| Objective: Tinnitus is the first of three major problems in otology,and its pathophysiological mechanism remains unclear.With the rapid development of society,the tinnitus problem has become more prominent and has shown a trend of youthfulness.In recent years,tinnitus treatment at home and abroad has been studied in depth.At present,tinnitus has a wide range of applications for acoustic therapy,and its efficacy is relatively positive.In this study,tinnitus refinement and matching were used to analyze chronic tinnitus,multiple multiple sounds were used to treat chronic tinnitus patients,and short-term efficacy was evaluated.It has provided a new program for the treatment of chronic tinnitus.Methods: We retrospectively analyzed the clinical data of 187 patients(244 ears)with chronic subjective tinnitus who performed multiple composite acoustic therapy at the General Hospital of Tianjin Medical University from November 2017 to January 2018.All subjects were treated with multiple superimposed composite sounds to treat tinnitus.Tinnitus fine matching was performed before treatment,1month of treatment,2 months of treatment,and 3 months of treatment.The Chinese version of tinnitus handicap inventory(THI)and visual analogue scals(VAS)were also improved.The collected data was statistically analyzed by SPSS 21.0 and graphed using GraphPad Prism 7.0.Results:1.The main tonal frequency of tinnitus is 14.35%(35/244),20.90%(51/244),and 64.75%(36/244)in the low,medium,and high frequency ranges,respectively.In the normal hearing group,the main tonal frequency of tinnitus was 6.88%(2/34),20.59%(7/34),and 73.53%(25/34)in the low,medium,and high frequency ranges,respectively.In the hearing-impaired group,the main tonal frequency of tinnitus in the low,medium,and high frequency bands accounted for 15.71%(33/210),20.95%(44/210),and 63.33%(133/210),respectively.2.The main tone frequency of tinnitus is about 75.56%(136/180)in the frequency range of hearing loss on this side.The proportion of tinnitus main tones for low,medium,and high frequencies in relativelylow,medium,and high frequency hearing loss is respectively 50.00%(13/26),60.00%(21/35),85.71%(102/119).3.About 68.44%(167/244)of the affected ears had a "V" shaped auditory threshold notch in the tinnitus refinement matching process,of which 78.44%(131/167)of the tinnitus sites corresponded to the lowest point of the notch.It accounts for 53.69%(131/244)of the total affected ear.4.The total effective rate of multiple composite acoustic therapy for one month was 53.28%(130/244),of which the cure rate was 11.48%(28/244),the effective rate was 41.80%(102/244),and the ineffective rate was 46.72%(114/244).The total effective rate was 20.25%(147/244)for 2 months,of which the cure rate was 14.24%(55/244),the effective rate was 37.70%(92/244),and the ineffective rate was 39.75(97/244).The total effective rate of treatment for 3 months was 65.16%(159/244),of which the cure rate was 27.87%(68/244),the effective rate was 37.30%(91/244),and the ineffective rate was 34.84(85/244).The effective rates of tinnitus vocalization frequency at earliest frequency of ear treatment at 1 month,2 months,and 3 months were 88.58%(31/35),91.43(32/35),and 91.43%(32/35)respectively.The effective rates at 1 month,2 months,and 3 months in the mid-range treatment were 78.43%(40/51),82.35%(42/51),and 86.27%(44/51),respectively.5.VAS scores of tinnitus loudness in the course of treatment.Analysis of variance showed that tinnitus in different frequency bands were compared before and after treatment with VAS scores.The main tone was located in the low frequency band(F=13.872,P=0.000),and in the middle frequency band(F=9.436,P = 0.000).The difference was not statistically significant(P>0.05),while the main tone was located in the high frequency range(F=0.701,P=0.393).The difference was statistically significant(P<0.05).The VAS scores of tinnitus loudness at different frequencies within the same treatment time were compared.Before treatment and 1 month after treatment,there was no significant difference in the average VAS of tinnitus between the main tone at different frequency bands(P>0.05).Treatment for 2 months and 3 months.The difference was significant at month(P<0.05).6.The three groups of tinnitus affected ears located at the low,middle,and high frequencies of the main tone were all reduced in loudness during the treatment.Three groups of ears in different treatment time: There was no significant difference in tinnitus loudness before and aftertreatment(P>0.05).However,the difference was statistically significant at 2 months(F=2.066,P=0.044)and 3 months(F=4.775,P=0.027).Comparing the patients before and after treatment with the ears of the same group,the results showed that the average loudness of the tinnitus before and after the treatment was dominated by the main tone frequency(F=4.773,P=0.038)and intermediate frequency(F=3.155,P=0.043).The difference was statistically significant(P<0.05).There was no significant difference in the mean of loudness of the tinnitus with main tone frequency of high frequency(F=1.201,P=0.182)before and after treatment(P>0.05).7.Pretreatment tinnitus affected ears were subjected to residual inhibition test.Among them,the positive rate,partial positive rate,negative or rebound rate were57.79%(141/244),27.87%(68/244),14.34%(35/244)respectively.With the extension of treatment time,the test results show a certain relationship with the efficacy.Among them,the effective rates of 1-month,2-month,and 3-month treatment in the positive group were 62.42%(88/141),68.09%(96/141),and 71.63%(101/141),respectively;part of the positive group was treated for 1 month The effective rates of 2 months and 3 months were 48.53%(33/68),54.41%(37/68),and64.71%(44/68)respectively;in the negative or rebound group,1 month,2 months,3months.The monthly effective rates were 25.71%(9/35),40.00%(14/35),and42.86%(15/35)respectively.Conclusion: Fine tinnitus in the ears of chronic tinnitus can be matched to determine the frequency and loudness of the main tinnitus tinnitus,enabling more sophisticated use of multiple compound sounds for treatment.In the course of treatment,the treatment plan can be adjusted in time according to changes in frequency and loudness.Before and after treatment,according to THI score,VAS score of tinnitus loudness,and fine tinnitus matching,tinnitus symptoms gradually reduced,loudness gradually decreased,and the effect was significant and stable in the short term.Multiple compound acoustic therapy provides a more individualized treatment plan for patients with chronic tinnitus. |
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