1.广州中医药大学第一临床医学院,广东省广州市白云区机场路12号,510405
2.广东祈福医院
3.广州中医药大学第一附属医院
4.广东省中医临床研究院岭南耳鼻喉病研究所
drlp@163.com
收稿:2024-06-05,
修回:2024-09-30,
纸质出版:2024-12-17
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陈艳芳,刘蓬,林文智等.医师疗法治疗原发性耳鸣496例远期疗效随访[J].中医杂志,2024,65(24):2558-2564.
CHEN Yanfang,LIU Peng,LIN Wenzhi,et al.Yishi Therapy for the Treatment of Primary Tinnitus:A Long-Term Efficacy Follow-up of 496 Cases[J].Journal of Traditional Chinese Medicine,2024,65(24):2558-2564.
陈艳芳,刘蓬,林文智等.医师疗法治疗原发性耳鸣496例远期疗效随访[J].中医杂志,2024,65(24):2558-2564. DOI: 10.13288/j.11-2166/r.2024.24.009.
CHEN Yanfang,LIU Peng,LIN Wenzhi,et al.Yishi Therapy for the Treatment of Primary Tinnitus:A Long-Term Efficacy Follow-up of 496 Cases[J].Journal of Traditional Chinese Medicine,2024,65(24):2558-2564. DOI: 10.13288/j.11-2166/r.2024.24.009.
目的
2
探讨医师疗法治疗原发性耳鸣的远期疗效,并分析疗效影响因素。
方法
2
于2023年7月1日至2024年1月31日期间通过面诊、网络、电话方式对2017年1月1日至2023年6月30日运用医师疗法治疗的原发性耳鸣病例进行远期随访,了解原发性耳鸣的最终转归及生活方式的变化,回顾患者治疗前的基本资料,统计分析医师疗法治疗耳鸣的痊愈率和总有效率及相关因素(生活方式、年龄、病程、性别、耳鸣部位、耳鸣严重程度、伴随症状、合并基础疾病情况)对总有效率的影响。
结果
2
完成随访的原发性耳鸣患者共496例,随访时耳鸣评价量表(TEQ)评分较治疗前降低(
P
<0.001)。496例患者中临床痊愈101例(20.36%),显效189例(38.10%),有效116例(23.39%),无效90例(18.15%),总有效率为81.85%(406/496)。随访时生活方式评分较治疗前提高(
P
<0.001),以随访时生活方式评分均值作为切点,分为随访时习惯较好组和习惯较差组,总有效率分别为97.53%(237/243)、66.80%(169/253),差异有统计学意义(
P
<0.001)。以治疗前后生活方式评分差值均值作为切点,分为生活方式调整幅度较大组和调整幅度较小组,总有效率分别为97.55%(239/245)、66.53%(167/251),差异有统计学意义(
P
<0.001)。多因素二分类Logistic回归分析显示随访时生活习惯好、生活方式调整幅度大、耳鸣程度严重与总有效率呈正相关(
P
<0.001),年龄增长、听力下降与总有效率呈负相关(
P
<0.05)。
结论
2
医师疗法治疗原发性耳鸣具有较好的远期疗效,生活方式、耳鸣严重程度、听力下降与否、年龄是影响耳鸣疗效的相关因素,其中生活方式是影响疗效的主要因素。
Objective
2
To demonstrate the long-term effect of Yishi Therapy for primary tinnitus and analyze the factors affecting the effectiveness.
Methods
2
We conducted long-term follow-ups of primary tinnitus cases treated with Yishi Therapy during 1 January 2017 to 30 June 2023 by face-to-face, online and telephone between 1 July 2023 and 31 January 2024, to understand the final regression of primary tinnitus and lifestyle changes. We retrospectively analysed the basic data of patients before treatment, and statistically analysed the recovery rate and overall effective rate of tinnitus treated by the Yishi Therapy, and the factors affecting the effectiveness such as lifestyle, age, duration of disease, gender, tinnitus location, severity of tinnitus, accompanying symptoms and complications on the overall effective rate.
Results
2
A total of 496 cases of primary tinnitus completed follow-ups successfully, and the total Tinnitus Evaluation Questionnaire (TEQ) at follow-up was significantly lower than that before treatment (
P
<0.001). Among the 496 cases, 101 (20.36%) cases cured, 189 (38.10%) cases showed significant improvement, 116 (23.39%) cases were effective, 90 (18.15%) cases were ineffective, and the overall effect rate was 81.85% (406/496). At follow-up, the score of lifestyle was higher than that before treatment (
P
<0.001). Grouped by the score of lifestyle at follow-up, the effective rates of better lifestyle group and poor lifestyle group were 97.53% (237/243) and 66.80% (169/253), respectively, with statistical significance (
P
<0.001). Grouped by the mean value of the difference in lifestyle scores before and after treatment, the effective rates of the group with greater lifestyle adjustment and the group with smaller adjustment were 97.55% (239/245) and 66.53% (167/251), respectively, and the differences were statistically significant (
P
<0.001). Binary logistic regression showed that the better lifestyle, the greater lifestyle adjustment and the severity of tinnitus were positively correlated with the total effective rate of tinnitus (
P
<0.001), while older and hearing loss were negatively correlated with the total effective rate of tinnitus (
P
<0.05).
Conclusion
2
Yishi Therapy on primary tinnitus shows good long-term effect, lifestyle, severity of tinnitus, hearing loss or not, age are the relevant factors affecting the efficacy of tinnitus, lifestyle is the main factor affecting clinical efficacy.
刘蓬 , 李明 , 王洪田 , 等 . 原发性耳鸣刍议 [J]. 听力学及言语疾病杂志 , 2010 , 18 ( 2 ): 99 - 101 .
TUNKEL DE , BAUER CA , SUN GH , etal . Clinical practice guideline:tinnitus executive summary [J]. Otolaryngol Head Neck Surg , 2014 , 151 ( 4 ): 533 - 541 .
NONDAHL DM , CRUICKSHANKS KJ , WILEY TL , et al . Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study [J]. J Am Acad Audiol , 2002 , 13 ( 6 ): 323 - 331 .
刘蓬 . 实用中医耳鼻喉科学 [M]. 北京 : 中国中医药出版社 , 2020 : 299 - 317 .
刘蓬 . 耳鸣医师疗法的基本理念 [J]. 中医眼耳鼻喉科杂志 , 2018 , 8 ( 3 ): 121 - 127 .
刘蓬 , 翁振声 . 耳鸣中医综合治疗的远期疗效随访 [J]. 中国中西医结合耳鼻咽喉科杂志 , 2014 , 22 ( 1 ): 12 - 15 .
卢兢哲 , 刘蓬 , 钟萍 , 等 . 医师疗法治疗耳鸣的远期疗效观察 [J]. 中医学 , 2019 , 8 ( 3 ): 153 - 159 .
刘蓬 , 徐桂丽 , 李明 , 等 . 耳鸣评价量表的信度与效度研究 [J]. 中华耳鼻咽喉头颈外科杂志 , 2012 , 47 ( 9 ): 716 - 719 .
卢兢哲 . 基于中医养生理念指导的生活方式调整对耳鸣疗效的影响 [D]. 广州 : 广州中医药大学 , 2018 .
世界中医药学会联合会中医耳鼻喉口腔科专业标准审定委员会 , 中华中医药学会耳鼻咽喉科分会 . 耳鸣严重程度评估与疗效评定参考标准 [J]. 世界中医药 , 2008 , 3 ( 2 ): 71 .
中华耳鼻咽喉头颈外科杂志编辑部 . 2012耳鸣专家共识及解读 [J]. 中华耳鼻咽喉头颈外科杂志 , 2012 , 47 ( 9 ): 709 - 712 .
王晓晓 , 陶立元 , 裴敏玥 , 等 . 连续变量转换为分类变量的几种方法 [J]. 中华儿科杂志 , 2022 , 60 ( 5 ): 420 - 420 .
CIMA RFF , MAZUREK B , HAIDER H , et al . A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment [J]. HNO , 2019 , 67 ( 1 ): 10 - 42 .
卢兢哲 , 刘蓬 , 曹祖威 . 耳鸣与脾胃的相关性研究 [J]. 中国中医基础医学杂志 , 2017 , 23 ( 5 ): 666 - 668 .
丁雷 , 魏然 , 刘大新 , 等 . 500例耳鸣患者中医证型分析 [J]. 北京中医药 , 2014 , 33 ( 6 ): 406 - 408 .
国家中医药管理局 . 国家中医药管理局办公室关于印发《中医临床路径管理试点工作方案》的通知 [EB/OL].( 2011-01-25 )[ 2023-01-26 ]. http://www.natcm.gov.cn/yizhengsi/zhengcewenjian/2018-03-24/3197.html http://www.natcm.gov.cn/yizhengsi/zhengcewenjian/2018-03-24/3197.html .
RAPPAPORT SM . Genetic factors are not the major causes of chronic diseases [J]. PLoS One , 2016 , 11 ( 4 ): e0154387 . doi: 10.1371/journal.pone.0154387 http://dx.doi.org/10.1371/journal.pone.0154387 .
FORD ES , BERGMANN MM , KRÖGER J , et al . Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study [J]. Arch Intern Med , 2009 , 169 ( 15 ): 1355 - 1362 .
王红梅 . 调整生活方式对难治性耳鸣及睡眠障碍的疗效 [J]. 中国继续医学教育 , 2017 , 9 ( 13 ): 189 - 190 .
卢兢哲 , 刘蓬 , 钟萍 , 等 . 原发性耳鸣预后影响因素分析 [J]. 中国听力语言康复科学杂志 , 2018 , 16 ( 6 ): 416 - 420 .
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