切迹掩蔽音乐治疗在主观性耳鸣首诊干预中的参数变化特征

宫琴; 林智豪; 陈欢; 方宏宇; 冀飞; 侯志强

doi:10.3969/j.issn.1672-4933.2025.04.004

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切迹掩蔽音乐治疗在主观性耳鸣首诊干预中的参数变化特征

耳鸣研究 | 更新时间：2025-07-15

- 切迹掩蔽音乐治疗在主观性耳鸣首诊干预中的参数变化特征
- Characteristics of Parameter Changes in the Initial Intervention with Tailor-made Notched-Masking Music Training in Subjective Tinnitus
- 中国听力语言康复科学杂志 2025年23卷第4期页码：360-366
- 作者机构：
  
  1.清华大学生物医学工程学院北京 100084
  2.天津工业大学生命科学学院天津 300387
  3.安徽工程大学电气工程学院安徽 214000
  4.解放军总医院第六医学中心耳鼻咽喉头颈外科医学部北京 100853
  5.山东大学，山东省耳鼻喉医院耳鸣疾病科济南 250022
- 作者简介：
  
  宫琴，博士副教授；研究方向：听觉系统的检测康复和认知工程 E-mail：gongqin@mail.tsinghua.edu.cn
- 基金信息：
  
  “十四·五”国家重点研发计划“诊疗装备与生物医用材料”耳鸣评估诊断治疗设备的研发及产业化(2023YFC2416200)
- DOI：10.3969/j.issn.1672-4933.2025.04.004
  中图分类号： R764.45
- 收稿日期：2025-03-19，
  
  纸质出版日期：2025-07-15
- 稿件说明：
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宫琴,林智豪,陈欢等.切迹掩蔽音乐治疗在主观性耳鸣首诊干预中的参数变化特征[J].中国听力语言康复科学杂志,2025,23(04):360-366.

GONG Qin,LIN Zhi-hao,CHEN Huan,et al.Characteristics of Parameter Changes in the Initial Intervention with Tailor-made Notched-Masking Music Training in Subjective Tinnitus[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2025,23(04):360-366.
宫琴,林智豪,陈欢等.切迹掩蔽音乐治疗在主观性耳鸣首诊干预中的参数变化特征[J].中国听力语言康复科学杂志,2025,23(04):360-366. DOI： 10.3969/j.issn.1672-4933.2025.04.004.

GONG Qin,LIN Zhi-hao,CHEN Huan,et al.Characteristics of Parameter Changes in the Initial Intervention with Tailor-made Notched-Masking Music Training in Subjective Tinnitus[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2025,23(04):360-366. DOI： 10.3969/j.issn.1672-4933.2025.04.004.

摘要

目的

探讨个性化切迹掩蔽音乐疗法（tailor-made notched-masking music training，TNMMT）在短期首诊干预治疗中量表和行为学参数的变化特征，为主观性耳鸣首诊干预中具有疗效表征的参数变化标准提供参考。

方法

采集2023年07月～2024年12月在国内20余家医疗机构首次就诊的主观性耳鸣患者1083例（1514耳），其中高频（≥3000 Hz）耳鸣患者764例（1092耳）。患者就诊时，首先由医师详细询问耳鸣病史并采集患者治疗前的耳鸣量表；通过调节耳鸣康复治疗仪中的音调、响度和宽度3个参数对患者耳鸣音进行匹配，选用匹配患者耳鸣音的个性化切迹掩蔽治疗声对患者进行10 min治疗。采集患者主观量表数据，包括耳鸣致残量表（tinnitus handicap inventory， THI）、视觉模拟量表（visual analogue scale， VAS）和耳鸣的行为学参数，包括音调、响度、宽度和残余抑制（residual inhibition， RI）时间等数据。通过患者治疗前后视觉模拟量表（VAS for loudness，VAS_L；VAS for anxiety，VAS_A）数据分别作为对照组和治疗组数据进行分析，并结合残余抑制RI确定匹配参数和治疗方案的有效性。

结果

治疗前患者VAS_L和VAS_A平均分数分别为4.5±1.8和3.9±2.0；治疗10 min后，得分分别降至3.3±1.8和2.9±1.8；治疗前后VAS_L和VAS_A得分均显著降低（

0.001）。在治疗后，1265（83.6%）耳的RI时长超过2 s，1065（70.3%）耳RI时长超过10 s。患者自述耳鸣音完全消失195（12.9%）耳，耳鸣音明显减轻1064（70.3%）耳。高频耳鸣患者自述耳鸣音完全消失124（11.4%）耳，耳鸣音减轻793（72.6%）耳。

结论

基于量表和行为学参数，TNMMT的治疗参数及方案对于不同频率、响度和严重程度的主观性耳鸣患者均表现出显著的变化特征和相关性；超过58%的主观性耳鸣患者在首诊干预后，呈现出有效或显效的疗效，RI时长≥40 s。为TNMMT的临床应用提供了可靠证据，并为未来深入了解耳鸣干预机制和优化干预方案奠定了基础。

Abstract

Objective

To investigate the characteristics of changes in scale and behavioral measures following short-term initial intervention with Tailor-made Notched-Masking Music Training (TNMMT) in subjective tinnitus

providing clinical assessment for establishing efficacy evaluation criteria in the initial intervention of subjective tinnitus.

Methods

We analyzed data from 1

083 initial intervention subjective tinnitus patients (1

514 ears) enrolled in over 20 medical institutions in China between July 2023 and December 2024

including 764 cases (1

092 ears) of high-frequency (≥3

000 Hz) tinnitus. During the visit

physicians first collected detailed tinnitus histories and pre-treatment tinnitus scales. The tinnitus sound perceived by the patients was then matched to the output of the "Tinnitus Rehabilitation Therapy Device" by adjusting three parameters—pitch

loudness

and bandwidth. A personalized notched masking sound was then tailor-made to the patient based on the above parameters. Subsequently

patients underwent a 10-minute TNMMT session. Subjective scale data (including the Tinnitus Handicap Inventory

THI

and Visual Analog Scale

VAS) and behavioral measures (pitch

loudness

bandwidth

and Residual Inhibition

RI) were collected. Finally

pre- and post-treatment VAS scores (VAS for loudness

VAS_L and VAS for anxiety

VAS_A) were compared and combined with RI to determine the effectiveness of the treatment protocol with the matching parameters.

Results

Before treatment

the mean VAS_L and VAS_A scores were 4.5±1.8 and 3.9± 2.0

respectively. After 10 minutes of treatment

the scores decreased significantly (P<0.001) to 3.3±1.8 and 2.9±1.8. Post-treatment

RI exceeded 2s in duration in 1

265 ears (83.6%) and 10s in 1

065 ears (70.3%). Patients reported complete tinnitus disappearance in 195 ears (12.9%) and significant reduction in 1

064 ears (70.3%). Among high-frequency tinnitus patients

complete tinnitus disappearance was reported in 124 ears (11.4%)

and tinnitus reduction reported in 793 ears (72.6%).

Conclusion

The TNMMT protocol with matched parameters used in this study induced significant changes and correlation across tinnitus patients with varying frequencies

loudness levels

and severity. More than 58% of patients with subjective tinnitus showed "significantly effective" or "effective" efficacy and the duration of RI was greater than or equal to 40 seconds after the first intervention. This study provides reliable evidence for the clinical application of TNMMT

and lays a foundation for in-depth understanding of tinnitus intervention mechanism and optimization of intervention programs in the future.

关键词

Keywords

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