草酸艾司西酞普兰配合视觉脱敏训练治疗老年持续性姿势-知觉性头晕的效果

Effect of escitalopram oxalate combined with visual desensitization training in the elderly patients with persistent posture-perceptual dizziness

目的 分析老年持续性姿势-知觉性头晕(PPPD)患者服用草酸艾司西酞普兰配合视觉脱敏训练的临床效果及其汉密尔顿焦虑评分(HAMA)和抑郁评分(HAMD)、眩晕障碍量表(DHI)的变化情况。方法 选取2018年2月至2021年12月南京医科大学附属脑科医院收治的98例老年PPPD患者。采用随机数字表分为对照组(n=49,单独服用草酸艾司西酞普兰)和视觉脱敏组(n=49,在对照组的基础上配合视觉脱敏训练)。分析比较两组患者治疗前后头晕发作频次及持续时间、DHI评分、头痛视觉疼痛评分(VAS)、活动—特定平衡信心量表(ABC)评分、HAMA、HAMD评分。对比两组患者临床有效率,记录两组患者不良反应。结果 与治疗后对照组比较,视觉脱敏组头晕发作频次、发作持续时间、DHI总分、ABC、VAS评分、抑郁和焦虑评分治疗前后差值更大(P<0.05)。视觉脱敏组临床疗效优于对照组(P=0.028)。结论 草酸艾司西酞普兰片配合视觉脱敏训练可有效改善老年PPPD患者临床症状,降低DHI、抑郁、焦虑评分,提高平衡信心,进一步提高临床疗效,且具安全性。

Objective To observe the effect of escitalopram oxalate combined with visual desensitization training in the elder-ly patients with persistent posture-perceptual dizziness(PPPD)and the changes of Hamilton Anxiety Rating Scale(HAMA)Depres-sion Scale(HAMD)and Dizziness Handicap Inventory(DHI).Methods 98 elderly PPPD patients admitted to the Nanjing Brain Hospital Affiliated to Nanjing Medical Universityfrom February 2018 to December 2021 were selected.A random number table was used to divide the patients into a control group(n=49,receiving treatment of escitalopram oxalate alone)and a visual desensitization group(n=49,receiving combined treatment of escitalopram oxalate and visual desensitization training).The frequency and duration of dizzi-ness,DHI,headache Visual Analogue Scale(VAS),Activity-specif-ic Balance Confidence Scale(ABC),and HAMA score of the two groups of patients before and after treatment were analyzed and com-pared.The clinical effectiveness of the two groups was compared,and the adverse reactions were recorded.Results Compared with the control group,the visual desensitization group had greater differences in frequency and duration of dizziness,DHI score,ABC score,VAS score,depression scoreand anxiety score before and after treat-ment(P<0.05).The clinical efficacy of the visual desensitizationgroup was superior to that of the control group(P=0.028).Conclusion Escitalopram oxalate tablets combined with visual desensitization training can effectively improve the clinical symptoms of the elderly patients with PPPD,with a reduction in DHI,depression score and anxiety score,and improvement in the balance confi-dence.It was safe and further improved the clinical efficacy.