突发性耳聋患者耳鸣转归与一些因素的相关性探讨

发布时间：2018-02-21 02:53

本文关键词： 突发性耳聋耳鸣中医证型听力学预后　出处：《广州中医药大学》2011年硕士论文　论文类型：学位论文

【摘要】：背景突发性耳聋简称为突聋,为耳科急症。目前国内外对于突发性聋的研究主要是针对听力方面,对于这一疾病的疗效标准也是以听力转归为观察指标,而突发性耳聋患者常伴有耳鸣症状,耳鸣常常是突发性聋患者就诊主诉的第二症状,有时甚至是首要症状。耳鸣的存在,使部分突聋患者觉得苦恼、忧虑或者抑郁,其生活质量、工作效率下降,严重者甚至不能进行正常的生活工作和学习。这些耳鸣带来的影响甚至可以发生在部分听力得到改善的患者身上。目前虽开始有文献报道突发性聋患者耳鸣症状的特性研究,但局限于突发性聋患者伴不伴耳鸣症状对突聋疗效的影响,或者突聋患者耳鸣发生的相关因素报道,且报道数量少,暂未发现有关治疗后耳鸣转归的影响因素报道。因此有必要对突发性耳聋患者耳鸣症状的转归特点进行研究,以期能进一步加深对突发性耳聋这一疾病的认识。目的通过观察突发性耳聋患者耳鸣的临床特征、耳鸣转归情况、听力状况及突聋的疗效,探讨耳鸣症状在听力损害逐渐恢复过程中的变化规律；比较不同中医证型突聋患者其耳鸣的严重程度、主调及疗效特点,分析不同中医证型与耳鸣转归的关系。方法根据纳入和排除标准,选择2010年3月至2010年12月在广东省中医院耳鼻喉科住院,第一诊断为突发性耳聋的患者为研究对象,剔除脱落的病例,最后共64例患者纳入本次研究。收集64例研究对象的基本资料,如性别、年龄、患耳侧别、发病至就诊时间、住院天数、耳鸣响度自我评价、伴随症状、中医证型、治疗方案等；按临床标准行纯音听阈测定及耳鸣匹配等检查,收集纯音听阈测定结果及耳鸣匹配的音调、响度等数据,研究中医证型、听力损失情况、突聋疗效以及各种相关因素对患者耳鸣转归的影响。结果本次研究纳入的64例患者中,男性25例,女性39例,右耳鸣26例,左耳鸣34例,双耳鸣4例,年龄10-80岁,平均年龄40.37±13.54岁,发病至就诊住院治疗时间平均为8.17±6.87天,平均住院天数为11.72±3.85天,文化程度在小学以下的有2人,在中学、中专水平的有29人,在大专、大学及以上水平的有33人,25例伴有眩晕,45例伴耳堵塞胀闷感,21例伴睡眠障碍,38例伴倦怠乏力。单因素分析结果提示,64例患者听力损失的程度、听力损失曲线类型、中医证型、耳鸣耳侧别、耳鸣声主频类型(纯音性质、窄带噪声性质)、耳鸣频率、耳鸣感觉级、耳鸣响度自我评价、性别、发病至住院治疗时间、住院天数、伴或不伴耳堵塞感、睡眠障碍和倦怠乏力症状、突聋治疗方案均与耳鸣转归无明显相关性(P0.05)。多因素的患者的突发性耳聋的疗效、年龄、伴不伴眩晕症状与耳鸣转归存在相关性(P0.05)。经多因素的Logistic回归分析中,仅伴或不伴耳堵塞感和突发性耳聋的疗效与耳鸣转归存在相关性(P0.05)。结论突发性耳聋听力恢复越好,耳鸣转归越好；伴有眩晕症状的患者其耳鸣疗效比不伴眩晕患者的耳鸣疗效好；单因素分析中,青壮年患者的耳鸣预后优于老年人,通过Logistic回归分析,患者年龄这个因素对耳鸣预后的影响被剔除。突聋患者听力损失的程度、听力损失曲线类型、中医证型、耳鸣耳侧别、耳鸣主频类型、耳鸣频率、耳鸣感觉级、耳鸣响度自我评价、性别、发病至住院治疗时间、住院天数、突聋治疗方案等均对耳鸣转归无影响。
[Abstract]:Background Sudden deafness is referred to as deafness , which is an emergency . At present , the research on sudden deafness is mainly aimed at hearing . The effect of tinnitus is often accompanied by tinnitus symptoms . The effect of tinnitus is often the second symptom of sudden deafness . Purpose Through observing the clinical characteristics of tinnitus in patients with sudden deafness , the hearing condition and the curative effect of sudden deafness , the changes of tinnitus symptom in the course of gradual restoration of hearing impairment were discussed . method According to the inclusion and exclusion criteria , the patients who were hospitalized in the central hospital of Guangdong were selected from March 2010 to December 2010 . The first diagnosis was sudden deafness , and 64 patients were enrolled in this study . Results Among the 64 patients enrolled in this study , 25 male , 39 female , 26 right ear tinnitus , 34 left ear tinnitus , 4 tinnitus 4 , age 10 - 80 years , average age was 40.37 卤 13.54 years . The average age was 11.72 卤 3.85 days . The average age was 11.72 卤 3.85 days . The results of single factor analysis showed that 64 patients with hearing loss , hearing loss curve type , TCM syndrome type , tinnitus ear side , tinnitus sound main frequency type ( pure tone quality , narrow band noise property ) , tinnitus frequency , tinnitus sensation level , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset of hospitalization , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex , onset - to - hospital treatment time , tinnitus loudness self - evaluation , sex Conclusion The better the hearing recovery of sudden deafness , the better the outcome of tinnitus , the better curative effect of tinnitus in patients with vertigo symptoms than that in patients without vertigo . In single factor analysis , the effect of age on tinnitus was better than that of old people .

【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764.43

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