心因性头晕患者临床症候及治疗方法分析  

An analysis of clinical features and therapies of patients with psychogenic dizziness

作　　者：董秦雯[1] 戚晓昆[1] 

机构地区：[1]海军总医院神经内科,北京100048

出　　处：《中华内科杂志》2014年第10期768-771,共4页Chinese Journal of Internal Medicine

基　　金：海后课题（HW201402）

摘　　要：目的 提高对心因性头晕的认识,为今后正确处理该类头晕患者积累经验.方法 收集海军总医院神经内科就诊的208例心因性头晕患者临床资料,总结其临床症候特点与治疗方法.结果 208例患者（女152例,男56例）发病年龄17 ～ 77岁,平均52岁,以中年女性居多.根据临床症候特点及治疗转归,分为焦虑-抑郁状态型[176例（84.6％）]、转换性障碍型[18例（8.7％）]、躁狂状态型[14例（6.7％）]三大类.心因性头晕患者焦虑自评量表（SAS）、抑郁自评量表（SDS）、Bech-Rafaelsen躁狂量表评分可有不同程度的异常.焦虑-抑郁状态型患者使用提高兴奋性递质相关药物疗效好,转换性障碍型患者经诱导暗示治疗后可有明显缓解,情感稳定剂对躁狂状态型患者疗效好.结论 神经内科就诊的心因性头晕患者以中年女性居多,总体可分为焦虑-抑郁状态型、转换性障碍型、躁狂状态型三大类,临床症候及实验室检查有其各自特点,治疗策略有所不同.Objective To accumulate clinical experience and to directe clinical work.Methods A total of 208 patients with psychogenic dizziness from department of neurology of Navy General Hospital of PLA were included in the study.Self-rating anxiety scale （SAS）,self-rating depression scale （SDS） and Bech-Rafaelsen mania rating scale （BRMS） were used for the evaluation.Results Among all the patients aged from 17 to 77 （the average age：52）,152 were female and 56 were male.There were 3 types according to different clinical features and therapy prognosis：anxiety and depression type （176 cases,84.6%）,hysteria type（18 cases,8.7%） and mania type（14 cases,6.7%）.The drugs increasing the concentration of excitatory had a good therapeutic efficacy on anxiety and depression type.Alluding cure had notable effect on hysteria type and mood stabilizer had notable effect on mania type.Conclusions Women tended to have psychogenic dizziness.It can be divided into three types：anxiety and depression type,hysteria type and mania type.Clinical symptoms and laboratory examination of each type have their own characteristics,and treatment strategies are also different.

关 键 词：头晕 焦虑 抑郁 躁狂 心因性头晕 

分 类 号：R741.04[医药卫生—神经病学与精神病学]