虚拟现实前庭康复训练对突发性聋伴眩晕患者的治疗效果:一项随机对照试验

Efficacy of Virtual Reality Vestibular Rehabilitation Training in Patients with Sudden Deafness and Vertigo:a Randomized Controlled Trial

背景虚拟现实(VR)康复训练凭借其独特的优势,在康复治疗领域已经被广泛应用,但在突发性聋伴眩晕患者中的应用效果缺乏研究。目的观察常规前庭康复训练、VR技术辅助的前庭康复训练在突发性聋伴眩晕患者中的疗效。方法选取2022年1月—2023年1月山西医科大学第一医院耳鼻咽喉头颈外科收治的突发性聋伴眩晕患者84例,采用随机数字表法将患者分为两组,每组42例。对照组给予药物治疗联合常规前庭康复训练,观察组在药物治疗的基础上予以VR技术辅助的前庭康复训练。干预前及干预后7、14 d,分别使用眩晕残障量表(DHI)和医院焦虑抑郁量表(HADS)对两组进行评估。结果最终81例患者完成试验,其中观察组41例,对照组40例。组别与时间对DHI-功能(F)、DHI-情绪(E)、DHI-躯体(P)评分及DHI总分存在交互作用(P<0.05);组别及时间分别对DHI各分项评分及其总分主效应显著(P<0.05)。干预前两组患者DHI各分项评分及其总分比较,差异无统计学意义(P>0.05);干预7、14 d后,两组患者DHI各分项评分及其总分均较组内干预前降低(P<0.05)。干预7、14 d后,观察组患者DHI各项评分及总分低于对照组(P<0.05)。组别与时间对HADS-焦虑量表(A)、HADS-抑郁量表(D)评分及HADS总分存在交互作用(P<0.05);组别及时间分别对HADS各分项评分及其总分主效应显著(P<0.05)。干预前两组患者HADS各分项评分及其总分比较,差异无统计学意义(P>0.05);干预7、14 d后,两组患者HADS各分项评分及其总分均较组内干预前降低(P<0.05)。干预7、14 d后,两组患者HADS各分项评分及其总分比较,差异无统计学意义(P>0.05)。结论前庭康复训练对突发性聋伴眩晕患者疗效确切,VR技术辅助下的前庭康复训练可更明显改善患者的平衡障碍,提高患者生活质量。

Background Due to its unique advantages,virtual reality rehabilitation(VR)training has been widely used in the field of rehabilitation therapy,but there is a lack of study on its application efficacy in patients with sudden deafness and vertigo.Objective To observe the efficacy of coventional vestibular rehabilitation training and vestibular rehabilitation training assisted by VR technology in patients with sudden deafness and vertigo.Methods From January 2022 to January 2023,84 patients with sudden deafness and vertigo were selected from the Department of Otolaryngology Head and Neck Surgery,First Hospital of Shanxi Medical University and randomly divided into the two groups,with 42 cases in each group.The control group was given drug therapy combined with coventional vestibular rehabilitation training,while the observation group was given vestibular rehabilitation training assisted by VR technology on the basis of drug therapy.The Dizziness Disorder Scale(DHI)and Hospital Anxiety and Depression Scale(HADS)were respectively used to evaluate the two groups before intervention,7 and 14 days after the intervention.Results Finally 81 patients completed the trial,including 41 patients in the observation group and 40 patients in the control group.Group and time had interaction effects on DHI-Function(F),DHI-Emotion(E)and DHI-Physical(P)scores and total DHI score(P<0.05).The main effects of group and time on DHI sub-scores and total score were significant(P<0.05).There was no significant difference between the two groups in DHI sub-scores and total score before intervention(P>0.05);DHI sub-scores and total score in both groups after 7 and 14 days of intervention were lower than those before intervention(P<0.05).DHI sub-scores and total score in the observation group were higher than the control group after 7 and 14 days of intervention(P<0.05).Group and time had interaction effects on HADS-Anxiety Scale(A),HADS-Depression Scale(D)scores and total HADS score(P<0.05).The main effect of group and time on HADS sub-scores and total score was significant(P<0.05).There was no significant difference in HADS sub-scores and total score between the two groups before intervention(P>0.05).HADS sub-scores and total score in both groups after 7 and 14 days of intervention were lower than those before intervention(P<0.05).After 7 and 14 days of intervention,there was no significant difference in HADS sub-scores and total score between the two groups(P>0.05).Conclusion Vestibular rehabilitation training is effective for patients with sudden deafness and vertigo,and the vestibular rehabilitation training assisted by VR technology can obviously improve patients'balance disorders and quality of life.