The Study Of The Correlation Between Tinnitus And Hearing Loss From The Overall View Of Traditional Chinese Medicine

ObjectiveTinnitus and hearing loss are often accompanied.Based on this,some scholars presume that the cause of hearing loss is same with that of tinnitus.The clinical result of treating tinnitus through the method of treating deafness is not satisfactory.This article explores the correlation between tinnitus and hearing loss from the holistic perspective of TCM,trying to explore the true cause of tinnitus and provide a new view for seeking more effective treatments for tinnitus.MethodsA total of 634 patients with tinnitus and/or hearing loss were clinically surveyed,and general information was recorded.The clinical features of the course,location,tone,adverse effects,and severity of tinnitus and hearing loss were analyzed.The ears and time correlation of tinnitus and hearing loss were further discriminated,and pure tone audiometry,otoacoustic emission,tinnitus pitch and loudness match were also conducted.Statistical methods were adopted for analysis.Results1.Among the 634 cases,137(21.6%)was diagnosed with simple tinnitus,52(8.2%)simple hearing loss,and 445(70.2%)hearing loss with tinnitus.The average age of tinnitus patients was lower than the hearing loss patients(P<0.05);the patients with tinnitus group were better-educated(P<0.05),and the proportion of mental workers was higher(P<0.05).2.Clinical characteristics of tinnitus and its relationship with hearing loss Among the 582 patients with tinnitus,there was no significant difference in the level of different tinnitus,sounding position,tone,severity and hearing loss(P>0.05).Tinnitus matching was mostly highly-frequent:high frequency accounted for 59.5%(377 cases),intermediate frequency accounted for 22.2%(141 cases),low frequency accounted for 8.8%(56 cases),and unmatched ones accounted for 1.37%(8 cases);tinnitus loudness match≤there were 475 cases(81.62%)with 6dB SL;there was no significant difference between the perceived loudness and the matched loudness of tinnitus(P>0.05).The proportion of hearing loss in the quiet environment was significantly lower than that in general environment and in any environment(P<0.05);the degree of influence of tinnitus on sleep,mood,and attention was statistically different.Most patients had lower mood,which was worse than the effect on sleep and attention(P<0.05).3.The clinical characteristics of hearing loss and the relationship with tinnitus Among 497 patients with hearing loss,only 283 patients’ course of disease was defined.There was no significant difference between tinnitus of below 6 months and over 6 months(P>0.05).The ratio of sensorineural hearing loss combined with tinnitus was higher than that of conductive sputum and mixed sputum(P<0.05),but there was no significant difference in the matching frequency distribution between three types of hearing loss and tinnitus(P>0.05);The proportion of hearing loss and tinnitus was statistically different(P<0.05),the proportion of patients with mild hearing loss combined with tinnitus was the highest(94%),and the proportion of patients with severe hearing loss with tinnitus was the lowest(75%),indicating that the lighter the degree of hearing loss,the higher the proportion of combined tinnitus.4.Analysis of the correlation between tinnitus and hearing loss Among the 634 patients,93 cases were related to tinnitus and hearing loss,accounting for 14.6%;441 cases were unrelated,accounting for 69.6%;100 cases were uncertain,accounting for 15.80.5.Tinnitus and hearing-related examinations The matching frequency of 408 cases of sensorineural hearing loss and the frequency of the most serious hearing loss was only 22.5%,and the frequency of tinnitus and the most severe adjacent hearing loss was 18.1%.The inconsistency was as high as 59.3%.The undetected rate of otoacoustic emission in the simple tinnitus group was much lower than that in the hearing loss group(P<0.05).The tinnitus and hearing loss were included as risk factors in the binary logistic regression model,and the differences in undetected otoacoustic emissions were analyzed.Hearing loss was shown to be an independent risk factor for undetected otoacoustic emissions(OR=13.484),and tinnitus was not an independent risk factor for undetected otoacoustic emissions.Conclusion1.The incidence of tinnitus and hearing loss is 70.2%,but only 14.6%of those are with related tinnitus and hearing loss,69.6%unrelated,and 15.8%uncertain.It shows that tinnitus is related with hearing loss only a minority.Most tinnitus is not related to hearing loss,which means that the reasons may be different.The hearing loss is caused by local lesions in the ear.Tinnitus has another reason.It is likely that it is related to the overall dysfunction of the viscera and deserves further study.2.The course,location,tone,severity,etc.of tinnitus are not significantly related to hearing loss.It may be unreliable to locate the lesions of tinnitus according to the audiological examination and according to the characteristics of tinnitus tone and loudness as the basis of TCM syndrome differentiation.3.The distribution of tinnitus and hearing loss is different:compared with those with hearing loss,the average age of tinnitus is lower,and the degree of education is higher.There are more people engaged in mental work,and the pressure may be greater,which may affect the organs.Hearing loss leads patients to hear less external sounds,and thus they may be more likely to detect tinnitus than people with normal hearing,which may be one of the reasons why tinnitus and hearing loss are easily combined.