手法复位与机械复位治疗不同年龄段BPPV患者疗效差异的随机对照研究  

Differences in manual and mechanical repositioning treatments for benign paroxysmal positional vertigo patients across different age groups:A randomized controlled study

作　　者：茆月兰 张弘 田庆森 徐大飞 MAO Yuelan;ZHANG Hong;TIAN Qingsen;XU Dafei(不详;Department of Neurology,Tianchang Tiankang Hospital,Tianchang Anhui 239300,China)

机构地区：[1]江苏省南京市建邺区沙洲社区卫生服务中心眼耳鼻咽喉科,210019 [2]安徽省天长天康医院神经内科,239300 [3]同济大学附属天佑医院

出　　处：《中国神经免疫学和神经病学杂志》2024年第5期389-393,共5页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨手法复位与机械复位治疗不同年龄段良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的疗效差异。方法收集2022年6月至2023年9月期间,在天长天康医院神经内科眩晕中心就诊的BPPV患者260例。使用随机数字表法将患者分为机械复位组(机械组)和手法复位组(手法组),每组130例。根据WHO年龄分层标准,将两组患者进一步划分为中青年组(<60岁)和老年组(≥60岁),比较两组间的疗效,主要疗效观察指标为两组患者治愈所需要的治疗次数和治疗3 d、7 d、14 d内的治愈率,次要疗效指标为治疗90 d、180 d内的复发率。结果剔除无法完成复位治疗的患者后,机械组108例、手法组120例纳入分析。机械组108例中中青年患者50例(46.3%),老年患者58例(53.7%);手法组120例患者中中青年患者57例(47.5%),老年患者63例(52.5%)。机械组患者治疗次数显著低于手法组患者(P<0.05),且机械组老年患者治疗次数显著少于手法组老年患者[(2.93±1.42)次比(4.13±2.18)次,t=-3.529,P<0.001]。在治疗3 d、7 d和14 d内,机械组治愈率均高于手法组(P<0.05),且在治疗3 d内,机械组老年患者的治愈率显著高于手法组老年患者(48.27%比28.57%,χ^(2)=4.976,P=0.026),在治疗14 d内,机械组老年患者的治愈率高于手法组老年患者(100%比90.47%,χ^(2)=5.812,P=0.028)。两组治疗90 d内的复发率差异无统计学意义(P>0.05),治疗180 d内机械组复发率低于手法组(17.59%比30.00%,χ^(2)=4.781,P<0.05),且机械组老年患者复发率低于手法组老年患者(18.96%比38.09%,χ^(2)=5.375,P=0.027)。结论机械复位治疗BPPV相比手法复位具有更高的治愈率和更低的复发率,尤其是在老年患者中更加明显。Objective To investigate the efficacy differences of manual and mechanical repositioning treatments for benign paroxysmal positional vertigo(BPPV)across different age groups.Methods A total of 260 BPPV patients who visited the Vertigo Center of the Neurology Department at Tianchang Tiankang Hospital from June 2022 to September 2023 were collected.Patients were randomly assigned to either the mechanical repositioning group(mechanical group)or the manual repositioning group(manual group)using a random number table,with 130 patients in each group.According to the WHO age stratification standards,the patients were further categorized into young and middle-aged adults(<60 years)and elderly group(≥60 years).The primary outcome measures included the number of treatment sessions required for cure and the cure rates at 3,7,and 14 days post-treatment.Secondary outcomes included the recurrence rates at 90 and 180 days post-treatment.Results After excluding patients who could not complete the repositioning treatment,108 patients in the mechanical group and 120 patients in the manual group were included in the analysis.Among the 108 patients in the mechanical group,50 were young and middle-aged adults(46.3%),and 58 were elderly(53.7%).Among the 120 patients in the manual group,57 were young and middle-aged adults(47.5%),and 63 were elderly(52.5%).The number of treatment sessions in the mechanical group was significantly lower than that in the manual group(P<0.05).The number of treatment sessions for the elderly in the mechanical group was significantly lower than that for the elderly in the manual group[(2.93±1.42)sessions vs.(4.13±2.18)sessions,t=-3.529,P<0.001].The cure rates at 3,7,and 14 days post-treatment were all higher in the mechanical group than those in the manual group(P<0.05).Furthermore,within 3 days of treatment,the cure rate for older adults in the mechanical group was significantly higher than that in the manual group(48.27%vs.28.57%,χ^(2)=4.976,P=0.026).At 14 days post-treatment,the cure rate for the el

关 键 词：良性阵发性位置性眩晕 机械复位 手法复位 老年人 治愈率 复发率 

分 类 号：R747.9[医药卫生—神经病学与精神病学]