前庭康复联合抗焦虑治疗持续性姿势-知觉性头晕的疗效观察  

Efficacy of vestibular rehabilitation combined with anti-anxiety therapy for persistent postural-perceptual dizziness

作　　者：黄烨 杨雯 张琳 邵科峰 陈红芳 尤慧华 HUANG Ye;YANG Wen;ZHANG Lin;SHAO Kefeng;CHEN Hongfang;YOU Huihua(Department of Otorhinolaryngology,Head and Neck Surgery,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China;不详)

机构地区：[1]浙江大学医学院附属金华医院耳鼻咽喉头颈外科,321000 [2]浙江大学医学院附属金华医院神经内科,321000

出　　处：《浙江医学》2023年第24期2647-2650,共4页Zhejiang Medical Journal

基　　金：金华市科技计划项目(2021-4-027)。

摘　　要：目的 探讨前庭康复(VR)联合抗焦虑治疗持续性姿势-知觉性头晕(PPPD)的疗效。方法 收集2021年1月至2022年12月浙江大学医学院附属金华医院诊断为PPPD的患者,采用随机数字表法分为研究组(VR联合抗焦虑治疗)37例和对照组(仅抗焦虑治疗)37例。采用眩晕残障程度评定量表(DHI)评分评估患者眩晕程度,失眠严重程度指数量表(ISI)评分和医院焦虑抑郁量表(HADS,分为焦虑亚量表HADS-A和抑郁亚量表HADS-D)评分分别评估患者失眠、焦虑和抑郁程度。采用Pearson相关分析治疗前ISI、HADS-A和HADS-D与DHI的相关性;比较两组患者在治疗前和治疗8周后各项评分的差异。结果 治疗前,PPPD患者眩晕程度与失眠程度、焦虑程度、抑郁程度均呈显著正相关(r=0.581、0.706、0.416,均P<0.01)。治疗前两组患者各项评分比较,差异均无统计学意义(均P>0.05)。治疗8周后两组患者HADS-A、HADS-D、ISI、DHI评分均显著下降,差异均有统计学意义(均P<0.05);研究组HADS-A、ISI、DHI评分均显著低于对照组,差异均有统计学意义(均P<0.05)。结论 VR联合抗焦虑治疗较仅抗焦虑治疗能显著改善PPPD患者焦虑、失眠和眩晕症状。Objective To investigate the efficacy of vestibular rehabilitation(VR)and anti-anxiety therapy for persistent postural-perceptual dizziness(PPPD).Methods Seventy four patients diagnosed with PPPD at Affiliated Jinhua Hospital,Zhejiang University School of Medicine from January 2021 to December 2022 randomly were divided into two groups with 37 cases in each group,patients in the study group received VR combined with anti-anxiety therapy and those in the control group received anti-anxiety therapy alone.Dizziness handicap inventory(DHI),insomnia severity index(ISI),hospital anxiety and depression scale(HADS,anxiety sub scale HADS-A,depression sub scale HADS-D)were used to assess the dizziness,insomnia,anxiety and depression of patients before and after treatment,respectively.The correlation of pre-treatment DHI with ISI and HADS was analyzed.The above indicators were compared before and 8 weeks after treatment and also compared between the two groups.Results Before treatment,the severity of dizziness in PPPD patients was positively correlated with the severity of insomnia,anxiety and depression(r=0.581,0.706,0.416,all P<0.01).There was no statistically significant difference in various indicators between two groups before treatment(all P>0.05).After 8 weeks of treatment,the HADS-A/HADS-D,ISI and DHI scores of the two groups significantly decreased compared to pre-treatment scores(all P<0.05);while the HADS-A,ISI and DHI scores of the study group were significantly lower than those of the control group(all P<0.05).Conclusion Compared to anti-anxiety therapy alone,VR combined with anti anxiety therapy can significantly improve anxiety,insomnia,and dizziness symptoms in PPPD patients.

关 键 词：持续性姿势-知觉性头晕 失眠 焦虑 抑郁 前庭康复 抗焦虑治疗 

分 类 号：R764[医药卫生—耳鼻咽喉科]