手法复位与合并综合方法治疗后半规管良性阵发性位置性眩晕的疗效比较  

Maneuver versus Epley's maneuver plus comprehensive treatment of posterior semicircular canal benign paroxysmal positional vertigo:a prospective randomized study

作　　者：郭宏庆[1] 许晓燕[2] 刘端端[3] 杨静[3] 李莹[3] 王志凯[1] 杨志超[1] 马瑞霞[1] 

机构地区：[1]宁夏医科大学总医院耳鼻咽喉头颈外科,宁夏银川750004 [2]宁夏医科大学总医院内分泌科,宁夏银川750004 [3]宁夏医科大学临床医学院研究生院,宁夏银川750004

出　　处：《宁夏医学杂志》2014年第10期885-887,共3页Ningxia Medical Journal

摘　　要：目的比较单纯使用Epley手法复位治疗和Epley手法复位联合综合治疗两种方法对后半规管良性阵发性位置性眩晕(PC-BPPV)的疗效及治疗后患者头晕症状缓解情况。方法采用前瞻性的方法对确诊为原发性PC-BPPV的94例患者进行比较。41例对照组患者单纯采用Epley手法复位;53例试验组患者除了采用Epley手法复位以外同时联合使用治疗后限制体位、静脉滴注银杏叶制剂及前庭康复训练的综合治疗方法,1周及1个月后比较2组患者的治疗疗效及治疗后头晕症状(使用眩晕障碍量表比较)的缓解情况。结果经过1周治疗后试验组患者的痊愈率为72%,与对照组(痊愈率68%,P>0.05)接近;治疗后试验组眩晕障碍量表总评分4.02±1.20与对照组总评分8.40±2.54比较,差异有统计学意义(P<0.05);治疗1个月后,试验组患者的痊愈率为91%,与对照组比较(痊愈率88%),差异无统计学意义(P>0.05)。试验组眩晕障碍量表总评分3.80±1.10与对照组总评分3.50±1.40比较,差异无统计学意义(P>0.05)。结论 Epley手法复位对于PC-BPPV的治疗简单、有效;联合综合治疗的方法可以显著改善复位治疗后患者的头晕不适症状。Objective To compare the efficacy of Epleyg maneuver and Epleyg maneuver plus comprehensive treatment in the treatment of posterior semicircular canal benign paroxysmal positional vertigo （ PC - BPPV）. Methods Nightly - four patients with PC - BPPV were included in a randomized study. Forty - one cases in control group were treated with Epleyg maneuver alone and the other 53 cases in treated group were received Epleyg maneuver together with comprehensive treatment. Both groups were analyzed after seven days and one month. Results After seven dayg treatment,there was no significant difference in cure rate between the treated group and control group （72% vs. 68% P 〉0.05 ,respectively）. But the treated groupg total score of DHI was 4.02 _＋ 1.20 and the control groupg total score of DHI was 8.40 ＋ 2.54, with the difference statistically significant （ P 〈 0.05 ）. After one month treatment, there was no sig- nificant difference in cure rate between two groups （91% vs. 88% P 〉 0.05, respectively） ;and the total score of DHI was no significant difference between two groups. （3.80 ＋ 1.10 vs. 3.50 ＋ 1.40 P 〉 0.05, respectively）. Conclusion Epleyg maneuver is the best treat- ment method of PC- BPPV ,and the comprehensive treatment can improve the patientg score of DHI.

关 键 词：后半规管良性阵发性位置性眩晕 Epley手法复位 综合治疗 眩晕障碍量表 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]