影响老年性耳聋患者助听器助听效果的因素与中医证型相关性分析

发布时间：2018-04-04 10:10

本文选题：老年性聋　切入点：助听器　出处：《福建中医药大学》2014年硕士论文

【摘要】：目的分析老年性耳聋患者助听器使用效果的相关影响因素,对患者在临床上听力康复采取相应的干预方式提供理论依据,并对老年性耳聋助听器使用患者进行耳聋的中医辨证,探讨其肾精亏损证、肝火上扰证的临床听力学特征及两大证型与助听器效果间的相关性。方法采用日常生活助听满意度量表对120例接受助听器验配的老年性耳聋患者进行调查,统计资料中每位患者各项得分、总均分,并根据患者年龄、性别、教育程度、平均听力阈值、助听器类型、佩戴方式、佩戴时长、每日使用时长、自感听力下降时长等9个因素进行分组,采用单因素分析及逐步多元回归分析进行统计处理,筛选影响助听效果的主要因素。分析可能影响助听器使用效果的相关因素,并进行中医辨证分型,比较分析临床常见的证型听力学特征及差异,分析证型与使用助听器效果的关系。结果教育程度越高、每日佩戴时间越长、双耳佩戴者得分高于教育程度低、每日佩戴时间短、单耳佩戴(P0.01)；自感听力下降时长短者得分高于自感听力下降时长长者(P0.01)；总体满意度方面教育程度越高、每日佩戴时间越长者得分高于教育程度低、每日佩戴时间短(P0.01),其中性别对助听效果无影响。中医两组证型相关因素比较,年龄方面,肾精亏损证组较肝火上扰证组高,SADL分值方面,肾精亏损证组较肝火上扰证组低,耳鸣频率方面,肾精亏损证集中在中高频,肝火上扰证集中在中频,以上资料统计分析均有显著性差异(P0.05),而在自感听力下降时长、纯音听阈、每日佩戴时长、佩戴时长、鼓室图、外耳道容积、声顺值、振幅方面资料比较无统计差异(P0.05)。结论影响助听器效果的因素较多,其中教育程度、每日佩戴时长是主要因素,两者联合可获得助听效果最大化,双耳佩戴、自感听力下降时间短助听效果满意度高,而性别对助听效果无明显影响。老年性耳聋患者中肾精亏损证与肝火上扰证相比,患者在年龄、SADL分值、耳鸣频率方面有显著统计差异(P0.05)。在自感听力下降时长、纯音听阈、每日佩戴时长、佩戴时长、鼓室图、外耳道容积、声顺值、振幅资料比较中无统计差异(P0.05),佩戴助听器助听效果较差的老年性耳聋患者可能与肾虚程度相关,与肝火上扰证老年聋患者相比,其助听满意度量表SADL分值相对较低。
[Abstract]:PurposeTo analyze the influencing factors of the effect of hearing aid in the patients with presbycusis, to provide the theoretical basis for the corresponding intervention in clinical hearing rehabilitation, and to differentiate the symptoms and signs of deafness in the patients with presbycusis hearing aids.To explore the clinical audiological characteristics of kidney essence deficiency syndrome, liver fire disturbance syndrome and the correlation between the two syndrome types and hearing aid effect.MethodA total of 120 patients with presbycusis who received hearing aids were investigated with the daily living hearing satisfaction scale. The scores of each patient in the statistical data, the total average score, and the average hearing threshold according to the patient's age, sex, educational level and level of education, were investigated.Nine factors, such as type of hearing aid, way of wearing, duration of wearing, duration of daily use, length of time of self-induced hearing loss, were divided into 9 groups. Single factor analysis and stepwise multiple regression analysis were used for statistical analysis.To screen the main factors affecting the effect of hearing aid.To analyze the related factors that may affect the effect of hearing aid use, and to carry out TCM syndrome differentiation and classification, to compare and analyze the characteristics and differences of hearing mechanics of common clinical syndromes, and to analyze the relationship between syndromes and the effect of hearing aid use.ResultThe higher the education level, the longer the daily wear time, the higher the score of the binaural wearer than the lower the education level, the shorter the daily wear time.The longer the hearing loss was, the higher the score was, the higher the education level was, the higher the education level was, the higher the score was higher than the lower the education level.The short daily wear time (P0.01) had no effect on hearing aid.Comparing the related factors of TCM two groups, age, kidney essence deficit syndrome group has higher SADL score than liver fire upper disturbance syndrome group, kidney essence deficit syndrome group is lower than liver fire upper disturbance syndrome group, tinnitus frequency, kidney essence deficiency syndrome is concentrated in middle and high frequency.The statistical analysis of the above data showed significant difference (P 0.05). However, the length of hearing loss, the threshold of pure tone hearing, the length of the day, the length of the wear, the tympanogram, the volume of the external auditory canal, the volume of the external auditory canal, and the normal value of the external auditory canal were significantly different.There was no statistical difference in amplitude data (P 0.05).ConclusionThere are many factors that influence the effect of hearing aid, among which education level and the length of daily wear are the main factors. The combination of the two can maximize the effect of hearing aid, wear both ears, and improve the satisfaction of hearing aid in the short time of hearing loss.Gender had no significant effect on hearing aid.There were significant statistical differences in age and tinnitus frequency between kidney essence deficiency syndrome and liver fire disturbance syndrome in patients with presbycusis.Length of hearing loss, pure tone threshold, length of day, length of wear, tympanogram, volume of external auditory canal,There was no statistical difference in amplitude data (P 0.05). The patients with presbycusis with poor hearing aid effect may be related to the degree of kidney deficiency. Compared with the elderly deafness patients with liver fire disturbance, the SADL score of hearing aid satisfaction scale was relatively lower.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R764.436

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