仪器辅助耳石复位法治疗前庭性偏头痛的疗效

Device-assisted repositioning maneuvers for treatment of vestibular migraine

目的探讨仪器辅助耳石复位法对前庭性偏头痛(vestibular migraine, VM)的治疗效果。方法选择2017年9月至2019年4月北京康复医院收治的VM患者60例,随机分为对照组和试验组,每组30例。对照组接受VM药物治疗,试验组在VM药物治疗的同时接受耳石复位法治疗,共接受3次耳石复位法治疗,1次/周,对比两组患者治疗前及治疗1个月后的运动病(motion sickness, MS)敏感性以及6个月后头痛、眩晕症状的发作次数、持续时间和程度。结果 60例VM患者全部完成随访。治疗1个月后对照组MS敏感性较治疗前无明显变化,而试验组MS敏感性降低且差异有统计学意义(P<0.05)。治疗6个月后对照组与试验组患者的头痛和眩晕的发作频次、天数及强度较治疗前均减少(P<0.05),试验组减少程度比对照组更明显(P<0.05)。结论仪器辅助耳石复位法治疗VM相较于单纯药物治疗更能降低患者的MS敏感性,头痛、眩晕发作频率和程度,具有更好的治疗效果。

Objective To investigate the effect of device-assisted repositioning maneuvers for treatment of vestibular migraine(VM).Methods Sixty patients with VM from September 2017 to April 2019 who had received treatment in Beijing Rehabilitation Hospital of Capital Medical University,who were randomly divided into the control group and the experimental group,30 cases in each group.Medication was only used in the control group,and medication and device-assisted repositioning maneuvers were used in the experimental group.The experimental group received three repositioning maneuvers,one time each week.The motion sickness(MS)sensitivity was compared between the two groups before and after one month of treatment;the frequency,duration and intensity of vertigo and headache were compared before and after six months of treatment.Results All patients completed the study.After one month of treatment,there was no significant difference in VAS of MS in the control group,but there was significant difference in the experimental group.After six months of treatment,the frequency,duration and intensity of vertigo and headache were reduced in both groups,while the experimental group had a higher degree of reduction than the control group(P<0.05).Conclusions Device-assisted repositioning maneuvers in the treatment of VM could reduce the sensitivity of MS,the frequency,duration and intensity of vertigo and headache compared with drug therapy alone,which has better therapeutic effect.