嗓音声学分析评估不同中医证型慢性喉炎患者的疗效

摘要

Objective To investigate the application of the voice acoustic analysis in the evaluation of curative effects of different chronic laryngitis.Methods The adult patients with chronic laryngitis (80 cases)were divided into 3 different syndrome types what were as the Yin deficiency group (28 cases),the Qi deficiency group (25 ca-ses),and the TanNing blood stasis group (27 cases).According to the different compositions of golden voice series medicines,the medicines were administered,combined in two to three.A total of 30 normal people were set to the control group.The German ATMOS voice test and analysis system was used to detect continuous vowel signals and the results were compared before and after treatment.Results Before the treatment,the chronic laryngitis group, compared with control group,had higher jitters,shimmers and NHR.The MPT was significarry shorter and DSI smaller compared with the control group(P <0.05).After 1 month of medication,the Yin deficiency group was the best and there were no significant differences in almost all parameters compared with control group (P >0.05)ex-cept for the parameter-jitter.The jitter,shimmer,and NHR decreased significantly after 1 month treatment while the MPT and DSI increased significantly in the Yin deficiency group and the Qi deficiency group compared with be-fore treatment (P <0.05).There was a statistically significant difference on jitter,shimmer,NHR and DSI and no difference on MPT compared with before treatment in TanNing blood stasis group.Conclusion The voice acoustic a-nalysis could be objective and quantitative to analysis the chronic laryngitis patients'voice quality with different syn-drome types and evaluate the curative effects.%目的：探讨嗓音声学分析对中成药治疗不同中医证型慢性喉炎患者疗效评估的意义。方法将80例成人慢性喉炎患者（喉炎组）辩证分型，分为肺肾阴虚型28例、肺脾气虚型25例、气滞血瘀痰凝型27例，根据金嗓灵系列中药制剂（开音丸、利咽丸、散结丸、清音丸）的不同成分，针对不同证型患者分别联合用药（利咽丸、开音丸、清音丸、散结丸中选取2～3种），疗程一个月；30例正常成人设为对照组；应用德国 ATMOS 嗓音测试分析系统对对照组和喉炎组用药前、用药后1月的持续元音信号进行分析。结果治疗前喉炎组各证型患者的基频微扰（jitter）、振幅微扰（shimmer）、噪谐比（NHR）均较对照组高，最长发声时间（MPT）较对照组短，发音障碍指数（DSI）较小，差异均有统计学意义（均为 P ＜0．05）；喉炎组用药后1月，肺肾阴虚型患者除振幅微扰外，其余各指标与对照组比较差异无统计学意义（P ＞0．05）；喉炎组治疗后1月与治疗前比较，肺肾阴虚型及肺脾气虚型患者 jitter、shim-mer、NHR 均下降，MPT 延长，DSI 值增大，差异有统计学意义（P ＜0．05）；气滞血瘀痰凝型患者治疗后，jitter、shimmer、NHR 均下降，DSI 值增大，差异有统计学意义（P ＜0．05），仅 MPT 与治疗前差异无统计学意义（P ＞0．05）。结论嗓音声学分析可客观、定量地分析不同证型慢性喉炎患者的嗓音质量，评价治疗效果。