| Tinnitus is a condition in which there is no objective sound and self-sensing sound exists in the outside world.It can exist in the pathogenesis of many diseases,or it can exist alone.When it exists,it causes people's troubles such as life,emotions,and sleep.When can't determining the obvious cause,it is called primary subjective tinnitus.The incidence of tinnitus varies from 5%to 30%.Although it is concerned about the severity of its tinnitus,it is one of the three major diseases of otitis with poor efficacy.Chinese medicine believes that tinnitus is caused by wind-heat,phlegm-heat,liver fire and other real evils,resulting in poor circulation or blood stasis in the meridians,blood and body fluids can not be deafness,or spleen deficiency,insufficiency of kidney essence,etc.Blood fineness is not enough to raise hearing loss and cause tinnitus.Tinnitus affects the patient's sleep status and is a symptom often complained by the patient.Long-term disturbance of tinnitus is more detrimental to sleep status,and patients with longer tinnitus complain of poor sleep status.Traditional Chinese medicine theory advocates the concept of wholeness.Historical doctors look for the pathogenesis of tinnitus from the liver,heart,spleen,lungs,and kidneys.The pathological manifestations of tinnitus,whether caused by actual evils or deficiency damage,do not appear only in tinnitus,when long-term or sudden tinnitus disturbs the human body's yin and yang balance,it will inevitably affect the body's visceral function,such as sleep,emotions,etc.When the tinnitus patient's sleep status problems,the entire the yin and yang balance system has been disrupted,and through the improvement of sleep,we are also adjusting the yin and yang balance of the entire body to adjust the status of tinnitus.Tinnitus is difficult to measure because of its subjective nature.With the development of modern medicine,many examination methods can measure the degree of tinnitus.However,the annoying and annoying manner of tinnitus on patients is usually assessed by subjective scales;Sleep is also a person's internal brain activity.With the research on sleep science in recent years,more and more inspection methods have some objective understanding of people's sleep status through the detection of different signals from the human body.In the study,it was found that sleep does not merely play a role in restoring physical strength and brain power.It is inextricably linked with chronic diseases in many physiological and pathological aspects.Subjective tinnitus is an internal stimulus,and how does it stimulate sleep?It is not clear that each patient has different descriptions of the sleep disturbances associated with tinnitus.Starting from objective sleep conditions,we hope to explore the relationship between tinnitus and sleep,and find out the factors that are related to each other clinically.This can provides some help to treating tinnitus with sleep disorders.We can through objective and subjective evaluation of the severity of deficiency syndrome deaf tinnitus and sleep status,and we can better understand whether or not this condition exists objectively in patients,and what the sleeping condition is different from the normal people.Objective:Including Tinnitus Handicap Inventory(THI),Pittsburgh Sleep Quality Index(PSQI),Cardiopulmonary Coupling(CPC)of tinnitus patients with subjective non acute deficiency and actual syndrome in this study,the subjective tinnitus severity,subjective sleep quality evaluation and objective evaluation of sleep were retrospectively analyzed,explore the relationship between subjective tinnitus severity(THI)and subjective sleep quality(PSQI)of deficiency and actual syndrome of tinnitus patients,explore the objective sleep structure and sleep quality of tinnitus with deficiency syndrome,explore the relationship between subjective tinnitus severity(THI)and objective sleep quality evaluate(CPC)of tinnitus patients with deficiency syndrome.To provide objective data for study of TCM clinical tinnitus and sleep,adjust the balance of yin and Yang of the body from the angle of sleep,to treat tinnitus,tinnitus and sleep condition exist at the same time provide basis for overall intervention;reasonable way of life to guide patients to improve sleep,thereby improving tinnitus status;provide direction for tinnitus retraining therapy,cognitive behavioral therapy intervention case,so as to improve the treatment of tinnitus,tinnitus patients relieve pain,improve the quality of life of patients with tinnitus.Research methods:Storage to meet the requirements of the complaint is more than 3 months the subjectivity of non acute tinnitus.Inquire about the history of disease by two attending doctors or higher than attending doctors according to the patient's symptoms to identify TCM syndromes,and the patients according to their symptoms independently complete Tinnitus Handicap Inventory(THI)and Pittsburgh Sleep Quality Index(PSQI),deficiency syndrome tinnitus with Cardiopulmonary Coupling(CPC),collected data for statistical analysis.The actual situation of two card THI score and PSQI score of each factor through correlation analysis,the THI sleep score and other factors with CPC indices were analyzed.The statistical method used independent sample t test between two sets of data.The paired t test was used for comparison between the groups.Variance analysis was used among the multiple groups.Correlation analysis between the two groups was conducted by Pearson correlation analysis.The difference of P?0.05 was statistically significant,and the difference of P<0.01 was statistically significant.Results:A total of 107 patients with subjective non acute tinnitus were included,including 86 cases of deficiency syndrome and 21 cases of actual syndrome.There were 45 males and 62 females.The deficiency and actual syndrome tinnitus patients'THI total score were not statistically significant(P?0.05).The deficiency and actual syndrome tinnitus patients' PSQI total score were not statistically significant(P?0.05).?The total score of PSQI in all tinnitus patients was significant positively correlated with the total score of THI(P?0.01),and the total score of PSQI was significantly positively correlated with the factors of THI(P?0.01).The total score of THI in all tinnitus patients was positively correlated with PSQI's sleep quality and fall asleep time(P?0.01).The total score of THI was positively correlated with PSQI's sleep efficiency and daytime dysfunction(P?0.05).?In deficiency syndrome tinnitus patients,there was a significant positive correlation between the total score of THI and the total score of PSQI(P?0.01).The total score of PSQI was significant positively correlated with the emotion factors and functional factors of THI(P?0.01).In deficiency syndrome tinnitus patients,the total score of THI was significantly positively correlated with sleep quality and fall asleep time in PSQI(P?0.01).The total score of THI was positively correlated with sleep disorders and using of sleep medication in PSQI(P?0.05).?In actual syndrome tinnitus patients,there was a significant positive correlation between total score of PSQI and THI total score(P?0.01),total score of PSQI was significant positively correlated with functional factors(P?0.01),and PSQI total score was positively correlated with catastrophic factors(P?0.05).In actual syndrome tinnitus patients,the total score of THI was significant positively correlated with the fall asleep time and daytime dysfunction of PSQI(P?0.01).? deficiency syndrome tinnitus patients were doing CPC evaluation,the relationship between the data of CPC and the mnumber of patients involved in the evaluation:abnormal sleep efficiency accounted for 70.27%,the fall asleep time abnormalities in 67.57%of the patients,abnormal deep sleep proportion accounted for 64.86%,abnormal awakening time accounted for 83.78%,abnormal AHI patients accounted for 56.76%.?Statistical analysis of CPC related sleep data and THI scale showed that there was a significant positive correlation between the fall asleep time of CPC and the total score of THI and its emotional factors and functional factors(P<0.01),and the fall asleep time of CPC was positively correlated with the THI catastrophic factor(P<0.05).?According to the THI grade I(slight)and ?(light)into low group,?(middle),?(severe),?(catastrophic)into severe group,in deficiency syndrome tinnitus low-group THI group,no correlation with fall asleep time and deep sleep proportion and AHI of CPC.In deficiency syndrome tinnitus severe-group THI group,the total score of THI was positively correlated with the fall asleep time(P?0.01).It was not related to sleep efficiency and deep sleep proportion and AHI.Conclusion:?Most of the non-acute tinnitus is actual syndrome tinnitus,and do not exclude the deficiency syndrome tinnitus??The total score of THI and the total score of PSQI are not different from the syndrome types of deficiency and actual syndrome tinnitus.?There was a positive correlation between the total score of THI and the total score of PSQI.The total score of THI was positively correlated with sleep quality,fall asleep time,sleep efficiency and daytime dysfunction in PSQI.?The total score of THI in non-acute tinnitus patients with deficiency syndrome was positively correlated with total PSQI score.The total score of THI was positively related to the factors such as sleep quality,fall asleep time,sleep disorder,and drug intervention in PSQI,and the total score of PSQI was positively correlated with the emotion factors and functional factors of THI.?The total score of THI in non-acute tinnitus patients with actual syndrome was positively correlated with total PSQI scores.The total score of THI was positively correlated with PSQI's fall asleep time and daytime dysfunction.The total score of PSQI was positively correlated with THI's functional factors and catastrophic factors.? The CPC evaluation of non-acute deficiency syndrome tinnitus patients confirmed that the objective sleep problems were true in non-acute tinnitus patients.Abnormal sleep efficiency accounted for 70.27%,the fall asleep time abnormalities in 67.57%of the patients,abnormal deep sleep proportion accounted for 64.86%,abnormal awakening time accounted for 83.78%,abnormal AHI patients accounted for 56.76%.?The total THI score of non-acute deficiency syndrome tinnitus patients was positively correlated with CPC fall asleep time.It indicates that the more serious the tinnitus is,the longer the fall asleep time is,or the longer the fall asleep time of the tinnitus patients is,the greater the impact on the tinnitus severity.?The total score of severe-group THI in non-acute deficiency syndrome tinnitus patients was positively correlated with CPC fall asleep time.It indicates that the more serious the tinnitus is,the longer the fall asleep time is,or the longer the fall asleep time of the tinnitus patients is,the greater the impact on the tinnitus severity.In conclusion,the severity of subjective tinnitus has a certain correlation in subjective sleep assessment and objective sleep assessment.The higher the subjective degree of subjective tinnitus,the more serious the subjective sleep disorder is,the worse the objective sleep condition is,especially the fall asleep time.In the patients with subjective non acute tinnitus,there is a significant correlation between tinnitus and sleep.Among the patients with more deficiency syndrome,the objective sleep evaluation also confirmed the correlation between the two.But whether the tinnitus interferes with sleep or whether sleep problems affect or cause the tinnitus,or the interrelationship between the two,we need to further explore. |
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