三联疗法治疗良性阵发性位置性眩晕耳石复位治疗成功后残余症状痰浊中阻型临床研究  

Clinical research of triple therapy for residual symptoms of benign positional paroxysmal vertigo with phlegm turbid obstruction syndrome by canalith repositioning

作　　者：李金飞[1] 丁雷[1] 王嘉玺[1] 张丽[1] 王冬梅[1] LI Jinfei;DING Lei;WANG Jiaxi;ZHANG Li;WANG Dongmei(Department of Otolaryngology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078)

机构地区：[1]北京中医药大学东方医院耳鼻咽喉科,北京100078

出　　处：《河北中医》2022年第1期54-59,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察三联疗法治疗良性阵发性位置性眩晕(BPPV)耳石复位治疗成功后残余症状痰浊中阻型的临床疗效。方法将160例BPPV耳石复位治疗成功后残余症状痰浊中阻型患者按照随机数字表法分为2组,治疗组80例予针刺、耳穴贴压、穴位贴敷三联疗法,对照组80例予甲磺酸倍他司汀片口服,2组疗程均为2周。比较2组残余症状持续时间;比较2组治疗前后眩晕残障量表(DHI)评分、前庭症状指数量表(VSI)评分、汉密尔顿焦虑量表(HAMA)评分、中医证候评分变化;比较2组治疗前后眼性前庭诱发肌源性电位(oVEMP)引出率、N1潜伏期、P1潜伏期及双侧不对称比异常率。结果治疗组残余症状持续时间短于对照组(P<0.05)。2组治疗后DHI躯体、情绪性、功能评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后VSI头晕、头痛、眩晕、恶心、平衡、视觉敏感评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后HAMA各项评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后中医证候头重如裹、胸闷不舒、恶心呕吐、耳内胀满评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后oVEMP引出率均较本组治疗前升高(P<0.05),双侧不对称比异常率较本组治疗前降低(P<0.05),且治疗组治疗后oVEMP引出率高于对照组(P<0.05),双侧不对称比异常率低于对照组(P<0.05)。结论针刺、耳穴贴压、穴位贴敷三联疗法治疗BPPV耳石复位治疗成功后残余症状痰浊中阻型,能缓解残余症状,重建患者平衡功能,提高患者活动平衡信心,减轻焦虑情绪,oVEMP引出率、双侧不对称比异常率可作为评估BPPV复位治疗成功后残余症状的客观指标。Objective To observe the clinical research of triple therapy for residual symptoms in patients with benign positional paroxysmal vertigo(BPPV)of phlegm turbid obstruction syndrome by canalith repositioning.Methods Totally 160 BPPV patients(phlegm turbid obstruction syndrome)underwent canalith repositioning were randomly assigned into two equal groups,patients in treatment group received triple therapy(acupuncture+auricular point sticking+acupoint patching),and patients in control group received oral betahistine mesilate tablets.Treated for 2 weeks,duration of residual symptoms;dizziness handicap inventory(DHI)score,vestibular symptom index(VSI)score,hamilton anxiety scale(HAMA),traditional Chinese medicine(TCM)syndrome score;extraction rate,N1 and P1 latencies,abnormality rates of bilateral asymmetry in ocular vestibular evoked myogenic potentials(oVEMPs)were included as comparators.Results The duration of residual symptoms in treatment group was shorter than that in control group(P<0.05).After treatment,reduced DHI scores(physical,emotional,functional)in groups were found(P<0.05),and treatment group was significantly lower(P<0.05);decreased VSI scores(dizziness,headache,vertigo,nausea,balance,visual sensitive)in groups were recorded(P<0.05),which decreased notably in treatment group compared with control group(P<0.05);HAMA scores in groups were decreased(P<0.05),which in treatment group were obviously decreased(P<0.05);TCM syndrome(head heavy,chest tightness,nausea and vomiting,inner ear swelling)scores in groups were decreased(P<0.05),which in treatment group were significantly decreased(P<0.05);extraction rate of oVEMPs in groups was increased(P<0.05),which in treatment group was more common(P<0.05);abnormality rates of bilateral asymmetry was decreased,treatment group was decreased in comparison with control group(P<0.05).Conclusion For BPPV patients(phlegm turbid obstruction syndrome)with residual symptoms by canalith repositioning,triple therapy is capable of relieving residual symptoms,rebuilding balance f

关 键 词：眩晕 针刺疗法 耳穴贴压 穴位贴敷法 

分 类 号：R255.3[医药卫生—中医内科学] R245.31[医药卫生—中医学]