嗓音训练辅助治疗小学及幼儿教师声带小结患者的疗效分析

The Efficacy of Voice Behavioral Training for Primary School and Preschool Teachers with Vocal Nodules

康宁;冯淑秀;张文娟;蔡爱卿;

1:厦门医学院附属第二医院耳鼻咽喉科

2:厦门医学院附属第二医院质控科

3:厦门市集美区教育局

摘要
目的探讨嗓音训练辅助治疗对小学、幼儿教师声带小结患者的疗效。方法采用随机整群抽样选取厦门市集美区公立小学、幼儿园教师中患有声带小结者89例,随机分成甲、乙两组,甲组(44例)口服金嗓散结丸治疗2个月,乙组(45例)口服金嗓散结丸联合嗓音训练治疗2个月,选取同期健康体检者50例为正常对照组。所有研究对象在治疗前和治疗结束后2周进行嗓音障碍指数(voice handicap index,VHI)量表评估、嗓音声学分析,比较各组结果。结果甲组、乙组患者治疗后VHI评分较治疗前均降低(P<0.05),乙组治疗后VHI评分接近正常对照组(P>0.05),低于甲组(P<0.05)。甲、乙两组患者治疗后嗓音基频微扰(jitter)、振幅微扰(shimmer)、噪谐比(NHR)均降低,基频(F0)升高(P<0.05),且乙组治疗后F0、jitter与shimmer值接近正常对照组(P>0.05);治疗后乙组F0高于甲组,jitter和shimmer低于甲组(P<0.05);甲组声带小结治愈率为47.73%(21/44),乙组治愈率为75.56%(34/45),后者高于前者,差异有统计学意义(P<0.05)。结论口服金嗓散结丸联合嗓音训练治疗小学、幼儿教师声带小结患者的疗效较单纯使用金嗓散结丸效果更佳。
关键词
声带小结;嗓音训练;金嗓散结丸;嗓音声学分析
基金项目(Foundation):
作者
康宁;冯淑秀;张文娟;蔡爱卿;
参考文献

1 Fu S,Theodoros DG,Ward EC,et al.Delivery of intensive voice therapy for vocal fold nodules via telepractice:a pilot feasibility and efficacy study[J].Journal of Voice,2015,29:696.

2 Fu S,Theodoros DG,Ward EC,et al.Long-term effects of an intensive voice treatment for vocal fold nodules[J].International Journal of Speech-Language Pathology,2016,18:77.

3 傅德慧,陈磊,崔壮,等.天津市 47 796 名中、小学及幼儿园教师嗓音健康现状调查[J].听力学及言语疾病杂志,2016,24:559.

4 韩德明,Sataloff RT.嗓音医学[M].北京:人民卫生出版社,2007.130~132.

5 黄永望.实用临床嗓音疾病矫治学[M].天津:天津科技翻译出版有限公司,2018.484~486.

6 Craig J,Tomlinson C,Stevens K,et al.Combining voice therapy and physical therapy:a novel approach to treating muscle tension dysphonia[J].Journal of Communication Disorders,2015,58:169.

7 徐文,李红艳,胡蓉,等.嗓音障碍指数量表中文版信度和效度评价[J].中华耳鼻咽喉头颈外科杂志,2008,43:670.

8 Won SJ,Kim RB,Kim JP,et al.The prevalence and factors associate with vocal nodules in general population:cross-sectional epidemiological study[J].Medicine,2016,95:153.

9 Tezcaner CZ,Ozgursoy SK,Sati I,et al.Changes after voice therapy in objective and subjective voice measurements of pediatric patients with vocal nodules[J].European Archives of Oto-Rhino-Laryngology,2009,266:1923.

10 岑瑞祥,万浪,彭聪,等.发声训练联合药物治疗声带小结疗效观察[J].听力学及言语疾病杂志,2015,23:265.

11 张璐,翁立冬.金嗓散结丸质量标准的研究[J].山西医科大学学报,2011,42:641.

12 高晓葳,李超,杨芳,等.金嗓散结丸治疗声带小结的疗效观察[J].中国耳鼻咽喉颅底外科杂志,2014,20:215.

13 Casper JK,Leonard R.Understanding voice problems:a physiological perspective for diagnosis and treatment[M].Baltimore:Lippincott Williams & Wilkins,2006.58~65.

14 项秀英,邱宝珊,杨素娟,等.嗓音训练联合中医综合疗法治疗声带小结的疗效观察[J].听力学及言语疾病杂志,2016,24:286.