Objective: Tailor-made notched music was applied to alleviate the symptoms of chronic idiopathic tinnitus and compared its effectiveness with other existing sound treatment of tinnitus. Methods: Subjects (n=43; ears=75 )were recruited during June 2015 to October 2016 from the out-patients of our hospital. These patients had chronic (longer than 6months) and idiopathic tinnitus, with or without significant sensorineural hearing loss. In the prospective design, the patients were randomly divided into group A (treated with tailor-made notched music) and group B (treated with analogous sound masking), and received the treatment for 3 months. The tinnitus scale, tinnitus questionnaire and audiological findings were evaluated before treatment, and at one month and three months after treatment started. Results: After onemonth of treatment, the effective rate between the two groups was 40.9% and 42.9%, there was no significant difference between the two groups (χ(2)= 0.017, P=0.897). The average VAS for patients in group A showed more decrease in group A than in group B(VAS: 1.8 vs. 0.8, the percentage : 29.5% vs. 13.6%), but there was no significant difference between the two groups (t=-1.450, P=0.155). After 3 months of treatment, the effective rates were 68.2% and 23.8%, respectively. There was significant difference between the two groups (χ(2)= 8.503, P=0.004). The difference of the VAS scores between the two groups was statistically significant (t=-3.263, P=0.002), and the VAS score of group A was less.After 3 months of treatment, there was significant decreaseinthe average tinnitus loudness for patients in group A(t=5.569, P<0.01), and there was no significant changein group B(t=-0.953, P=0.374). There was also significant decreasein the scores of tinnitus handicap inventory (THI) (F=7.334, P<0.05), loudness visual analog scale (VAS) (F=20.48, P<0.001), and the proportion of patients with moderate to severe tinnitus(χ(2)=11.289, P<0.05) in the group A, and there was no significant change in group B(F=2.198, F=0.989, χ(2)=1.651; P=0.120, P=0.378, P=0.438>0.05). Conclusions: Our resultssuggest that long-term normalized listening to tailor-made notched music, can significantly reduce the perceived tinnitus loudness in varying degrees and improve the quality of life of patients. The effects and possible mechanism of this method were discussedin this paper.
目的： 应用定制音乐疗法对慢性特发性耳鸣患者进行个体化干预，并与现有耳鸣声治疗方法进行疗效比较。 方法： 研究对象为2015年6月至2016年10月就诊于北京海军总医院的不明原因、伴有或不伴有感音神经性聋，病程≥6个月的耳鸣患者43例(75耳)。采用前瞻性设计，将其随机分为个体化干预组(A组22例，39耳)和类掩蔽组(B组21例，36耳)进行为期3个月的声治疗。治疗前、治疗中1个月及3个月分别对其进行耳鸣量表、耳鸣响度及听力学评估。以SPSS16.0软件对数据进行统计学分析。 结果： 经过1个月的规律治疗，两组间有效率分别为40.9%和42.9%，组间差异无统计学意义(χ(2)＝0.017，P＝0.897)，A组患者的耳鸣平均响度值较B组有更多下降(VAS下降1.8比0.8，下降百分比为29.5%比13.6%)，但差异无统计学意义(t＝－1.450，P＝0.155)。治疗3个月后两组有效率分别为68.2%和23.8%，组间差异有统计学意义(χ(2)＝8.503，P＝0.004)；组间响度视觉模拟量表(VAS)比较，差异有统计学意义，A组占优(t＝－3.263，P＝0.002)；组内耳鸣匹配响度比较，A组治疗前后差异有统计学意义(t＝5.569，P<0.01)，B组未见明显变化(t＝－0.953，P＝0.374)，且随治疗时间的累积A组耳鸣残疾量表(THI)得分(F＝7.334，P<0.05)、VAS(F＝20.48，P<0.01)及中重度耳鸣患者的比例(χ(2)＝11.289，P<0.05)也显著减少，B组未见明显变化(F值分别为2.198、0.989，χ(2)值为1.651；P值均>0.05)。 结论： 长时程规范聆听经个体化处理的定制音乐，可显著减轻患者的耳鸣响度，不同程度地改善耳鸣对患者生活质量造成的影响。.
Keywords: Individuation; Music therapy; Prospective study; Sound treatment; Tinnitus.