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首页> 外文期刊>Frontiers in Psychology >Bimodal Therapy for Chronic Subjective Tinnitus: A Randomized Controlled Trial of EMDR and TRT Versus CBT and TRT
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Bimodal Therapy for Chronic Subjective Tinnitus: A Randomized Controlled Trial of EMDR and TRT Versus CBT and TRT

机译：慢性主观耳鸣的双峰治疗：EMDR和TRT与CBT和TRT的随机对照试验

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Introduction: To date, guidelines recommend the use of a stepped care approach to treat tinnitus. The current clinical management of tinnitus frequently consists of audiologic interventions and Tinnitus Retraining Therapy (TRT) or Cognitive Behavioral Therapy (CBT). Due to the high heterogeneity of the tinnitus population and comorbidity of tinnitus with insomnia, anxiety and depression, these interventions may not be sufficient for every patient. The current study aims to determine whether a bimodal therapy for chronic, subjective tinnitus consisting of the combination of TRT and Eye Movement Desensitization Reprocessing (EMDR) results in a clinically significant different efficacy in comparison with the prevailing bimodal TRT and CBT therapy. Methods: Patients were randomized in two treatment groups. The experimental group received the bimodal therapy TRT / EMDR and the active control group received the bimodal therapy TRT / CBT. Evaluations took place at baseline (T0), at the end of the treatment (T1) and 3 months after therapy (T2). The Tinnitus Functional Index (TFI) was used as primary outcome measurement. Secondary outcome measurements were the Visual Analogue Scale of tinnitus loudness (VASLoudness), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale (HADS), Hyperacusis Questionnaire (HQ), Global Perceived Effect (GPE), and psychoacoustic measurements. Findings: The TFI showed clinically significant improvement in both bimodal therapies (mean decrease 15.1 in TRT / CBT; p .001 vs. 16.2 in TRT / EMDR; p .001). The total score on the TQ, HADS, HQ, and VASLoudness all demonstrated significant decrease after treatment and follow-up (p .001) in the experimental and the active control group. GPE-measurements revealed that more than 80% (i.e. 84% in TRT/CBT vs. 80% in TRT/EMDR) of the patients experienced substantial improvement of tinnitus at follow up. Treatment outcome remained stable after three-month follow-up and no adverse events were observed. Conclusion: Both psychotherapeutic protocols result in a clinically significant improvement for patients with chronic subjective tinnitus. No significant different efficacy was found for the TRT/EMDR treatment compared to the combination of TRT and CBT. Trial registration: ClinicalTrials.gov, ID: NCT03114878. April 14, 2017.
机译：简介：迄今为止，指南建议使用步进护理方法来治疗耳鸣。目前耳鸣的临床管理经常由听力干预和耳鸣再培训治疗（TRT）或认知行为治疗（CBT）组成。由于耳鸣种群的高异质性和耳鸣的耳鸣，焦虑和抑郁症，每个患者可能都不足够。目前的研究旨在确定对Trt和眼部运动脱敏的组合组成的慢性主观耳鸣的双峰治疗是否导致临床上具有临床显着的不同疗效，与普遍的双峰Trt和CBT疗法相比。方法：患者在两个治疗组中随机化。实验组接受了双峰治疗TRT / EMDR，活性对照组接受了双峰治疗TRT / CBT。评估在基线（T0），治疗结束时（T1）和治疗后3个月（T2）。耳鸣功能指数（TFI）用作主要结果测量。次要结果测量是耳鸣响度（Vasloudness），耳鸣调查症（TQ），医院焦虑和抑郁症（HAS），Hyperacusis问卷（HQ），全局感知效果（GPE）和心理声学测量的视觉模拟等级。结果：TFI在双模疗法中显示出临床显着改善（TRT / CBT中的平均减少15.1; P <.001对16.2在TRT / EMDR中; P <.001）。在实验和活性对照组中处理和随访后，TQ，HAS和Vasloudness的总分均显示出显着降低（P <.001）。 GPE测量显示，患者的大于80％以上（即TRT / CBT与TRT / EMDR中的84％）经历了随访时耳鸣的大量改善。在三个月的随访后，治疗结果保持稳定，并且没有观察到不良事件。结论：两种心理治疗方案均导致慢性主观耳鸣患者临床显着改善。与TRT和CBT的组合相比，没有发现TRT / EMDR治疗的显着不同的疗效。试用注册：ClinicalTrials.gov，ID：NCT03114878。 2017年4月14日。

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