重复经颅磁刺激治疗耳鸣的临床现状
Clinical Status of Repetitive Transcranial Magnetic Stimulation for the Treatment of Tinnitus
DOI: 10.12677/acm.2026.1651970, PDF,   
作者: 高 嵩：西安医学院研究生工作部，陕西 西安
关键词: 耳鸣；重复经颅磁刺激治疗；Tinnitus； Repetitive Transcranial Magnetic Stimulation Therapy
摘要: 耳鸣是一种在无外界声源刺激情况下产生听觉感知的常见症状，严重影响患者的生活质量。重复经颅磁刺激(Repetitive Transcranial Magnetic Stimulation, rTMS)作为一种非侵入性脑刺激技术，近年来在耳鸣治疗领域展现出巨大的潜力。本文基于现有学术文献，综述rTMS治疗耳鸣的神经机制、临床疗效、参数优化、个体化治疗策略及安全性。本报告发现rTMS在短期内改善耳鸣障碍量表(Tinnitus Handicap Inventory, THI)和耳鸣问卷(Tinnitus Questionnaire, TQ)评分方面具有中等效应量，但长期疗效仍存在争议。报告进一步探讨了基于脑电图源定位和静息态功能磁共振成像的个体化靶点定位算法，以及间歇性θ爆发刺激等新型刺激模式的临床应用前景。此外，本报告对当前研究中存在的异质性问题进行了初步分析，并对未来标准化治疗指南的构建方向提出了一些初步思考与设想。
Abstract: Tinnitus is a common symptom of auditory perception without external sound source stimulation, which seriously affects the quality of life of patients. As a non-invasive brain stimulation technique, repetitive transcranial magnetic stimulation (rTMS) has shown great potential in the field of tinnitus treatment in recent years. Based on the existing academic literature, this paper reviews the neural mechanism, clinical efficacy, parameter optimization, individualized treatment strategy and safety of rTMS in the treatment of tinnitus. This report found that rTMS has a moderate effect on improving the scores of Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ) in the short term, but the long-term effect is still controversial. The report further discusses the individualized target localization algorithm based on EEG source localization and resting functional magnetic resonance imaging, and the clinical application prospect of new stimulation modes such as intermittent θ burst stimulation. In addition, this report makes a preliminary analysis of the heterogeneity existing in the current research, and puts forward some preliminary thoughts and ideas on the construction direction of standardized treatment guidelines in the future.
文章引用：高嵩. 重复经颅磁刺激治疗耳鸣的临床现状[J]. 临床医学进展, 2026, 16(5): 1676-1686. https://doi.org/10.12677/acm.2026.1651970

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