An improved system for grading and treating tinnitus.
An improved system for grading and treating tinnitus.
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改进的耳鸣分级和治疗系统。
DOI：
10.1016/j.anl.2017.11.012
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发表时间：
2017
影响因子：
1.7
通讯作者：
Murakami S.
中科院分区：
文献类型：
--
作者：
Takahashi M;Kabaya K;Sekiya K;Matsuda F;Sekiya Y;Esaki S;Sato Y;Inagaki A;Murakami S.
耳鸣是一种听觉，可能会导致不适甚至疼痛。耳鸣的症状有哪些呢？耳鸣的症状有哪些呢？我们开发了一种新的分级系统和实用的方案，用于系统治疗耳鸣，说明其严重程度，患者的心理问题和灾难性事件的频率。本研究的目的是采用和验证新的系统在患者耳鸣。MethodsThis研究包括两个部分：（一）我们确定了113例，然后分析耳鸣的严重程度，心理问题，和灾难性的事件。然后将他们分为5个等级，并仔细检查他们以前的治疗记录。从这些记录中，我们设计了一个实用的治疗方案，适用于每5个等级。(ii)然后，我们确定了82名新患者，并根据第（i）部分开发的系统对他们进行分级和治疗。患者随访至少6个月;使用治疗前和治疗后的Tinshire残疾量表（THI）和医院焦虑和抑郁量表（HADS）评分评估治疗疗效。结果（1）Ⅰ级38例，平均THI = 37.6分，平均HADS = 10.9分，灾难性事件= 0分; Ⅱ级24例，平均THI = 70.6分，平均HADS = 13.1分，灾难性事件= 0分; III级，5例患者，THI = 73.2，HADS = 28.4，灾难性事件= 0; IV级，33例患者，THI = 63.5，HADS = 18.8，灾难性事件= 1.0; V级，13例患者，THI = 73.2，HADS = 22.4，灾难性事件= 2.2。治疗记录显示，40%的III级患者、45.5%的IV级患者和84.6%的V级患者接受精神药物治疗; 20%的III级患者、12.5%的IV级患者和53.8%的V级患者接受精神科会诊。(ii)THI评分显着改善，在等级II，IV和V治疗后，使用新的协议; HADS评分显着改善，在等级IV和V级灾难性事件评分显着改善，在等级IV和V.ConclusionWe发现足够大的差异THI和HADS评分成功地将耳鸣患者分为5个不同的等级，占耳鸣的严重程度，心理问题，和灾难性事件。我们发现，当这个系统被用来指导治疗时，耳鸣的严重程度和心理问题在更高（更严重）的等级中得到了显着改善。这个系统不仅提供了一个合理可靠的分类系统，它简化了治疗而不牺牲疗效。
ObjectiveTinnitus is an auditory sensation that can cause discomfort or even pain. Because patients with tinnitus frequently have psychological problems, self-reporting of the severity of tinnitus is unreliable. We developed a new grading system and practical protocol for the systematic treatment of tinnitus that accounts for its severity, patients’ psychological problems, and the frequency of catastrophic episodes. The aim of this study is to employ and validate the new system in patients with tinnitus.MethodsThis study comprised two parts: (i) We identified 113 patients, who were then analyzed in terms of severity of tinnitus, psychological problems, and catastrophic episodes. They were then classified into 5 grades, and the records of their previous treatments were scrutinized. From these records, we designed a practical treatment protocol suitable for each of the 5 grades.(ii) We then identified 82 new patients, and graded and treated them according to the system developed in part (i). Patients were followed-up for at least 6 months; treatment efficacy was evaluated using the pre- and post-treatment scores on the Tinnitus Handicap Inventory (THI) and Hospital Anxiety and Depression Scale (HADS). Psychological status was also assessed with the DSM-IV.Results(i) The overall patient group was categorized as follows: Grade I, 38 patients, average THI = 37.6 points, average HADS = 10.9 points, catastrophic episodes = 0 points; Grade II, 24 patients, THI = 70.6, HADS = 13.1, catastrophic episodes = 0; Grade III, 5 patients, THI = 73.2, HADS = 28.4, catastrophic episodes = 0; Grade IV, 33 patients, THI = 63.5, HADS = 18.8, catastrophic episodes = 1.0; Grade V, 13 patients, THI = 73.2, HADS = 22.4, catastrophic episodes = 2.2. The treatment records revealed treatment via psychotropic drugs for 40% of Grade III, 45.5% of Grade IV, and 84.6% of Grade V patients; psychiatric consultation was provided for 20% of Grade III, 12.5% of Grade IV, and 53.8% of Grade V patients.(ii) THI scores improved significantly in Grades II, IV, and V after treatment using the new protocol; HADS scores improved significantly in Grades IV and V. Catastrophic episode scores improved significantly in Grades IV and V.ConclusionWe found large enough differences in THI and HADS scores to successfully classify patients with tinnitus into 5 distinct grades that accounted for tinnitus severity, psychological problems, and catastrophic episodes. We found significant improvements in tinnitus severity and psychological problems in the higher (more severe) grades when this system was used to guide treatment. This system not only provided a reasonably reliable categorization system, it simplified treatment without sacrificing efficacy.
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DOI：
10.3109/03005369009077842
发表时间：
1990
期刊：
British journal of audiology
影响因子：
--
作者：
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影响因子：
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通讯作者：
U. Lindblom
影响因子：
2.4
作者：
Kugaya, A;Akechi, T;Uchitomi, Y
通讯作者：
Uchitomi, Y
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影响因子：
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