聲音頻率對於耳鳴的遮蔽與舒緩之初探

A Preliminary Study on the Shading and Relieving of Tinnitus by Sound Frequency

張德翔(Der-Shyang Chang)

指導教授 ： 盧士一

中山醫學大學/健康管理學院/職業安全衛生學系/碩士(2019年)

https://doi.org/10.6834/CSMU201900241

摘要

噪音為職場環境常見危害因子之一，過度暴露將引起聽力受損或出現耳鳴現象，此研究計畫為因應職業安全衛生法及施行細則、作業環境有關噪音防範，以耳鳴患者對於上述研究題目自認有因果關係且願意嘗試測量以期改善為主要目的。
許多文獻資料與教科書都說明耳鳴現象的生成原因，是一複雜原因，至今還是沒有團隊確立生成的確切說明，或許耳鼻喉間的生理器官太多，牽一髮而動全身，又或者每一個部分都有一點點影響，造成這個耳鳴現象。因此從數十年前的生理解剖為主要的研究方向，到復健性質的「耳鳴再訓練」tinnitus retraining therapy(TRT)，再邁向社會心理層面的探索「耳鳴」，這是一種方向性的改變，若是能發現些新的數據或論點支持，則表示此一方向是值探討的議題。
我們的研究設計，也是往TRT及社會心理的角度切入，將實驗單純化，除了生理構造性的耳鳴(稱他覺性耳鳴)，我們將蒐集自覺性耳鳴(俗稱腦鳴)案例，這類耳鳴只有本人能知曉，因此透過問卷的設計，請受測者做主觀性的回答，另還有一開放式的軟體測量，來輔證受測者的回答，在結束後分析結果，主要分析測試耳鳴頻率是否會因為中低頻率的微刺激而改變原頻率，研究發現中低頻率可以誘發原頻率的改變，並且發現耳鳴頻率的反饋變動可分為高低頻率兩屬族群，是患者心理認知行為所牽動而形成的(遮蔽與舒緩)結果。

關鍵字

職業衛生 ； 耳鳴 ； 社會心理 ； 頻率改變

並列摘要

Noise is one of the common hazard factors in the workplace and Long-term exposure to this would cause the hearing loss or tinnitus. This research is based on the Enforcement Rules of the Occupational Safety and Health Act and the Amendment to Noise Control Standards patients suffering from tinnitus consider it as causal relationship and are willing to take a test for improvements on it.
A large number of literature and textbooks in this field have come to the conclusion that it is complicated and difficult to establish the cause of tinnitus. There is no single team, up to this time, giving an accurate description of the reason why it happens. Maybe there are too many organs to be dealt within otorhinolaryngology, or perhaps one or more of them are responsible for doing with this problem. In the past decades, the main research interests have been switched from physiological anatomy to tinnitus retraining therapy (TRT) and to the exploration at the psycho-social level. With more data and support, it could be argued that the modification of study orientation is worthy of notice.
This research is specially designed for the simplification of setting up the experiment by following the trail of TRT and social psychology. In addition to physiological tinnitus (objective tinnitus), we will collect the cases of subjective tinnitus (known as ringing in the brain) as well, and such tinnitus is only you can hear. With the questionnaire subject to the testers’ subjective answers and the open-source software measurement, we analyze the testers’ responses at the end of the test. The main subject is to examine whether the original tinnitus frequency of a tester is changed due to the low and medium frequencies microstimulation. It is found in this research that the low and medium frequencies make a quite impact on the original frequency. The changes are present in both low and high frequencies and are resulted from their cognitive behavior as a protective shield for comfort.

並列關鍵字

tinnitus ； trt

參考文獻

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5.Swain, S. K., Nayak, S., Ravan, J. R., et al., Tinnitus and its current treatment–Still an enigma in medicine. Journal of the Formosan Medical Association, 2016 Mar;115(3):139-44.