI及SAS评分，并进一步比较对照组耳鸣合并焦虑患者（n=6）和联合治疗组耳鸣合并焦虑患者（n=9）的THI及SAS评分。结果两组治疗后的THI及SAS评分均低于治疗前，差异有统计学意义（P＜0.05）；两组治疗前后的THI及SAS评分比较，差异无统计学意义（P＞0.05）。联合治疗组患者的治疗总有效率（83.33%）高于对照组（31.25%），差异有统计学意义（P＜0.05）；两组耳鸣合并焦虑患者治疗后的THI及SAS评分均低于治疗前，差异有统计学意义（P＜0.05）；联合治疗组耳鸣合并焦虑患者治疗后的SAS及THI评分均低于对照组，差异有统计学意义（P＜0.05）。结论 CBT能够有效改善爆震性耳鸣合并焦虑患者的主观症状，减轻耳鸣对其生活的影响，缓解其负面情绪，值得临床积极推广。

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	杨美艳
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	李旭
	贾宗鑫
	赵旭萍
	王冰

关键词 ：爆震性耳鸣, 噪声, 认知行为疗法

Abstract：Objective To investigate the effect of cognitive behavioral therapy(CBT)on explosive tinnitus.Methods A total of 62 patients with explosive tinnitus admitted to the Department of Otolaryngology,No.984 Hospital of the People′s Liberation Army from January 2018 to June 2019 were selected as the subjects.They were divided into control group(n=32)and combined treatment group(n=30)by coin toss method.Patients in the control group were given conventional drug treatment,and patients in the combined treatment group were given drug combined CBT treatment.The course of treatment was 1 month.The tinnitus handicap inventory(THI)and anxiety self-assessment scale(SAS)were used to estimate the tinnitus severity and negative emotions before and 1 month after treatment.The THI and SAS scores were compared between the two groups,respectively.The THI and SAS scores of patients with tinnitus and anxiety in control group(n=6)and patients with tinnitus and anxiety in combined treatment group(n=9)were further compared.Results The THI and SAS scores after treatment in the two groups were lower than those before treatment,and the differences were statistically significant(P＜0.05).There were no significant differences in THI and SAS scores between the two groups before and after treatment(P＞0.05).The total effective rate of combined treatment group(83.33%)was higher than that of control group(31.25%),and the difference was statistically significant(P＜0.05).After treatment,the THI and SAS scores of tinnitus patients with anxiety in the two groups were lower than those before treatment,the differences were statistically significant(P＜0.05).After treatment,SAS and THI scores of patients with tinnitus and anxiety in the combined treatment group were lower than those in the control group,the differences were statistically significant(P＜0.05).Conclusion CBT can effectively improve the subjective symptoms of patients with explosive tinnitus with anxiety,reduce the impact of tinnitus on their lives and alleviate their negative emotions,which is worthy of active clinical promotion.

Key words： Explosive tinnitus Noise Cognitive behavior therapy

通讯作者: 李旭（1978-），女，辽宁开原人，博士，副主任医师，解放军第九八四医院耳鼻喉科主任，研究方向：神经性耳聋防治

作者简介: 杨美艳（1981-），女，山西原平人，本科，主治医师，研究方向：耳鸣诊治

引用本文:

杨美艳；齐丽丽；李旭；贾宗鑫；赵旭萍；王冰. 认知行为疗法在爆震性耳鸣治疗中的应用[J]. 中国当代医药, 2021, 28(15): 30-33转37.
YANG Mei-yan；QI Li-li；LI Xu；JIA Zong-xin；ZHAO Xu-ping；WANG Bing. Application of cognitive behavioral therapy on explosive tinnitus. 中国当代医药, 2021, 28(15): 30-33转37.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I15/30

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