辨证眩晕论治难治性良性阵发性位置性眩晕  

Treatment of intractable benign paroxysmal positional vertigo based on TCM syndrome differentiation

作　　者：姜金鹏 梁颖茵[1] 牛媛媛[1] 陈松林[1] JIANG Jinpeng;LIANG Yingyin;NIU Yuanyuan;CHEN Songlin

机构地区：[1]中山大学附属第一医院,广东广州510700

出　　处：《中医临床研究》2024年第18期25-28,共4页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨采用中医眩晕理论对难治性良性阵发性位置性眩晕(Intractable Benign Paroxysmal Positional Vertigo,IBPPV)的临床疗效。方法:收集30例IBPPV患者辨证分为瘀血阻络证、气血亏虚证、肾精不足证、痰浊内蕴证和肝阳上亢证型,予以相应治疗。在治疗前及治疗第7天、14天、28天,采用眩晕障碍量表(Dizziness Handicap Inventory,DHI)评估患者躯体(Physical,P)、功能(Functional,F)和情绪(Emotional,E)状态,观察对照治疗疗效。由于西医对IBPPV无有效治疗方法,无法设立西医治疗对照组。我们依据患者年龄、病程和合并症分组,比较组间DHI、P、F、E评分改善情况;比较不同患者组血清维生素D、雌激素、钙离子水平。结果:与治疗前比较,治疗第14天、28天,总DHI、P、F、E评分较治疗前显著降低(均P<0.01)。≤55岁组、合并症≤1个组、病程≤1年组,分别与>55岁组、合并症>1个组、病程>1年组比较,在治疗14 d DHI评分下降较快(P<0.05);而中医证型≤2个组和>2个组,在治疗第14天、28天,疗效恢复无差异(P>0.05)。治疗28 d,与治疗前比较,各组DHI评分均明显下降(P<0.01)。三组间血清维生素D和雌激素有差异(P<0.05)。结论:辨证眩晕治疗IBPPV疗效确定。年龄≤55岁或合并症≤1个或病程≤1年的患者恢复较快。IBPPV患者血清维生素D和雌激素异常特异性不确定。Objective:To investigate the effect of TCM vertigo theory on Intractable Benign Paroxysmal Positional Vertigo(IBPPV).Methods:30 cases of IBPPV patients were divided into the syndrome types of blood stasis,Qi(气)and blood deficiency,kidney essence deficiency,phlegm turbidness,liver-yang overactivity,and corresponding treatment was given.Physical(P),Functional(F)and Emotional(E)status were assessed by Dizziness Handicap Inventory(DHI)before treatment and at days 7,14 and 28.The therapeutic effect was observed and compared.Since Western medicine has no effective treatment method for IBPPV,it is impossible to set up Western medicine treatment control group.The patients were divided into groups according to age,course of disease and number of comorbidities,and the improvement of DHI,P,F and E scores among groups was compared.Serum levels of vitamin D,estrogen and calcium ions were compared among different groups.Results:Compared with situation before treatment,the total DHI,P and F scores were significantly decreased on day 14(P<0.05)and day 28(P<0.01).The E score decreased on day 14(P<0.01)and day 28(P<0.01)compared with those before treatment.DHI score of≤55 years old group,complications≤1 group,duration≤1 year group decreased faster than that of>55 years old group,complications>1 group,duration>1 year group at 14 days of treatment(P<0.05).However,there was no difference in the curative effect between≤2 groups and>2 groups on the 14th and 28th day of treatment(P>0.05).After 28 days of treatment,DHI scores in all groups decreased significantly compared with those before treatment(P<0.01).Serum vitamin D and estrogen were different among the three groups(P<0.05).Conclusion:TCM vertigo differentiation has significant and exact therapeutic effect in the treatment of IBPPV.Those who have age≤55 years,complications≤1,disease duration≤1 year have rapid recovery.The specificity of serum VitD and estrogen abnormalities in IBPPV patients is uncertain.

关 键 词：难治性良性阵发性位置性眩晕 辨证论治 疗效 

分 类 号：R441.2[医药卫生—诊断学]