Michels Thomas, Lehmann Nils, Moebus Susanne
Practice for Internal Medicine, Hematology, Radiology, Natural Cure, Cologne (Köln), Germany.
J Altern Complement Med. 2007 Jun;13(5):513-8. doi: 10.1089/acm.2007.6102.
Cervical vertigo (CV) is commonly attributed to a disturbed cervical proprioception and is associated with cervical pain (CP). It is assumed to respond to a treatment that improves CP. In a prospective observational study, we examined whether a treatment originally devised for patients with CP could improve CV also in cases without CP.
During a period of 3 years, a total of 238 consecutive patients, 41 patients with CV only, 43 patients with CV and CP, 154 patients with CP only, received the same treatment, which consisted of local anaesthetics applied on average in 8 sessions to a fixed set of epidermal, epithelial, and periosteal locations. Outcome was relief of symptoms measured by a verbal-analogue scale at the end of therapy and on average a year later.
At the end of therapy, 58% of patients with CV responded with complete remissions compared to 41% of patients with CP. At follow-up a year later, there were complete remissions in more than 50% in CV as well as in CP.
The applied therapy led to complete remissions of long duration in a high percentage of patients with CV even when symptoms of CP were missing. This therapy produced good effects for CP as well. Its neurophysiological basis is discussed and may offer a new approach not only to the treatment of CV and CP but in a general sense also to that of acute, chronic, and neuropathic pain. It needs to be emphasized, however, that this study was not a randomized controlled trial and its encouraging results have to be proved by further research.
颈性眩晕(CV)通常归因于颈部本体感觉紊乱,并与颈部疼痛(CP)相关。人们认为它对改善CP的治疗有反应。在一项前瞻性观察研究中,我们研究了最初为CP患者设计的一种治疗方法是否也能改善无CP的CV患者的症状。
在3年期间,共有238例连续患者,其中41例仅患有CV,43例患有CV和CP,154例仅患有CP,接受了相同的治疗,该治疗包括平均8次将局部麻醉剂应用于一组固定的表皮、上皮和骨膜位置。结局是通过治疗结束时和平均一年后的视觉模拟量表测量症状缓解情况。
治疗结束时,58%的CV患者完全缓解,而CP患者为41%。一年后的随访中,CV和CP患者中超过50%完全缓解。
即使没有CP症状,所应用的治疗方法也使高比例的CV患者长期完全缓解。该治疗方法对CP也产生了良好效果。文中讨论了其神经生理学基础,这可能不仅为CV和CP的治疗,而且从广义上讲也为急性、慢性和神经性疼痛的治疗提供一种新方法。然而,需要强调的是,本研究不是随机对照试验,其令人鼓舞的结果必须通过进一步研究来证实。