多感觉训练及康复治疗对平衡障碍患者的临床效果

Efficacy of multisensory training and rehabilitation in patients with balance disorders

目的分析多感觉训练及康复治疗对平衡障碍患者的临床疗效。方法华中科技大学同济医学院附属协和医院耳鼻咽喉头颈外科眩晕中心2020年1至12月就诊的95例平衡障碍患者,根据中华医学会制定的指南及专家共识常规治疗后,恢复欠佳或未达到满意治疗效果的患者,经全面评估后,行多感觉训练及康复治疗1个月。对治疗前后的眩晕视觉模拟评分(VAS)、眩晕障碍量表(DHI)、Berg平衡量表(BBS)、平衡信心量表(ABC)、躯体化症状自评量表(SSS)、9项患者健康问卷(PHQ9)、广泛性焦虑障碍量表(GAD7)进行评估和比较。结果行多感觉训练及康复治疗的平衡障碍患者95例,男34例,女61例,年龄(44±14)岁。与治疗前相比,治疗1个月后VAS[(2.1±1.1)分比(5.9±2.5)分,P<0.01]、DHI[(15.6±7.7)分比(33.1±13.2)分,P<0.01]、SSS[(1.5±0.6)分比(2.4±0.8)分,P<0.01]、PHQ9[(6.0±2.7)分比(8.6±4.3)分,P=0.01]、GAD7[(5.2±2.6)分比(9.5±2.8)分,P<0.01]评分均降低;BBS[(53.4±10.0)分比(34.8±10.7)分,P<0.01]和ABC[(89.6±8.0)分比(55.7±21.8)分,P<0.01]评分均升高。结论多感觉训练及康复治疗能有效提高平衡障碍人群的眩晕控制率和平衡能力,降低摔倒风险,并可改善患者精神心理状态,从而提高生活质量。

Objective To analyze the clinical efficacy of multisensory training and rehabilitation treatment in patients with balance disorders.Methods From January to December 2020,95 patients with balance disorders in the Vertigo Center of Department of Otorhinolaryngology,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology were enrolled.All patients were treated according to the treatment guidelines of Chinese Medical Association or expert consensus.Those with poor recovery or unsatisfactory treatment results underwent multisensory training and rehabilitation for 1 month after a comprehensive evaluation.The scores of Visual Analogue Scale(VAS),Dizziness Handicap Inventory(DHI),Berg Balance Scale(BBS),and Activities-specific Balance Confidence Scale(ABC),Somatization Symptom Self-Rating Scale(SSS),9-item Patient Health Questionnaire(PHQ9)and the 7-item Generalized Anxiety Disorder(GAD7)were evaluated and compared before and after the treatment.Results Totally,95 patients were enrolled.There were 34 males and 61 females,aged(44±14)years.VAS(2.1±1.1 vs 5.9±2.5,P<0.01),DHI(15.6±7.7 vs 33.1±13.2,P<0.01),SSS(1.5±0.6 vs 2.4±0.8,P<0.01),PHQ9(6.0±2.7 vs 8.6±4.3,P=0.01)and GAD7(5.2±2.6 vs 9.5±2.8,P<0.01)decreased after treatment,while BBS(53.4±10.0 vs 34.8±10.7,P<0.01)and ABC(89.6±8.0 vs 55.7±21.8,P<0.01)increased.Conclusion Multisensory training and rehabilitation therapy can effectively enhance the vertigo control rate and balance ability in patients with balance disorders,reduce the risk of falling,promote their mental and psychological state,and thus improve the quality of life.