前庭康复联合抗焦虑治疗良性发作性位置性眩晕

Vestibular rehabilitation combined with anti-anxiety therapy in the treatment of benign paroxysmal positional vertigo

目的探讨前庭康复联合抗焦虑治疗良性发作性位置性眩晕(BPPV)的临床疗效。方法随机数字法将108例BPPV患者分为对照组与观察组各54例,对照组前庭康复训练治疗,观察组在对照组基础上联合抗焦虑治疗,均干预2周,比较两组临床疗效、治疗前后汉密尔顿焦虑量表(HAMA)、前庭症状指数(VSI)及生活质量评分。随访1年,比较两组眩晕复发率。结果观察组临床治愈率90.74%高于对照组68.52%,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后HAMA评分、VSI评分、生活质量(功能、情感、躯体)评分均显著下降(P<0.05),且观察组治疗后HAMA评分、VSI评分、躯体评分分别为(2.78±2.01)分、(18.16±7.54)分、(2.83±0.42)分,均显著低于对照组的(5.47±3.68)分、(25.35±8.05)分、(3.95±0.38)分,差异均有统计学意义(P<0.05)。两组随访1年眩晕复发率比较差异无统计学意义(P>0.05)。结论前庭康复训练联合抗焦虑治疗能明显改善良性发作性位置性眩晕症状及生活质量,且复发率低,可在临床推广应用。

Objective To investigate the clinical effects of vestibular rehabilitation combined with anti-anxiety therapy in the treatment of benign paroxysmal positional vertigo （BPPV）. Methods 108 patients with BPPV were randomly divided into control group and observation group by the random number table method, with 54 cases in each group. The control group was treated with vestibular rehabilitation training. The observation group, on the basis of treatment of control group, was treated with anti-anxiety therapy. Both of the two groups were intervened for 2 weeks. The clinical effect, Hamilton Anxiety Scale （HAMA）, vestibular symptom index （VSI） and quality of life scores before and after treatment were com- pared between the two groups. With 1 year of follow-up, the recurrence rate of vertigo in the two groups was statistically analyzed. Results The clinical cure rate in the observation group （90.74% ） was significantly higher than that in the control group （68.52%） （P 〈0.05）. After treatment, HAMA score, VSI score and quality of life （functional, emotional, physical） scores after treatment were significantly lower than those before treatment （P 〈 0.05）. After treatment, HAMA score, VSI score and body score in observation group [-（2.78±2.01）, （18.16±7.54）, （2.83±0.42）] were significant- ly lower than those in control group [（5.47± 3.68）, （25. 35±8.05）, （3.95±0.38）] （P 〈 0.05）. There was no significant difference in the recurrence rate between two groups after 1 year of follow-up （P 〉 0.05）. Conclusion Vestibular rehabilitation training combined with anti-anxiety therapy can significantly improve the symptoms and quality of life in patients with BPPV, and can effectively reduce the recurrence rate of vertigo.