手法复位联合前庭康复训练对良性阵发性位置性眩晕病儿的疗效  

Clinical effect of manual reduction combined with vestibular rehabilitation training in children with benign paroxysmal positional vertigo

作　　者：万秀明[1] 王丽君[1] 金书香 张晓恒[1] 孙秀梅 付涛[1] WAN Xiuming;WANG Lijun;JIN Shuxiang;ZHANG Xiaoheng;SUN Xiumei;FU Tao(Department of Otolaryngology Head and Neck Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院耳鼻咽喉头颈外科,山东青岛266003 [2]滨州医学院烟台附属医院耳鼻咽喉头颈外科

出　　处：《青岛大学学报(医学版)》2025年第1期134-137,共4页Journal of Qingdao University(Medical Sciences)

基　　金：青岛大学附属医院临床医学+X科研项目面上项目(2019-33)。

摘　　要：目的观察手法复位联合前庭康复训练对良性阵发性位置性眩晕(BPPV)病儿的治疗效果。方法选取2015年1月—2022年12月在我院确诊的48例BPPV病儿为研究对象。对照组24例采取手法复位治疗,研究组24例采取手法复位联合前庭康复训练治疗。治疗后1个月对两组病儿的治愈率和眩晕残障程度评定量表(DHI)、前庭症状指数(VSI)、Berg平衡量表(BBS)、计时平衡时间进行评价,并与治疗前进行比较。结果治疗后1个月内研究组的复发率低于对照组(χ^(2)=4.547,P=0.033)。治疗1个月后,研究组的疗效优于对照组(Z=2.066,P=0.039)。治疗后,两组DHI及其功能(DHI-F)、情感(DHI-E)、躯体(DHI-P)评分均有改善(t=21.01~73.84,P<0.05),但研究组的评分均显著低于对照组(t=2.44~3.78,P<0.05);两组治疗后的DHI、DHI-F、DHI-E评分改善值差异有统计学意义(t=4.10~9.46,P<0.05)。治疗后,两组的VSI评分下降(t=19.08、29.82,P<0.05),BBS评分和计时平衡时间升高(t=37.54~119.35,P<0.05),但研究组VSI评分低于对照组(t=3.80,P<0.05),BBS评分和计时平衡时间高于对照组(t=2.05、5.18,P<0.05);两组治疗后的VSI评分、BBS评分、计时平衡时间改善值差异有统计学意义(t=8.11~42.89,P<0.05)。结论手法复位联合前庭康复训练可有效促进前庭功能恢复,改善病儿的平衡能力,对儿童BPPV的疗效优于单纯手法复位。Objective To investigate the clinical effect of manual reduction combined with vestibular rehabilitation training in children with benign paroxysmal positional vertigo(BPPV).Methods A total of 48 children who were diagnosed with BPPV in our hospital from January 2015 to December 2022 were enrolled as subjects.The 24 children in the control group received manual reduction treatment,while the 24 children in the study group received manual reduction combined with vestibular rehabilitation training.At 1 month after treatment,the children in both groups were evaluated and compared in terms of cure rate,Dizziness Handicap Inventory(DHI),vestibular symptom index(VSI),Berg Balance Scale(BBS),and timed balance time.Results At 1 month after treatment,the study group had a significantly lower recurrence rate than the control group(χ^(2)=4.547,P=0.033),and the study group had a significantly better treatment outcome than the control group(Z=2.066,P=0.039).After treatment,both groups had significant improvements in DHI,DHI-F,DHI-E,and DHI-P scores(t=21.01-73.84,P<0.05),but the study group had significantly lower scores than the control group(t=2.44-3.78,P<0.05);there were significant differences in the degree of improvements in DHI,DHI-F,and DHI-E scores between the two groups after treatment(t=4.10-9.46,P<0.05).After treatment,both groups had a significant reduction in VSI score(t=19.08,29.82,P<0.05)and significant increases in BBS score and timed balance time(t=37.54-119.35,P<0.05),and compared with the control group,the study group had a significantly lower VSI score(t=3.80,P<0.05)and significantly higher BBS score and timed balance time(t=2.05,5.18,P<0.05);there were significant differences in the degree of improvements in VSI score,BBS score,and timed balance time between the two groups after treatment(t=8.11-42.89,P<0.05).Conclusion Manual reduction combined with vestibular rehabilitation training can effectively promote the recovery of vestibular function and improve balance ability in children with BPPV,with a better

关 键 词：良性阵发性位置性眩晕 正骨手法 运动疗法 治疗结果 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]