1.河北大学附属医院 2.耳鼻喉科;3.保定市第二医院 4.
摘要：目的 通过对急性耳鸣、亚急性耳鸣、慢性耳鸣三组高调耳鸣患者药物治疗前后畸变产物耳声发射（DPOAE）反应幅值变化及三组不同发病时长高调耳鸣患者药物治疗前后DPOAE反应幅值差值结果的分析，了解药物治疗对高调耳鸣患者DPOAE反应幅值的影响及分析药物疗效与疾病发病时长的关系。方法 按发病时长将听力正常高调耳鸣患者分为三组，急性耳鸣组（病程≤3个月），25例（27耳）；亚急性耳鸣组（3﹤病程≤12个月），23例（26耳），慢性耳鸣组（病程>12个月），20例（24耳），对三组患者检测其DPOAE反应幅值，通过药物治疗两周后，再次测量三组患者DPOAE反应幅值，初步评估药物治疗对耳鸣患者DPOAE反应幅值的影响和药物疗效与疾病发病时长的关系。结果 三组患者在药物治疗两周后，其在0.500~1.000 KHz频点DPOAE反应幅值的变化以及DPOAE反应幅值变化差值比较差异均无统计学意义，但在 2.000～8.000KHz 频点，除第三组患者在6 .000 、8 .000 kHz治疗前后DPOAE 反应幅值的变化无统计学意义外，其余每组患者经药物治疗后，DPOAE 反应幅值的改变以均具有统计学意义（P＜0.05），且三组患者治疗前后 DPOAE 反应幅值的差值比较亦有统计学意义（P＜0.05）。三组患者在治疗前后DPOAE引出率变化，在0.500-1.500KHz 频点无统计学意义；在2.000～8.000KHz 频点有统计学意义，但第三组患者在6 .000 、8 .000 kHz频点除外。经药物治疗后，三组患者有效率分别为，第一组患者有效率100 %，第二组患者有效率65.38 %)，第三组患者有效率29.17%。三组间比较治疗的有效率, 差异有统计学意义(χ2 =19.38 ,P <0 .01)。结论 给予高调耳鸣患者予以改善内耳微循环等药物治疗是一种有效的治疗方法，发病时长越短，治疗后DPOAE反应幅值提高越大，且治疗后有效率越高，表明病程越短、疗效越佳，让其早发现、早干预，提高治愈率，以改善患者的生活质量。
Abstract: Objective To analyze the changes in the response amplitude of distortion product otoacoustic emissions (DPOAE) before and after drug treatment in three groups of high-profile tinnitus patients with acute tinnitus, subacute tinnitus, and chronic tinnitus, and the amplitude of DPOAE response in three groups of high-profile tinnitus patients with different onset duration before and after drug treatment Analysis of the difference results, to understand the influence of drug treatment on the DPOAE response amplitude of patients with high-profile tinnitus, and to analyze the relationship between drug efficacy and the duration of the disease. Methods According to the duration of onset, the patients with normal hearing and high-profile tinnitus were divided into three groups: acute tinnitus group (disease duration ≤ 3 months), 25 cases (27 ears); subacute tinnitus group (3 ﹤ disease course ≤ 12 months), 23 cases ( 26 ears), chronic tinnitus group (disease duration> 12 months), 20 cases (24 ears), the three groups of patients were tested for the DPOAE response amplitude, after two weeks of drug treatment, the DPOAE response amplitude of the three groups was measured again, To preliminarily evaluate the influence of drug treatment on the magnitude of DPOAE response in tinnitus patients and the relationship between drug efficacy and the duration of the disease. Results After two weeks of drug treatment, the three groups of patients had no statistically significant differences in the changes in DPOAE response amplitude between 0.500~1.000 KHz and the difference in DPOAE response amplitude. However, at the frequency of 2.000～8.000KHz, except for the change of the DPOAE response amplitude of the third group of patients before and after the 6,000 and 8,000 kHz treatments, the DPOAE response amplitude of each group of patients after drug treatment The changes in DPOAE were statistically significant (P<0.05), and the difference in DPOAE response amplitudes before and after treatment in the three groups was also statistically significant (P<0.05). The changes in the DPOAE elicitation rate of the three groups of patients before and after treatment were not statistically significant at the frequency of 0.500-1.500KHz; there was statistical significance at the frequency of 2.000～8.000KHz, but the third group of patients was at the frequency of 6.000 and 8.000 kHz except points.After drug treatment, the effective rates of the three groups of patients were 100% in the first group, 65.38% in the second group, and 29.17% in the third group. The effective rate of treatment was compared among the three groups, and the difference was statistically significant (χ2 = 19.38, P <0.01). The changes in the DPOAE elicitation rate of the three groups of patients before and after treatment were statistically significant at the frequency of 2.000～8.000KHz, using the χ2 test, P<0.05, but the third group of patients had no elicitation rate before and after the treatment of 6,000 and 8,000 kHz.Conclusion It is an effective treatment method to give high-profile tinnitus patients to improve the inner ear microcirculation and other drugs. The shorter the onset time, the greater the increase in the DPOAE response amplitude after treatment, and the higher the effective rate after treatment, indicating that the shorter the course of the disease, the better the effect. It is better to allow early detection and early intervention to increase the cure rate and improve the quality of life of patients.