手法复位结合Brandt-Daroff锻炼治疗水平半规管良性阵发性位置性眩晕的疗效

Efficacy of manipulative reduction combined with Brandt-Daroff exercise in treating horizontal semicircular canal benign paroxysmal positional vertigo

目的探讨手法复位结合Brandt-Daroff锻炼治疗水平半规管良性阵发性位置性眩晕(HC-BPPV)的疗效。方法首次手法复位无效的HC-BPPV患者76例随机均分为观察组和对照组,两组患者根据HC-BPPV类型给予相应的手法复位,观察组患者在此基础上行Brandt-Daroff练习,观察两组患者治疗1周、2周的临床疗效及不良反应发生情况。结果观察组治疗1周有效率为92.1%,高于对照组的68.4%(P<0.05);观察组治疗2周有效率为94.7%,与对照组的89.5%相仿(P>0.05)。治疗1周后,观察组所需手法复位的次数为(1.45±0.63)次,少于对照组的(1.66±0.90)次(P<0.05);两组治疗2周后所需手法复位次数相仿[(2.43±1.62)次vs.(2.49±1.47)次](P>0.05)。治疗过程中两组患者不良反应发生率差异无统计学意义(P>0.05)。结论对于首次复位无效的HC-BPPV患者,手法复位结合Brandt-Daroff锻炼可提高治疗效果,减少手法复位次数。

Objective To investigate the efficacy of manipulative reduction combined with Brandt-Daroff exercise in the treatment of horizontal semicircular canal benign paroxysmal positional vertigo（HC-BPPV）. Methods Seventy-six patients with HC-BPPV failed to the first manipulative reduction were equally randomly divided into two groups. The patients of two groups were treated with manipulative reduction according to HC-BPPV types continuously. The patients in group A were treated with Brandt-Daroff exercise additionally. Clinical efficacy and adverse effects were observed and compared between two groups after treatment for one and two weeks. Results The effectiveness rate after treatment for one week was higher in group A than that in group B（92.1% vs. 68.4%） （P〈0. 05）,which was not significantly different after treatment for two weeks between two groups （94. 7% vs. 89.5%）（P〉0. 05）. The number of manual reduction was less in group A than that in group B after treatment for one week[（1.45 ± 0.63） times vs. （ 1.66 ± 0. 90） times）] （P〈0. 05）, which was not significantly different after treatment for two weeks[（2.43 ±1.62） times vs. （2.49± 1.47） times] （P〉0. 05 ）. There was no significant difference in the incidence of adverse effects between two groups （P〉0. 05）. Conclusion The manipulative reduction combined with Brandt- Daroff exercise can improve the clinical efficacy and reduce the number of manipulative reduction with less adverse effects in the treatment of patients with HC-BPPV.