改良手法复位联合盐酸倍他司汀氯化钠注射液治疗不典型良性阵发性位置性眩晕的临床研究

Effectiveness Analysis of Modified Manipulative Reduction Combined with Betahistine Hydrochloride and Sodium Chloride Injection in Treatment of Patients with Atypical Benign Paroxysmal Positional Vertigo

目的观察改良手法复位联合盐酸倍他司汀氯化钠治疗不典型良性阵发性位置性眩晕(BPPV)的效果。方法选取2015年8月—2016年8月哈励逊国际和平医院耳鼻喉科收治的330例不典型BPPV为研究对象,按治疗方法分为观察组、手法复位组、倍他司汀组,每组110例,观察组使用改良Semont1、Semont2、Gufoni手法复位联合盐酸倍他司汀氯化钠注射液治疗,手法复位组使用传统Semont手法复位治疗,倍他司汀组采用盐酸倍他司汀氯化钠注射液治疗。结果 3组治疗后VSI评分明显降低,BBS评分、计时平衡试验结果升高,LVA、RVA、BA平均血流速度显著上升,且观察组各项指标改善均优于手法复位组和倍他司汀组(P<0.05);治疗后1周、3个月,观察组总有效率高于手法复位组和倍他司汀组(P<0.05);治疗后3个月、6个月,观察组复发率低于手法复位组和倍他司汀组(P<0.05)。结论采用改良手法复位联合盐酸倍他司汀氯化钠注射液治疗不典型BPPV有利于减轻症状,改善血液循环,提高治疗效果,降低复发率,可在临床积极推广和应用。

Objective To observe effectiveness of modified manipulative reduction combined with Betahistine Hydrochloride and Sodium Chloride Injection in treatment of patients with atypical benign paroxysmal positional vertigo（ BPPV）. Methods A total of 330 BPPV patients admitted during August 2015 to August 2016 were divided into observation group,manipulative reduction group and Betahistine group（ n = 110 for each group） according to therapeutic methods. Observation group was treated with Semont1,Semont2 and Gufoni manipulative reduction combined with Betahistine Hydrochloride and Sodium Chloride Injection,and manipulative reduction group was treated with traditional Semont manipulation reduction,while Betahistine group was treated with Betahistine Hydrochloride and Sodium Chloride Injection. Results After treatment,vestibular symptom index（ VSI） scores were significantly decreased,while values of Berg balance scale（ BBS） scores,results of timing balance test and mean blood flow velocity of left vertebral artery（ LVA）,right vertebral artery（ RVA） and basilar artery（ BA） were significantly increased in three groups; improved conditions of all the indexes in observation group were better than those in manipulative reduction and Betahistine groups（ P〈0. 05）. In 1 weeks and 3 months after treatment,the total effective rates in observation group were higher than those in manipulative reduction and Betahistine groups（ P〈0. 05）. In 3 and 6 months after treatment,recurrence rates in observation group were significantly lower than those in manipulative reduction and Betahistine groups（ P〈0. 05）. Conclusion Modified manipulative reduction combined with Betahistine Hydrochloride and Sodium Chloride Injection in treatment of patients with atypical benign paroxysmal positional vertigo may help relieve symptoms and improve blood circulation,improve clinical effectiveness and reduce recurrence rate.