A Research On Assessment Of Tinnitus Treatment Effectiveness And Clinical Significance Of TCM Treatment

Objectives of research1. Through the detailed investigations to 219 tinnitus patients and the data collection of their Chinese four diagnosis results, the researcher studies the feature of tinnitus, and find out a reasonable criterion of judging tinnitus.2. To study and observe the effects and treatments of Chinese medicine to tinnitus, which is under the scientific design, and establishes the basis for studying the treatment of tinnitus and the author digs out the advantages of Chinese medicine for treating tinnitus.Content of the research and MethodologyIn the first research, the author collected the detailed data and examined results of 219 tinnitus patients which have the chief complaint of ear ring in the first applicant Hospital of Guangzhou TCM University, and analyzed those statistics to find out the clinic features of tinnitus. By using the tinnitus scoring method and THI scoring system to evaluate the disease, and study a reasonable assessment to tinnitus.In the second research, on the basis of detailed investigating and wholly examining to 69 patients, the researcher did the Chinese medicine integrated treatment, and studied the current situation, the advantages and some must-be improved elements of tinnitus in China are obvious by comparing with another group with 34 patients which is under the western medicine integrated treatment in one treatment period of 30 days.Results1. Clinical features of tinnitus: there are 174 patients, whose ages arebetween 21 and 60, accounting for 79. 45%. Tinnitus with high-pitched tone is in large proportion with153 people occupying 69. 9%, and there is no correlation between tinnitus loudness self-evaluation and loudness matching (P>0. 05). The value of tinnitus loudness matching has an effective reflection on patients' subjective perception of pitch (P<0.05). However, the value of tinnitus loudness matching doesn' t have a reflection on loudness of patients' subjective perception. The majority of 139 cases (63.5%) is with obvious inducement, among which there are 31 (14. 6%) suffering from mental strain. The degree of tinnitus seriousness is correlated with emotional changed and dyssomnia interrupted by tinnitus and self-perception of loudness (the scores from self-perception of tinnitus) (P<0. 05). There is no correlation among age, lasting of disease, gender, tone matching of tinnitus and loudness matching (P>0.05). The symptom of tinnitus in TCM aspect is mostly reflected as the following perspectives: the week spleen and stomach with 102 cases (47%), phlegm with 44 cases (20%), depression of hepatic qi with 40 cases (18%), damage of kidney-essence with 27 cases (12%), affection of exogenous wind-heat with 6 cases (3%). These types are with no statistical difference with age, tinnitus loudness and pitch matching (P>0. 05). By comparing tinnitus pitch between the group of stencil syndrome and asthenia syndrome, the group of asthenia syndrome is higher (P<0. 05).2. In this research, 50. 7% of patients with tinnitus and hearing loss may have correlation. Among the 50. 7% correlated, 29. 2% have significant correlation and 21. 5% may have correlation. Among the 49. 3% uncorrelated, 31. 5% are with normal hearing; 17.8% with hearing loss and tinnitus are not significantly correlated.3. The correlated coefficient between the tinnitus assessment methods and THI is 0.73(P<0.001). The degree of tinnitus gravity measured by the tinnitus assessment methods is positively correlated with THI scores. After the tinnitus assessment methods scaling, tinnitus assessment scores of every scale, THI scores, functional scores, emotional scores and scores of seriousness are increased with the increasing scaling of tinnitus degree. According to ANOVA, there is statistical difference between scores of tinnitus assessment and every two scales (P<0.001). In THI and its three subitems, there is no statistical difference between , Levelâ… ,â…¡and Levelâ…£,â…¤(P>0. 05). There is statistical difference between the rest scales (P<0. 001). The correlation between scores of tinnitus assessment and the six indexes is as follows: tinnitus influenced by moods (0.766), the self-perception scores on tinnitus seriousness (0.743), the influence of tinnitus to work and life (0.739), the influence of tinnitus to sleeping (0. 622), the environment of tinnitus (0. 376) and the lasting of tinnitus (0.284).4. There is great difference between the group of western-style medicine and TCM. The rate of cure of the latter group is 4. 35%, with obvious effect 10.14%, with effect 43.48%. With a global effectiveness of 57.97% is higher than the control group of 26. 47%, (P<0. 05).5. The group of TCM made a statistical analysis for three groups with different treating time and they got three different rates of effectiveness: one period of treatment with 57.97%, two periods of treatment with 80% and more than two periods of treatment with 76.92%. The effectiveness of two periods is much higher than one period of treatment and the statistics have statistical difference (P<0. 05). The effectiveness of more than two periods of treatment is higher than the one period of treatment, but the statistics have no statistical difference (P>0.05)6. The group of TCM, the scores of the six subitems after the treatment are lower than those before treatment, P<0.05 The improved value of the six items can be done with multiple regression, among which, the effect of treatment can be defined as Y, the improved emotional index, improved sleeping index, improved time index and improved environment group can be defined as X₁, X₂, X₃, X₄, and X₅ respectively. A regression equation can be like this;Y=3.879-0. 298X₁-0. 281X₂-0. 27X₃-0.184X₄-0.194X₅Conclusion1 Through this research, the researcher discovers that tinnitus has its specific clinic features such as age, loudness, influenced causes, traditional medicine feature, hearing damage, during its appearance, development, and changing processes. All those deserve our further study.2 Both the tinnitus scoring method and THI scoring system have the same theoretical basis, and both of them have the good result correlation. But the tinnitus scoring method is simpler and concise, and easier to use and grasp, it is a practical and scientific assessment method.3 Tinnitus treatments which are under TCM have more advantages. Compared to the Western medicine integrated treatment, the Chinese medicine integrated treatment has better effects. In one treatment period, the efficiency rate is 57.97%, and it deserves our research to find our benefits of the TCM treatment.4. In the TCM treatment group, the effectiveness of two periods is much higher than one period of treatment. It is likely to be related with periods of treatment, which can be helpful for further research. The effectiveness of more than two periods of treatment (76. 92%) is higher than the one period of treatment (57.97%), but the statistics have no statistical difference. Maybe it is related with the sample of the group of more than two periods (13 cases). More samples should be considered in future study. The effectiveness of the group of two periods of treatment (80%) is close but higher than the effectiveness of the group of more than two periods of treatment (76.92). It is likely to be related with the sample (13 cases). Further study scheme can be designed in future research.5. The influence of sleeping and emotion plays a key role in both the tinnitus seriousness degree and the period of treatment, which implies the function of the psychological guidance and adjustment of sleeping in treatment of tinnitus.