| Objective:A randomized controlled trial was made for tinnitus retraining therapy(TRT) group,medicine treatment group and combined treatment group with short-term medicine and TRT, to observe the curative effect and difference among combined treatment of short-term medicine and TRT, medicine treatment and TRT, observe whether the three groups of patients adapt to the chronic subjective tinnitus and confirm their adaption level.Method:The 90 patients, having a chronic subjective tinnitus(course being > 1 year) with low and mid frequency hearing impairment being ≤ 55 d BHL during a pure tone test, were divided into three groups at random, including medicine treatment group, TRT group and combined treatment group with short-term medicine treatment and TRT, with 30 patients for each group respectively. For medicine treatment group, such medicines as trophic nerve,vascular dilation and the ones improving the accompanying symptoms, instead of TRT,were selected. TRT consists of guidance counseling and sound therapy. For the combined treatment group with short-term medicine and TRT, the short-term medicine treatment and corresponding TRT were taken. The three groups of patients filled in the tinnitus handicap inventory(THI) before treatment, and at the time of 1 month, 3 months and 6 months following the treatment. The difference of curative effect of the three groups is evaluated based on the change of pre-treatment and post-treatment THI grade and the total adaption rate of the three groups of patients at the same stage and that at the different stage.Result:There is a statistical significance in difference of pre-treatment and post-treatment THI grade for medicine treatment group, TRT group and the combined treatment group with short-term medicine and TRT(P < 0.05). For the medicine treatment group, the total adaption rates following treatment of 1 month, 3 months and 6 months are 6.7%, 33.3%and 43.3% respectively. For TRT group, the curative effect following 1 month, 3 months and 6 months is superior to that of medicine treatment group respectively; and it increases gradually with time, with a total adaption rate of 16.7%, 60% and 76.7% respectively. For combined treatment group with short-term medicine and TRT, the total adaption rates,superior to that of medicine treatment group and TRT group, are 20%, 70% and 80%respectively. In addition, it is observed that music provided in the study has the same effect as the ambient noise provided in other literatures. After 1 month’s treatment, there is no statistical significance in difference of the total adaption rate among TRT group, medicine treatment group and combined treatment group with short-term medicine and TRT; after 3months’ treatment, there is statistical significance in difference of total adaption rate among the three groups, and it shows that there is statistical significance in difference among the medicine treatment group and another two groups, and the total adaption rate of medicine treatment group is lower than that of TRT group and the combined treatment group; after 6months’ treatment, there is statistical significance in difference of total adaption rate of the three groups, and it shows that there is statistical significance in difference of medicine treatment group and another two groups, and the total adaption rate of medicine treatment group is lower than TRT group and the combined treatment group, while there is no statistic significance in difference of TRT group and the combined treatment group.Conclusions:There is significant clinical effect for the combined treatment with short-term medicine and TRT. For patients having a chronic subjective tinnitus, the combined treatment is an effective treatment method. However, the stability of corresponding clinical effect shall be verified further due to the small sample size and the short visit time.Therefore, the clinical effect shall be researched based on the multicenter randomizedcontrolled trials with large sample size. |
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