经颅磁刺激联合艾司西酞普兰对良性阵发性位置性眩晕患者伴焦虑的疗效

Efficacy of transcranial magnetic stimulation combined with escitalopram in patients with benign paroxysmal positional vertigo and anxiety

目的 观察经颅磁刺激对良性阵发性位置性眩晕(BPPV)患者伴焦虑的治疗作用。方法 BPPV合并焦虑的患者168例,随机分为对照组和联合组,每组各84例。2组均给予艾司西酞普兰联合倍他司汀治疗,联合组在此基础上给予经颅磁刺激,均治疗4周。于治疗前、后,采用汉密尔顿焦虑量表(HAMA)评价患者焦虑程度,眩晕障碍量表(DHI)评价眩晕程度。比较2组疗效。结果治疗后,联合组与对照组的HAMA评分均较治疗前明显降低,差异有统计学意义(P<0.05),且联合组低于对照组,差异有统计学意义(P<0.05);联合组的治疗有效率为81%,对照组的治疗有效率为68%,联合组的治疗有效率高于对照组。治疗后,联合组与对照组的DHI评分均较治疗前明显降低(P<0.05),且联合组低于对照组(P<0.05);联合组的有效率为83%,对照组的有效率为66%,联合组的有效率高于对照组。结论 经颅磁刺激联合艾司西酞普兰及倍他司汀能有效改善BPPV患者的焦虑症状,疗效高于艾司西酞普兰联合倍他司汀治疗。

Objective To evaluate the effect of transcranial magnetic stimulation(TMS) on benign paroxysmal positional vertigo(BPPV) with anxiety.Methods A total of 168 BPPV patients with anxiety were randomly divided into control group and combined group,with 84 patients in each group.Both groups were treated with escitalopram combined with betahistine,and the combined group was additionally treated with TMS,with a treatment duration of 4 weeks in both groups.The degrees of anxiety and vertigo were evaluated using the Hamilton Anxiety Scale(HAMA) and the Dizziness Handicap Inventory(DHI) before and after treatment,respectively,and the efficacy of the two groups was compared.Results After treatment,HAMA scores in the two groups were significantly reduced(P<0.05),and those in the combined group were significantly lower than those in the control group(P<0.05).The response rate was higher in the combined group than in the control group(81% vs 68%).After treatment,DHI scores in the two groups were significantly reduced(P<0.05),and those in the combined group were significantly lower than those in the control group(P<0.05).The response rate was higher in the combined group than in the control group(83% vs 66%).Conclusions TMS combined with escitalopram and betahistine can effectively relieve anxiety in patients with BPPV,with better efficacy than escitalopram combined with betahistine.