半夏白术天麻汤加减治疗风痰上扰型后半规管耳石症复位后残余症状的临床疗效评价

Clinical evaluation of Banxia Baizhu Tianma decoction in the treatment of residual symptoms after reduction treatment of posterior semicircular canal otolithiasis

目的探讨半夏白术天麻汤加减治疗风痰上扰型后半规管耳石症复位后残余症状的临床疗效。方法选取2019年5月至2020年2月首都医科大学附属北京中医医院收治的复位成功后伴有残余症状的风痰上扰型后半规管耳石症患者80例,随机分为半夏白术天麻汤加减组(治疗组)和银杏叶提取物滴剂组(对照组),每组40例。两组均治疗14 d。比较两组治疗前和治疗后3 d、2周、1个月眩晕障碍量表(dizziness handicap inventory, DHI)评分、视觉模拟评分(visual analogue score, VAS),比较治疗后2周的疗效分级。结果两组DHI总分以及躯体(DHI-P)、情感(DHI-E)、功能(DHI-F)各专项评分、VAS均随访时间的延长有明显改善,治疗后2周、1个月治疗组DHI总分及各专项评分、VAS均明显低于对照组,差异有统计学意义(P <0.01)。治疗组的疗效明显好于对照组(92.5%比87.5%;Z=2.138,P=0.033)。结论半夏白术天麻汤加减治疗风痰上扰型后半规管耳石症复位后残余症状疗效好,可明显缩短残余症状的病程,值得临床推广。

Objective To explore the clinical efficacy of Banxia Baizhu Tianma decoction in the treatment of residual symptoms after reduction of posterior semicircular canal otolithiasis. Methods Eighty patients with posterior semicircular canal otolithiasis with residual symptoms after canalith repositioning maneuvers in the outpatient clinic of Department of Otorhinolaryngology from May 2019 to February 2020 were randomly divided into experimental group and control group.The experimental group was treated with Banxia Baizhu Tianma decoction and the control group was treated with Extract of Ginkgo Biloba Leaves injection. Both groups were treated for 14 days. Dizziness handicap inventory(DHI) and visual analogue score(VAS) scales were filled in before treatment and three days, two weeks and one month after treatment. And the curative effect was graded at two weeks after treatment. Results The total score of DHI and the scores of physical(DHI-P),emotion(DHI-E) and function(DHI-F) of the two groups were significantly improved with the extension of follow-up time.The total score of DHI and the scores of each item in the experimental group were significantly lower than those in the control group at two weeks and one month after treatment, and the difference was statistically significant(P<0.001). The VAS score of the experimental group was significantly lower than that of the control group at two weeks and one month of treatment, and the difference was statistically significant(P<0.01). The clinical efficacy of the experimental group was better than that of the control group(92.5% vs. 87.5%, Z = 2.138, P = 0.033). Conclusions Banxia Baizhu Tianma decoction has good results in the treatment of residual symptoms of posterior semicircular canal otolithiasis, which can obviously shorten the course of residual symptoms and reduce uncomfortable symptoms for patients, which is worthy of further promotion in clinic.