基于头脉冲试验评估前庭功能训练对前庭神经炎患者的影响

Effect of vestibular function training on patients with vestibular neuritis evaluated based on the head impulse test

目的探讨基于头脉冲试验评估前庭功能训练对前庭神经炎患者的应用效果,以期为临床早期制定相应干预方案提供参考依据。方法前瞻性选取56例新县人民医院2022年2月至2023年2月就诊的前庭神经炎患者,根据治疗方案不同分为研究组、参照组,各28例,其中参照组给予常规药物(甲钴胺、泼尼松)治疗,研究组在参照组基础上给予基于头脉冲试验评估前庭功能训练,比较两组临床疗效及治疗前、治疗3周后眩晕障碍量表(DHI)、前庭功能障碍等级量表(VADL)、Berg平衡量表(BBS)评分、前庭功能指标[优势偏向(DP)、半规管麻痹(CP)、自发性眼震值(SN)]、血清炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平。结果研究组治疗总有效率92.86%,高于参照组治疗总有效率75.00%(P<0.05);与参照组比较,研究组治疗3周后DHI、VADL评分较低,BBS评分较高(P<0.05);与参照组比较,研究组治疗3周后DP、CP、SN较低(P<0.05);与参照组比较,研究组治疗3周后IL-6、TNF-α水平较低(P<0.05);与参照组比较,研究组治疗3周后MDA水平较低,SOD水平较高(P<0.05)。结论基于头脉冲试验评估前庭功能训练可用于前庭神经炎早期干预,可有效改善眩晕症状,有利于恢复平衡感及前庭功能,抑制机体炎症、氧化应激状态。

Objective To evaluate the effect of vestibular function training on patients with vestibular neuritis based on the head impulse test,thus providing references for the early formulation of clinical interventions.Methods A total of 56 patients with vestibular neuritis admitted to Xinxian People's Hospital from February 2022 to February 2023 were prospectively selected and divided into study group and reference group(n=28 in each group)according to different treatment plans.Patients in both groups were treated with conventional drugs(mecobalamine and prednisone),and those in the study group were additionally given vestibular function training based on the findings of the head impulse test.The clinical efficacy,and the dizziness handicap inventory(DHI),vestibular disorders activities of daily living scale(VADL),Berg balance scale(BBS),vestibular function indexes(directional preponderance[DP],canal paresis[CP],spontaneous nystagmus[SN]),serum inflammatory factors(interleukin-6[IL-6],tumor necrosis factor-α[TNF-α]),and oxidative stress indexes(malondialdehyde[MDA],superoxide dismutase[SOD])before and 3 weeks after treatment were compared.Results The total effective rate was significantly higher in the study group than that of the reference group(92.86%VS 75.00%,P<0.05).Significantly lower DHI and VADL,and higher BBS at 3 weeks after treatment were detected in the study group than those of the reference group(P<0.05).Compared with those of the reference group,significantly lower DP,CP and SN at 3 weeks after treatment were detected in the study group(P<0.05).Significantly lower IL-6 and TNF-αat 3 weeks after treatment were detected in the study group than those of the reference group(P<0.05).Significantly lower MDA and higher SOD at 3 weeks after treatment were detected in the study group than those of the reference group(P<0.05).Conclusion Vestibular function training based on the head impulse test can be used for early intervention of vestibular neuritis,which can effectively improve vertigo symptoms,restore balance sense and vestibular function,and inhibit inflammation and oxidative stress.