倍他司汀治疗原发性HC-BPPV患者复位后残余头晕的效果

Effect of Betahistine on Residual Dizziness After Reduction in Patients with Primary HC-BPPV

目的研究倍他司汀治疗原发性水平半规管良性阵发性位置性眩晕(HC-BPPV)患者复位后残余头晕的效果。方法选择2019年10月-2020年10月本院收治的HC-BPPV复位后残余头晕的患者76例作为研究对象,使用随机数表字法将其分为观察组和对照组,每组38例。对照组使用手法复位进行治疗,观察组在对照组基础上联合使用盐酸倍他司汀治疗,比较两组治疗前后眩晕障碍量表(DHI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分、纤维蛋白原(FIB)、全血高切黏度、血浆粘度水平、眼性及颈性前庭诱发肌源性动作电位(VEMP)异常情况及HC-BPPV复发情况。结果观察组DHI、SDS、SAS评分低于对照组,差异有统计学意义(P<0.05);观察组FIB、血浆粘度、全血高切黏度水平低于对照组,差异有统计学意义(P<0.05);观察组治疗后2、4周眼性、颈性VEMP异常发生率低于对照组,差异有统计学意义(P<0.05);两组治疗后2、4、6个月HC-BPPV复发率比较,差异无统计学意义(P>0.05)。结论倍他司汀治疗原发性HC-BPPV患者复位后残余头晕可减轻患者眩晕症状,改善抑郁、焦虑等不良情绪,减少VEMP异常情况,且复发率低。

Objective To study the effect of betahistine in the treatment of residual dizziness after reduction in patients with primary semicircular canal benign paroxysmal positional vertigo(HC-BPPV).Methods A total of 76 patients with residual dizziness after HC-BPPV reduction admitted to our hospital from October 2019 to October 2020 were selected as subjects.They were divided into observation group and control group by random number table method,with 38 cases in each group.The control group was treated with manual reduction,and the observation group was treated with betahistine hydrochloride on the basis of the control group.The vertigo disorder scale(DHI),self-rating depression scale(SDS),self-rating anxiety scale(SAS)score,fibrinogen(FIB),whole blood high shear viscosity,plasma viscosity level,ocular and cervical vestibular evoked myogenic action potential(VEMP)abnormalities and HC-BPPV recurrence were compared between the two groups before and after treatment.Results The scores of DHI,SDS and SAS in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).FIB,plasma viscosity and whole blood high shear viscosity in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of abnormal ocular and cervical VEMP in the observation group was lower than that in the control group at 2 and 4 weeks after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the recurrence rate of HC-BPPV between the two groups at 2,4 and 6 months after treatment(P>0.05).Conclusion Residual dizziness after reduction in patients with primary HC-BPPV treated with betahistine can reduce vertigo symptoms,improve depression,anxiety and other adverse emotions,reduce VEMP abnormalities,and the recurrence rate is low.