甲磺酸倍他司汀治疗内耳缺血相关性眩晕的疗效研究

The effect of betahistine mesylate as a treatment to vertigo induced by inner ear ischemia

目的通过观察良性阵发性位置性眩晕(benign positional paroxysmal vertigo,BPPV)、后循环缺血(posterior circulation ischemia,PCI)、偏头痛性眩晕(migrainous vertigo,MV)、青少年良性眩晕在服用不同剂量的甲磺酸倍他司汀后的临床表现,了解甲磺酸倍他司汀治疗内耳缺血性眩晕的疗效。方法BPPV、PCI、MV各30例,分成2组。组一:甲磺酸倍他司汀6mg,3/日;组二:甲磺酸倍他司汀12mg,3/日,治疗均为期1个月。观察量-效关系。青少年良性阵发性眩晕25例不分组,甲磺酸倍他司汀6mg,3/日,服药治疗1个月。分别观察治疗前后高刺激率听性脑干测听(auditory brainstem response,ABR)和眩晕残障程度(dizziness handicap inventory,DHI)的变化。结果四类眩晕治疗后症状减轻,高刺激率ABR和DHI均有改善,而眼动异常变化不明显。连续用药1个月后,BPPV、PCI、MV三类患者12mg,3/日方案疗效优于6mg,3/日方案。青少年良性眩晕6mg,3/日方案也获得满意疗效。结论甲磺酸倍他司汀对良性阵发性位置性眩晕、后循环缺血、偏头痛性眩晕和青少年良性眩晕等与内耳低灌注有关的眩晕有较好的治疗作用,并表现出量效关系,12mg,3/日方案疗效优于6mg,3/日方案。

Objective To observe the effects of betahistine mesylate as a treatment to benign positional paroxysmal vertigo （BPPV）, posterior circulation ischemia （PCI）, migrainous vertigo （MV） and teenager benign paroxysmal vertigo and to study the causal relationships of dosages. Methods Ninety cases of BPPV, PCI and MV with 30 cases for each disease were recruited for the experiment. Patients with each disease were then divided into 2 groups, 15 cases in each group. Group 1 was treated with betahistine mesylate 6 mg 3/d, Group 2 with betahistine mesylate 12 mg 3/d. Twenty-five patients with teenager benign paroxysmal vertigo were given betahistine mesylate, 6rag 3/d for duration of I month. High stimulating rate of auditory brainstem response（ABR） and dizziness handicap inventory（DHI） were administered and compared before and after administration of betahistine mesylate. Results The symptoms of the patients were reduced. Both high stimulating rate ABR and DHI were improved, whereas the abnormality of ocular motion remained. One month after treatment, the therapeutic protocol of 12mg 3/d was better than that of 6 mg 3/d. The protocol of 6 mg 3/d for 1 month also indicated satisfactory treatment results on teenager benign paroxysmal vertigo. Conclusion The curative effect of betahistine mesylate on BPPV, PCI, MV and teenager benign paroxysmal vertigo was satisfactory. The therapeutic protocol of 12mg 3/d was more effective than that of 6mg 3/d.