中医临床研究中眩晕疗效评价方法的思考

眩晕是患者的一种主观感觉,病情轻重与多种因素密切相关,而临床上缺乏一种公认的能够准确、全面评价眩晕的量化评估方法。减少眩晕发作、促进平衡功能恢复、提高生活质量应做为眩晕疗效评价的重点。笔者认为建立眩晕的中医疗效评价体系,首先应区分不同＂病＂,可以考虑比较粗略地分成系统性眩晕和非系统性眩晕。系统性眩晕可以选择UCLA眩晕调查问卷或头晕残障量表结合一种平衡功能测定指标来综合评价眩晕的疗效,而对于非系统性眩晕则以UCLA眩晕调查问卷或头晕残障量表为主要疗效指标较为合适;其次,应结合不同的眩晕病因,选择既符合疾病特点又符合中医学理论的症状表征,针对不同疾病制定相应的证候疗效标准,而不应简单地将证候诊断标准做为疗效评价标准。

Thinking about Vertigo Effectiveness Evaluation Methods in Clinical Research of Chinese Medicine

Vertigo is a kind of patients＇ subjective feelings. The severity of vertigo is closely related to many factors. But we are short of a well accepted quantitative evaluation method capable of accurately and comprehensively evaluating vertigo in clinics. Reducing the onset of vertigo, enhancing the recovery of equilibrium function, and improving the quality of life of vertigo patients should be taken as the focus of evaluating therapeutic effects. As for establishing a Chinese medical effectiveness evaluation system for vertigo, we believe we should distinguish different ＂diseases＂. We could roughly identify it as systemic vertigo and non-systemic vertigo. For systemic vertigo, the efficacy of vertigo could be com- prehensively evaluated by UCLA Vertigo questionnaire or dizziness handicap inventory combined with e- quilibrium function testing indices. But for non-systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by taking UCLA vertigo questionnaire or dizziness handicap inventory as main efficacy indices. Secondly, we should analyze different reasons for vertigo, choose symptoms and signs in line with vertigo features as well as with Chinese medical theories, and formulate corresponding syndrome effectiveness standards according to different diseases. We should not simply take syndrome diagnosis standards as efficacy evaluation standards.