目的:研究各种非侵入性治疗技术(NIT)在慢性耳鸣管理中的相对有效性。
方法:我们搜索了PubMed,Embase和Cochrane图书馆数据库从数据建设到2022年12月31日。根据系统评价和荟萃分析指南的首选报告项目,NIT进行了评估,包括接受和承诺疗法(A),认知行为疗法(C),声音疗法(S),经颅磁刺激(T),电刺激治疗(E),虚拟现实疗法(V),耳鸣再训练疗法(R),一般心理治疗(D),和安慰剂(P)。结果指标包括耳鸣障碍量表(THI),耳鸣问卷(TQ),医院焦虑抑郁量表-焦虑抑郁(HADS-D),失眠严重程度指数(ISI),视觉模拟刻度-响度(VAS-L),和视觉模拟比例尺(VAS-D)。使用Stata14.0对NMA进行统计分析。
结果:本系统综述和荟萃分析包括22项随机对照试验,包括2,354名患者。治疗效果在每个量表上有所不同。对于THI,S(86.9%)是最有效的,而P(6.5%)最差。对于TQ,C(89.5%)是最有效的,而D(25.4%)最差。对于HADS-D,A(82.4%)是最有效的,而D(9.47%)最差。对于ISI,A(83.2%)是最有效的,而R(20.6%)最差。对于VAS-L,S(73.5%)是最有效的,而E(18.9%)最差。对于VAS-D,C(84.7%)是最有效的,而P(18.1%)最差。
结论:声学和认知行为疗法的结合可能是慢性耳鸣患者的有效治疗方法。
方法:问题有多普遍?2级。此诊断或监测测试是否准确?(诊断)1级。如果我们不添加治疗会发生什么?(预后)1级。这种干预有帮助吗?(治疗益处)1级。什么是常见的危害?(治疗危害)1级。什么是罕见的危害?(治疗危害)1级。这个(早期检测)测试值得吗?(筛选)1I级。
OBJECTIVE: To investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management.
METHODS: We searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA.
RESULTS: This systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst.
CONCLUSIONS: The combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus.
METHODS: How common is the problem? Level 2. Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1. What will happen if we do not add a therapy? (Prognosis) Level 1. Does this intervention help? (Treatment Benefits) Level 1. What are the COMMON harms? (Treatment Harms) Level 1. What are the RARE harms? (Treatment Harms) Level 1. Is this (early detection) test worthwhile? (Screening) Level 1I.