苓桂术甘汤合泽泻汤对痰饮型耳石症复位后残余头晕及复发的作用研究

Effect of Linggui Zhugan Decoction(苓桂术甘汤) Combined with Zexie Decoction(泽泻汤) on Residual Dizziness and Dizziness Relapse of Phlegm and Retained Fluid Typeafter Canalith Repositioning Procedure

目的:探讨苓桂术甘汤合泽泻汤对痰饮型耳石症复位后残余头晕及复发的作用。方法:将144例痰饮型耳石症复位后残余头晕患者按随机数字表分为A组、B组、C组和D组,4组均服用甲磺酸倍他司汀片,B组、C组、D组分别予以苓桂术甘汤、泽泻汤、苓桂术甘汤合泽泻汤治疗,均治疗3周。比较4组治疗前后头晕症状、总有效率、前庭症状指数(VSI)、Berg平衡量表(BBS)评分、不良反应;统计耳石症复发率。结果:治疗前4组眩晕障碍量表(DHI)各维度评分和总分差异无统计学意义(P>0.05),治疗后4组DHI各维度评分和总分均低于治疗前(P<0.05),且治疗后D组DHI各维度评分和总分均低于其余3组,B组和C组均低于A组(P<0.05);4组总有效率差异有统计学意义(P<0.05),D组总有效率高于A组(P<0.01);治疗后4组VSI评分均下降(P<0.05),且D组低于其余3组(P<0.05),B组、C组低于A组(P<0.05);治疗后4组BBS评分均升高(P<0.05),且D组高于其余3组(P<0.05),B组、C组高于A组(P<0.05);4组不良反应发生率比较,差异无统计学意义(P>0.05),D组随访6个月内耳石症复发率低于A组(P<0.01)。结论:对痰饮型耳石症复位后残余头晕患者在甲磺酸倍他司汀片的基础上采用苓桂术甘汤、泽泻汤治疗均可减轻症状,疗效确切、安全,且均能够减轻前庭症状、提升评分能力,二者合用效果更佳,且安全可靠,降低耳石症复发率。

Objective:To explore the effect of Linggui Zhugan Decoction(苓桂术甘汤)combined with Zexie Decoction(泽泻汤)on residual dizziness and dizziness relapse of phlegm and retained fluid type after canalith repositioning procedure(CRP).Methods:Totally,144 patients with residual dizziness of phlegm and retained fluid type after CRP were randomly divided into group A,group B,group C and group D.All groups were treated with betahistine mesylate tablets.Besides,group B,group C and group D were treated with Linggui Zhugan Decoction,Zexie Decoction,Linggui Zhugan Decoction combined with Zexie Decoction,respectively,for 3 weeks.Dizziness symptoms before and after treatment,total effective rates,changes of Vestibular Symptom Index(VSI)and Berg Balance Scale(BBS)scores before and after treatment and adverse reactions were compared among the 4 groups.The relapse rate of canalith were compared.Results:Before treatment,there were no significant differences in the scores of every dimension and total scores of vertigo disorder scale(DHI)among the 4 groups(P>0.05).After treatment,the scores of every dimension and total scores of DHI in the 4 groups were lower than those before treatment(P<0.05),and in group D were lower than those in the other 3 groups(P<0.05),and the scores in group B and group C were lower than those in group A(P<0.05).There was a significant difference in the total effective rates among the 4 groups(P<0.05),and the total effective rate of group D was higher than that of group A(P<0.01).The VSI score in the 4 groups after treatment decreased(P<0.05),and in group D was lower than that in the other 3 groups(P<0.05),and the score in group B and group C was lower than that in group A(P<0.05).The BBS score in the 4 groups after treatment increased(P<0.05),and in group D was higher than that in the other 3 groups(P<0.05),and the score in group B and group C was higher than that in group A(P<0.05).There was no significant difference in the incidences of adverse reactions among the 4 groups(P>0.05),and the relapse rate of canalith in group D within 6 months of following-up was lower than that in group A(P<0.01).Conclusions:Linggui Zhugan Decoction and Zexie Decoction are both effective and safe in the treatment of residual dizziness of phlegm and retained fluid type after CRP besides treated with betahistine mesylate.These two treatments are safe and reliable,and both can reduce vestibular symptoms and improve scores.The combination of both decoction is of better effect,and is safe and reliable.It can reduce the relapse rate of canalith.