耳石复位联合药物治疗对老年人良性阵发性位置性眩晕的疗效研究

Clinical efficacy of otolith-repositioning maneuver combined with medical treatment on benign paroxysmal positional vertigo in the elderly patients

目的观察手法复位联合药物治疗对老年人良性阵发性位置性眩晕患者的治疗价值。方法选取176例老年良性阵发性位置性眩晕患者随机分为观察组和对照组（各88例），两组患者均给予药物基础治疗与强迫体位，观察组在此基础上行手法复位，连续治疗21d，观察两组患者治疗后临床疗效、不良反应。结果观察组第2周治愈率为50．0％（44／88）、有效率70．5％（62／88），第3周治愈率77．3％（68／88）、有效率93．2％（82／88）均高于对照组的11．4％（10／88）、47．7％（42／88）和29．500（26／88）、86．4％（76／88），差异有统计学意义（χ2值分别为37．32、73．32、37．32、53．43，均P〈0．05）。两组治疗后均出现头晕伴恶心呕吐、情感障碍、走路不稳，但差异无统计学意义（χ2=3．25，均P〉O．05），中转手术率观察组低于对照组（χ2=45．43，P〈0．05）。结论手法复位联合药物治疗对老年人良性阵发性位置性眩晕有着很好的临床疗效，安全性高。

Objective To investigate the value of otolith-repositioning maneuver combined with medical treatment on benign paroxysmal positional vertigo in the elderly patients. Methods 176 elderly people who suffered from benign paroxysmal positional vertigo were randomly divided into observation group and control group （n=88, each）. All patients were treated with basal medicine treatment and compulsive position for 21 days, and patients in the observation group were treated with otolith-repositioning maneuver added on the basis. The clinical efficacy and adverse reactions were observed and compared between the two groups after treatment. Results The curative rate and effective rate were higher in observation group than in control group at 2, 3 weeks after treatment [50.0% （44/88） w 11.4% （10/88）, 70.5% （62/88） va 47.7% （42/88）, 77.3% （68/88） va 29.5% （26/88）, 93.2% （82/88） vs 86.4% （76/88）, χ2= 37.32, 73.32, 37.32, 53.43, respectively, all P〈0. 053. Dizziness combined with nausea and vomiting, and walking instability were both found in the two groups, which had no statistical difference （χ2 =3.25, P〉0.05）. Patients in observation group developed arrhythmia and Tumarkin otolith crisis after treatment. The transfer rate of surgery was lower in observation group than in control group （χ2 = 45.43, P〈0.01）. Conclusions Otolith-repositioning maneuver combined with medical treatment have good clinical effect and safety on benign paroxysmal positional vertigo in the elderly.