杨学平 何茹

【摘要】 耳鸣（tinnitus）是最常见的听力障碍之一，与其发生有关的危险因素广泛。耳鸣可能以多种方式对一个人产生影响，心理方面的影响通常是最明显、最深刻的。耳鸣可以影响人的情绪和睡眠状态，耳鸣患者易出现抑郁焦虑及失眠症状，导致生活质量下降。同时，抑郁焦虑等也是耳鸣发病的危险因素之一，能给患者带来严重的不良后果。而目前的现状是往往低估和忽视了抑郁焦虑等对预后不良的作用，这可能导致不正确的治疗方法或治疗启动的延迟。所以，建议在临床工作中应进行抑郁焦虑的筛查及睡眠情况的监测，以便及时予以干预和治疗。而耳鸣与异常心理状态关联密切的原因，研究证实可能与大脑形态结构的变化、人格特征及药物应用等有关。对于耳鸣和心理障碍的治疗方面，目前除了药物治疗外，佩戴助听器或耳鸣控制仪器的声学疗法及物理治疗、心理治疗，都是目前应用较多并被研究证实有效的治疗方法，但将来仍需要进一步的研究探讨及确定有效性和具体模式。

【关键词】 耳鸣 心理状态 治疗

[Abstract] Tinnitus is one of the most common hearing impairments and a lot of risk factors are associated with it. Tinnitus can affect a person in many ways， and the psychological effects are often the most obvious and profound. Tinnitus can affect peoples mood and sleep state， and tinnitus patients are prone to have depression， anxiety and insomnia symptoms， a decline in quality of life. Depression and anxiety are also one of the risk factors for tinnitus， leading to serious adverse consequences for patients. Now the adverse effects of depression and anxiety on prognosis is often underestimated and ignored， which can lead to incorrect treatment or delay in the initiation of treatment. Therefore， it is recommended that depression and anxiety screening and sleep monitoring should be carried out in clinical work， in order to take intervention and treatment timely. The reasons why tinnitus is closely related to abnormal psychological state have been confirmed to be related to changes in brain morphological structure， personality characteristics and drug use. For the treatment of tinnitus and psychological disorders， in addition to drug treatment， acoustic therapy such as hearing aids or tinnitus control instruments， physiotherapy and psychotherapy are currently more used and proven to be effective methods， but the further research is also needed to determine the effectiveness and specific patterns of treatment in the future.

[Key words] Tinnitus Psychological state Treatment

First-authors address： The Peoples Hospital of China Medical University （The Peoples Hospital of Liaoning Province）， Shenyang 110016， China

doi：10.3969/j.issn.1674-4985.2021.09.044

耳鳴（tinnitus）是在没有外部来源的情况下对声音的感知，是最常见的听力障碍之一。与耳鸣发生有关的危险因素广泛，如年龄、听力损失、噪音暴露、炎症性疾病、耳肿瘤、药物、头部或颈椎外伤以及心理障碍（如抑郁和焦虑）[1]。同时，研究证据也提示了耳鸣的遗传性，并且发现在任何年龄的群体中，双侧耳鸣的遗传性较高[2]。……