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[药物治疗在眩晕代偿中的作用]

[The effect of pharmacological treatment in the compensation of vertigo].

作者信息

Pons Rocher F

机构信息

Servicio de O.R.L. Hospital Dr. Peset-S.V.S. Valencia.

出版信息

An Otorrinolaringol Ibero Am. 1999;26(3):271-91.

Abstract

From the age of sixty, vertigo is mainly due to vertebro-basilar insufficiency. It has been described that the association of Dihydroergocristine-Piracetam (D-P) is a useful treatment for vertebro-basilar insufficiency. That is why we have designed a comparative study between D-P an a Placebo, so that to prove if this association can be usefull in the treatment of vertigo occasioned by cerebrovascular insufficiency. Fifty patients complaining of vertigo were included in the study after an untreated term. 19 received a daily capsule of Placebo, and the other 31, treated with D-P, were divided in two groups: 16 patients received a dose of 3 mg Dihydroergocristine + 1.6 g Piracetam every 12 hours per os; and 15 other were treated with 1.5 mg Dihydroergocristine + 0.8 g Piracetam every 8 hours during 90 days. The patients were evaluated at the beginning of the study and 90 days later, with anamnesis and vestibular tests. In the last consultation the patients autoevaluated themselves the effect and the tolerance to the drugs received. In the Placebo group it was observed an improvement or disappearance of vertiginous symptoms in the 68.5% of the cases, while with D-P was 93.7% at the dose of 3 mg Dihydroergocristine + 1.6 g Piracetam each 12 hours and 100% with the dose 1.5 mg Dihydroergocristine + 0.8 g Piracetam each 8 hours. None of the treated patients with D-P worsened their symptoms. We observe a considerable decrease in the number of patients with vegetative symptoms in the group treated with D-P related to the Placebo group, though the symptoms persisted more time in the group treated with D-P that in the Placebo group. The group treated with D-P get a higher percentage of improvements and disappearance of auditive and cervical symptoms that the groups treated with Placebo. In the vestibulo-spinal and cerebellous tests it was observed a better improvement with D-P at the dose of 1.5 mg of Dihydroergocristine + 0.8 g Piracetam each hours compared with the other two groups. It can be concluded that the association D-P is an effective treatment for vertigo, getting also a higher normalization of the vestibular tests than Placebo.

摘要

从60岁起,眩晕主要归因于椎基底动脉供血不足。据描述,双氢麦角隐亭-吡拉西坦(D-P)联合用药是治疗椎基底动脉供血不足的一种有效疗法。因此,我们设计了一项D-P与安慰剂的对照研究,以证实这种联合用药在治疗由脑血管供血不足引起的眩晕方面是否有效。50名主诉眩晕的患者在经过一段未治疗期后被纳入研究。19名患者每日服用一粒安慰剂胶囊,另外31名接受D-P治疗的患者被分为两组:16名患者口服3毫克双氢麦角隐亭+1.6克吡拉西坦,每12小时一次;另外15名患者在90天内每8小时服用1.5毫克双氢麦角隐亭+0.8克吡拉西坦。在研究开始时和90天后,通过问诊和前庭测试对患者进行评估。在最后一次会诊中,患者对所服用药物的效果和耐受性进行自我评估。在安慰剂组中,68.5%的病例眩晕症状有所改善或消失,而在每12小时服用3毫克双氢麦角隐亭+1.6克吡拉西坦剂量的D-P组中,这一比例为93.7%,在每8小时服用1.5毫克双氢麦角隐亭+0.8克吡拉西坦剂量的D-P组中,这一比例为100%。接受D-P治疗的患者症状均未加重。我们观察到,与安慰剂组相比,D-P治疗组中出现植物神经症状的患者数量显著减少,不过D-P治疗组症状持续的时间比安慰剂组长。与安慰剂治疗组相比,D-P治疗组在听觉和颈部症状的改善及消失方面所占百分比更高。在前庭脊髓和小脑测试中,每小时服用1.5毫克双氢麦角隐亭+0.8克吡拉西坦剂量的D-P组与其他两组相比,改善情况更好。可以得出结论,D-P联合用药是治疗眩晕的一种有效疗法,与安慰剂相比,在前庭测试中也能使更多指标恢复正常。

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