耳石复位与药物联合仰卧位摇头法治疗主观性良性阵发性位置性眩晕临床研究

目的:观察耳石复位与药物联合仰卧位摇头法治疗主观性良性阵发性位置性眩晕(S-BPPV)的效果。方法:选取2012年1月至2016年1月期间符合纳入标准的S-BPPV患者186例,采用随机数字表法将患者分为观察组与对照组各93例,对照组采用耳石复位联合药物治疗,观察组在对照组基础上采用仰卧位摇头法治疗。比较两组患者临床疗效、首次治疗成功率、中转手术治疗率、复发率与不良反应发生率的差异。结果:与对照组比较,观察组治疗总有效率、首次治疗成功率明显增高,中转手术治疗率与复发率明显降低,差异具有统计学意义(P<0.05);两组中共18例患者经外科手术治疗后症状彻底消失;随访3个月期间,观察组平均复发次数与对照组比较差异具有统计学意义(P<0.05);两组患者头晕、恶心呕吐、心律失常、走路不稳与情感障碍等不良反应发生率比较差异无统计学意义(P>0.05)。结论:耳石复位与药物联合仰卧位摇头法治疗S-BPPV效果显著,可降低复发率,且未增加不良反应的发生风险。

Clinical Study of Otolith Reduction and Drug Combined with Supine Head Shaking Treatment for Subjective Benign Paroxysmal Positional Vertigo

Objective:To study the effect of otolith reduction and drug combined with supine head shaking treatment for subjective benign paroxysmal positional vertigo(S-BPPV). Methods:There were 186 patients with S-BPPV meeting the inclusion criteria from January 2012 to January 2016 were included. The patients were divided into observation group and control group using the random number table method,93 patients in each group. The control group was treated with otolith reset and drug treatment,while the observation group was further treated with supine head shaking treatment. The difference of clinical efficacy,initial treatment success rate,transit surgical treatment rate,recurrence rate and adverse reactions incidence rate between the two groups were compared. Results:Compared with the control group,the total effective rate and the initial treatment success rate increased of the observation group obviously,while transit surgical treatment rate and recurrence rate were significantly lower,with statistical difference between the two groups(P<0.05). Totally 18 patients in the two groups were given surgical treatment,and the symptoms disappear completely. During the of 3-month follow-up,the average recurrence number in 3 patients of observation group was 2.15 ±0.56,while the average recurrence number in 10 patients of control group was 4.5±1.08,with a statistical difference between the two groups(P<0.05). On the incidence of adverse events like dizziness,nausea,vomiting,arrhythmia,walking instability and emotional disorders,there was no difference between the two groups(P> 0.05). Conclusion:Otolith reduction and drug combined supine head shaking treatments for S-BPPV shows obvious effect,and can reduce the recurrence rate without increasing the incidents of adverse events.