圣·约翰草提取物联合前庭康复治疗良性阵发性位置性眩晕复位后残余头晕的临床效果

Effect of St.John's Wort Extract Combined with Vestibular Rehabilitation Therapy for Residual Dizziness after Successful Reduction of Benign Paroxysmal Positional Vertigo

目的讨论圣·约翰草提取物联合前庭康复治疗(VRT)对良性阵发性位置性眩晕(BPPV)患者成功复位后残余头晕(RD)干预的疗效。方法选择2018年10月至2023年10月在宁夏回族自治区人民医院神经内科眩晕专病门诊确诊为BPPV并成功复位后有RD症状的患者为研究对象,随机分为观察组和对照组,观察组给予圣·约翰草提取物联合VRT,对照组给予VRT,比较两组患者眩晕程度及焦虑、抑郁情绪的改善情况。结果500例BPPV患者成功复位后,出现RD患者252例(50.4%),治疗2周后观察组和对照组眩晕障碍量表(DHI)评分,包括情绪(DHI-E)、功能(DHI-F)、躯体(DHI-P)和眩晕障碍量表总分(DHI-T)得分与治疗前相比均下降(P均<0.01),且观察组低于对照组(P均<0.01);两组患者抑郁症筛查量表(PHQ-9)、焦虑症筛查量表(GAD-7)评分均降低(P均<0.01),且观察组低于对照组(P<0.001)。观察组出现口干症状2例,停药后症状消失,对照组无不良反应发生。结论圣·约翰草提取物联合VRT BPPV成功复位后RD,可减轻患者眩晕症状及抑郁、焦虑程度,并且不良反应少。

Objective To discuss the efficacy and possible related factors of St.John's wort extract combined with vestibular rehabilitation therapy(VRT)after successful reduction of residual dizziness(RD)in patients with BPPV.Methods Patients with RD symptoms diagnosed with BPPV and successful manual reduction were randomly divided into observation group and control group.Observation group was treated with St.John's wort extract combined with VRT and control group was treated with VRT.The improvement of dizziness,disability,anxiety and depression of patients in the two groups was compared.Results There were 252 cases(50.4%)of RD patients after successful reduction in 500 cases of BPPV.Disability Scale in the observation and control groups after 2 weeks of treatment(dizziness handicap inventory,DHI)grade,Included emotions(emotional,DHI-E),function(functional,DHI-F),soma(physical,DHI-P)and vertigo disability scale total(DHI-T)scores decreased significantly compared with before treatment(P all<0.01).However,the observation group was lower than the control group(P all<0.01).The screening scale of depression(PHQ-9)and anxiety screening scale(GAD-7)scores decreased in both groups(P all<0.01),but the observed group was more significant than the control group(P<0.001).Two cases had dry mouth symptoms in the observation group,and the symptoms disappeared after drug withdrawal,and no adverse reactions occurred in the control group.Conclusion St.John's wort extract combined with VRT for RD after successful redultion of BPPV can reduce dizziness symptoms,depression and anxiety,with few adverse reactions.