家庭式改良Epley法补充性治疗后半规管BPPV的疗效观察

At Home Modified Epley Maneuver as Supplementary Treatment for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

目的观察家庭式改良Epley法补充性治疗后半规管BPPV的疗效。方法将2019年1月~2019年6月三甲医疗机构确诊的80例后半规管BPPV患者按随机数据表法分为对照组和治疗组,每组40例,对照组:在三甲医疗机构眩晕专科医师给予患者传统Epley法治疗,治疗组:在三甲医疗机构模拟家庭环境,以医患共同参与的医疗模式给予改良Epley法治疗,如患者仍有残余头晕或者位置性眩晕复发,予补充家庭式改良Epley法自我复位治疗。统计两组患者治愈率,记录两组患者治疗1天及1周后眩晕残障量表(DHI)评分。结果治疗1天后,治疗组治愈率85%,对照组治愈率60%,治疗组治愈率明显高于对照组(P<0.05);治疗1周后,治疗组治愈率92.5%,对照组治愈率87.5%,两组治愈率相当(P>0.05);治疗1天后、1周后治疗组的DHI得分均低于对照组(P<0.05),两组复位治疗过程均未出现严重不良反应。结论家庭式改良Epley法能有效、安全的补充性治疗后半规管BPPV,这一医患共同参与的医疗模式值得在临床上推广。

Objective To report efficacy of an at home modified Epley maneuver as a supplementary treatment for posterior semicircular canal BPPV. Methods Eighty patients diagnosed with posterior semicircular canal BPPV from January 2019 to June 2019 were randomly divided into a control group and a study group(40 in each group). Patients in the control group were treated with traditional Epley maneuver by a vertigo specialist, while patients in the study group received a modified Epley maneuver in a simulated home environment with participation by both the clinician and patient, which was to be self-administered by the patient in case of residual dizziness or recurrence of positional vertigo.Outcomes of the two groups were compared, including using the Dizziness Handicap Inventory(DHI), at 1 day and 1 week after treatment. Results At 1 day after treatment, the rate of symptoms resolution was 85% in the study group and60% in the control group(P<0.05). At 1 week, the rate of symptom resolution was 92.5% in the study group and 87.5%in the control group(P>0.05). DHI scores of the study group were lower than those of the control group both at 1 day and 1 week after treatment(P< 0.05). No severe adverse reactions occurred during treatment in either group. Conclusion The at home modified Epley maneuver with the participation of clinicians and patients can be used effectively and safely as a supplement to the treatment of posterior semicircular canal BPPV, is worthy of adoption.