前庭康复训练对前庭外周性眩晕患者眩晕残障症状的改善作用

The effects of vestibular rehabilitation training on the symptoms of vertigo and disability in patients with vestibular peripheral vertigo

目的了解前庭康复训练对前庭外周性眩晕患者眩晕残障症状的疗效。方法本研究为前瞻性研究。将复旦大学附属眼耳鼻喉科医院门诊就诊的前庭外周性眩晕患者随机分为对照组(药物治疗组)20例和试验组(药物治疗联合康复训练组)23例。自2018年1至12月共收集43例。所有患者在就诊当天及治疗后2、4、8周各填写1次眩晕残障程度评定量表(DHI)、特异性活动平衡信心量表(ABC)和焦虑自评量表(SAS),对3种量表数据进行统计分析。结果两组患者在一般资料方面差异无统计学意义(P>0.05),有可比性。两组患者的3种量表在治疗后评分[试验组治疗后4周DHI(45.5±30.6)、ABC(86.9±12.4)、SAS(37.9±8.2);对照组治疗8周DHI(34.8±28.5)、SAS(35.7±7.9)]优于治疗前[试验组DHI(59.2±25.9)、ABC(79.7±16.7)、SAS(41.1±6.8);对照组DHI(55.2±20.5)、ABC(80.3±18.3)、SAS(41.9±9.1)]。每组治疗前后数据配对比较显示:试验组DHI和ABC评分在治疗后2周、SAS评分在治疗后4周出现明显变化,差异有统计学意义(P<0.05)。而对照组DHI评分在治疗后4周、SAS评分在治疗后8周出现明显变化,差异有统计学意义(P<0.05);ABC评分虽有变化但差异无统计学意义(P>0.05)。结论经过治疗后两组患者眩晕残障症状及焦虑情绪均有好转。但与单纯药物治疗相比,药物治疗联合前庭康复训练能更早期地显著改善患者的眩晕残障症状及焦虑抑郁情绪,从而提高患者整体生活质量。

Objective To compare the effects of vestibular rehabilitation training and drug therapy on the symptoms of vertigo and disability in patients with vestibular peripheral vertigo.Methods This prospective study was enrolled 43 patients with vestibular peripheral vertigo who admitted to the outpatient department of Eye&ENT Hospital of Fudan University from January 2018 to December 2018.They were randomly divided into two groups:control group(drug treatment group)and experimental group(drug treatment combined rehabilitation training group).All patients filled in the first vertigo disability rating scale(DHI),specific activity balance confidence scale(ABC)and anxiety self-rating scale(SAS)on the day of treatment and at two,four and eight weeks after treatment intervention,and the data were statistically analyzed.Results There was no significant difference in gender,age and body weight between the two groups(P>0.05).After treatment(Control group(4w):DHI(45.5±30.6),ABC(86.9±12.4),SAS(37.9±8.2)Experimental group(8w):DHI(34.8±28.5),SAS(35.7±7.9)),the three scales of the two groups were better than before treatment(Control group:DHI(59.2±25.9),ABC(79.7±16.7),SAS(41.1±6.8);Experimental group:DHI(55.2±20.5),ABC(80.3±18.3),SAS(41.9±9.1)).The comparison of data before and after treatment in each group according to treatment time indicated that DHI and ABC scores in the experimental group showed that the DHI and ABC scores of the experimental group changed significantly at 2 weeks after treatment,and the SAS scores changed at 4 weeks after treatment.The difference was statistically significant(P<0.05).However,there was a statistically significant difference between the control group DHI score 4 weeks after treatment and SAS score 8 weeks after treatment(P<0.05).ABC score did not show statistical difference(P>0.05).Conclusion The subjective symptoms and anxiety of vertigo and disability in the two groups improved obviously after treatment.Compared with drug therapy alone,drug therapy combined with vestibular rehabilitation training can significantly improve patients′subjective symptoms of vertigo and disability,as well as their anxiety and depression,so as to improve their overall quality of life.