颈性眩晕的保守治疗效果

Therapeutic effect of conservative treatment for cervical vertigo

背景：颈性眩晕在临床上常见,目前关于颈性眩晕的病因、发病机制、诊断及治疗仍存在争议,许多问题尚需深入研究。目的目的：分析颈性眩晕保守治疗的效果。方法：分析31例门诊颈性眩晕患者保守治疗3个月后眩晕改善效果,男7例,女24例,年龄20-60岁,平均46.6岁。以Ishihara法测定颈椎曲度指数（cervical curvature index,CCI）,测量相邻椎体后缘滑移距离及椎间角,以Cobb法测量颈椎前凸角。采用美国耳鼻咽喉头颈外科学会听力及平衡委员会（Committee on Hearing and Equilibrium,CHE）标准,记录患者治疗前及治疗后眩晕评分,分析不同影像学特点眩晕症状缓解情况及其机制。结果：影像学上,26例患者单个节段不稳,5例患者双个节段不稳;治疗前眩晕评分平均3.5分,治疗后眩晕评分平均1.3分。26例患者症状改善满意,满意率83.9%。眩晕缓解程度与患者CCI、颈椎前凸角及颈椎不稳节段位置、个数无明显相关性（P〉0.05）。结论：颈部肌肉力量在稳定颈椎中具有重要作用,保守治疗能有效缓解颈性眩晕。

Background： Cervical vertigo is common in clinic. The etiology,pathogenesis,diagnosis and treatment of cervical vertigo are still controversial. Objective： To investigate the therapeutic effect and mechanism of the conservative treatment for cervical vertigo. Methods： Thirty-one outpatients who received conservative treatment for cervical vertigo for 3months were analyzed retrospectively. There were 7 males and 24 females with a mean age of 46.6 years（range,20-60 years old）. Cervical curvature index（CCI）,slip distance,intervertebral angle and Cobb angle were measured. The degree of vertigo was reported according to the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium（AAO-HNS CHE） standard. Results： X ray found that 26 cases had single vertebral instability and 5cases had double vertebral instability. The average score of vertigo was 3.5 and 1.3 before and after the treatment,respectively. It was reported that 26 out of the 31 patients（83.9%） got a satisfied recovery from vertigo. The improvement of vertigo was not significantly correlated with CCI,the Cobb angle,the position or the number of the instable vertebral columns（P〉0.05）. Conclusions： The cervical muscle strength has a crucial influence on the stability of cervical vertebral columns.Conservative treatment can effectively ameliorate the cervical vertigo.