本文關(guān)鍵詞： 突發(fā)性耳聾 耳鳴 中醫(yī)證型 聽力學(xué) 預(yù)后　出處：《廣州中醫(yī)藥大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：背景 突發(fā)性耳聾簡稱為突聾,為耳科急癥。目前國內(nèi)外對于突發(fā)性聾的研究主要是針對聽力方面,對于這一疾病的療效標(biāo)準(zhǔn)也是以聽力轉(zhuǎn)歸為觀察指標(biāo),而突發(fā)性耳聾患者常伴有耳鳴癥狀,耳鳴常常是突發(fā)性聾患者就診主訴的第二癥狀,有時甚至是首要癥狀。耳鳴的存在,使部分突聾患者覺得苦惱、憂慮或者抑郁,其生活質(zhì)量、工作效率下降,嚴(yán)重者甚至不能進(jìn)行正常的生活工作和學(xué)習(xí)。這些耳鳴帶來的影響甚至可以發(fā)生在部分聽力得到改善的患者身上。目前雖開始有文獻(xiàn)報道突發(fā)性聾患者耳鳴癥狀的特性研究,但局限于突發(fā)性聾患者伴不伴耳鳴癥狀對突聾療效的影響,或者突聾患者耳鳴發(fā)生的相關(guān)因素報道,且報道數(shù)量少,暫未發(fā)現(xiàn)有關(guān)治療后耳鳴轉(zhuǎn)歸的影響因素報道。因此有必要對突發(fā)性耳聾患者耳鳴癥狀的轉(zhuǎn)歸特點進(jìn)行研究,以期能進(jìn)一步加深對突發(fā)性耳聾這一疾病的認(rèn)識。 目的 通過觀察突發(fā)性耳聾患者耳鳴的臨床特征、耳鳴轉(zhuǎn)歸情況、聽力狀況及突聾的療效,探討耳鳴癥狀在聽力損害逐漸恢復(fù)過程中的變化規(guī)律；比較不同中醫(yī)證型突聾患者其耳鳴的嚴(yán)重程度、主調(diào)及療效特點,分析不同中醫(yī)證型與耳鳴轉(zhuǎn)歸的關(guān)系。 方法 根據(jù)納入和排除標(biāo)準(zhǔn),選擇2010年3月至2010年12月在廣東省中醫(yī)院耳鼻喉科住院,第一診斷為突發(fā)性耳聾的患者為研究對象,剔除脫落的病例,最后共64例患者納入本次研究。收集64例研究對象的基本資料,如性別、年齡、患耳側(cè)別、發(fā)病至就診時間、住院天數(shù)、耳鳴響度自我評價、伴隨癥狀、中醫(yī)證型、治療方案等；按臨床標(biāo)準(zhǔn)行純音聽閾測定及耳鳴匹配等檢查,收集純音聽閾測定結(jié)果及耳鳴匹配的音調(diào)、響度等數(shù)據(jù),研究中醫(yī)證型、聽力損失情況、突聾療效以及各種相關(guān)因素對患者耳鳴轉(zhuǎn)歸的影響。 結(jié)果 本次研究納入的64例患者中,男性25例,女性39例,右耳鳴26例,左耳鳴34例,雙耳鳴4例,年齡10-80歲,平均年齡40.37±13.54歲,發(fā)病至就診住院治療時間平均為8.17±6.87天,平均住院天數(shù)為11.72±3.85天,文化程度在小學(xué)以下的有2人,在中學(xué)、中專水平的有29人,在大專、大學(xué)及以上水平的有33人,25例伴有眩暈,45例伴耳堵塞脹悶感,21例伴睡眠障礙,38例伴倦怠乏力。 單因素分析結(jié)果提示,64例患者聽力損失的程度、聽力損失曲線類型、中醫(yī)證型、耳鳴耳側(cè)別、耳鳴聲主頻類型(純音性質(zhì)、窄帶噪聲性質(zhì))、耳鳴頻率、耳鳴感覺級、耳鳴響度自我評價、性別、發(fā)病至住院治療時間、住院天數(shù)、伴或不伴耳堵塞感、睡眠障礙和倦怠乏力癥狀、突聾治療方案均與耳鳴轉(zhuǎn)歸無明顯相關(guān)性(P0.05)。多因素的患者的突發(fā)性耳聾的療效、年齡、伴不伴眩暈癥狀與耳鳴轉(zhuǎn)歸存在相關(guān)性(P0.05)。經(jīng)多因素的Logistic回歸分析中,僅伴或不伴耳堵塞感和突發(fā)性耳聾的療效與耳鳴轉(zhuǎn)歸存在相關(guān)性(P0.05)。 結(jié)論 突發(fā)性耳聾聽力恢復(fù)越好,耳鳴轉(zhuǎn)歸越好；伴有眩暈癥狀的患者其耳鳴療效比不伴眩暈患者的耳鳴療效好；單因素分析中,青壯年患者的耳鳴預(yù)后優(yōu)于老年人,通過Logistic回歸分析,患者年齡這個因素對耳鳴預(yù)后的影響被剔除。突聾患者聽力損失的程度、聽力損失曲線類型、中醫(yī)證型、耳鳴耳側(cè)別、耳鳴主頻類型、耳鳴頻率、耳鳴感覺級、耳鳴響度自我評價、性別、發(fā)病至住院治療時間、住院天數(shù)、突聾治療方案等均對耳鳴轉(zhuǎn)歸無影響。
[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 鹵 13.54 years . The average age was 11.72 鹵 3.85 days . The average age was 11.72 鹵 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 .

【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R764.43

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