Brandt-Daroff锻炼法治疗老年人良性阵发性位置性眩晕的研究

Efficacy of Brandt-Daroff exercise on benign paroxysmal positional vertigo in elderly

目的评价比较Brandt-Daroff锻炼法和改善脑循环药物治疗老年人良性阵发性位置性眩晕(BPPV)的效果。方法 109例60岁以上后半规管BPPV患者纳入研究。BPPV诊断依据患者有反复位置性眩晕发作史,Dix-Hallpike试验表现有诱发性眩晕和眼震。MRI及DWI排除中枢性病变。根据患者意愿将其分入试验组和对照组。试验组47例,住院后2周内接受Brandt-Daroff锻炼,每日上下午各锻炼10次;对照组62例,给予血栓通静脉点滴。2组患者原有的应用药物不变。在治疗后2周时,根据是否仍有位置性眩晕症状和Dix-Hallpike试验评价两组患者的治疗效果。位置性眩晕症状消失且Dix-Hallpike试验眼震呈阴性者认为其BPPV被治愈。结果试验组患者BPPV治愈率为93.6%,显著高于对照组患者61.2%的治愈率(P<0.01)。结论 Brandt-Daroff锻炼法治疗老年人BPPV较使用改善脑循环药物更为有效。

Objectives To evaluate the efficacy of the Brandt-Daroff exercise on the treatment of posterior canal benign paroxysmal positional vertigo （PC-BPPV） in elderly. Methods One hundred and nine patients who were older than 60 years old with PC-BPPV were enrolled in this study. The diagnosis of PC-BPPV was made based on a history of recurrent vertigo attacks and typical position-induced nystagmus on the Dix-Hallpike test. In the experimental group, 47 patients were allocated to receive the Brandt-Daroff exercise and in the control group, 62 patients were allocated only to receive medical treatment. Patients were evaluated after the Brandt-Daroff exercise or medical treatment. A post-treatment negative result on the Dix-Hallpike test was considered as the resolution of BPPV. Results The cure rate （93.6%） for patients in the experimental group was significantly higher than that （61.2%） of patients in the control group （P 〈 0.01）. Conclusion The efficacy of Brandt-Daroffexercise is better than that of the medical treatment for PC-BPPV in elderly.