Jurkiewicz Dariusz, Kantor Ireneusz
Wojskowy Instytut Medyczny w Warszawie, CSK MON, Klinika Otolaryngologiczna.
Pol Merkur Lekarski. 2009 Jan;26(151):29-34.
In spite of detailed examinations it is impossible to find reasons for balance system disturbances in more than 25 per cent of patients. Therefore doctors have to treat symptoms but not the reasons for balance system disturbances. One of the most frequently administered medicine in treatment of both central and peripheral balance system disturbances is betahistine dihydrochloride (Betaserc). The aim of the study was to evaluate the influence of Betaserc an balance system disturbances with reference to dosage.
Patients were divided into two groups. The first group (Group I) was treated with Betaserc three times a day: 16 mg for minimum 4 weeks and 8 mg for minimum 8 weeks. The second group (Group II) was treated with Betaserc twice a day: 24 mg for maximum 4 weeks and next 12 mg for minimum 8 weeks. The data from interviews and additional examinations (videonystagmography and posturography) were considered.
The latter group more often showed smaller balance system disturbances and vertigo than the first group both after 4 and 12 weeks. After 12 weeks of treatment more patients from the second group reported "a complete disappearance" of the symptoms. A substantial improvement of results was observed in videonystagmography and posturography examinations.
The treatment with 24 mg for 4 weeks and 12 mg for 8 weeks twice daily was better tolerated and gave higher positive effects than the treatment three times a day with 16 mg for 4 weeks and 8 mg for 8 weeks.
尽管进行了详细检查,但仍有超过25%的患者无法找到平衡系统紊乱的原因。因此,医生不得不治疗症状而非平衡系统紊乱的原因。在治疗中枢性和外周性平衡系统紊乱时,最常用的药物之一是倍他司汀二盐酸盐(敏使朗)。本研究的目的是评估敏使朗对平衡系统紊乱的影响,并参考剂量。
患者分为两组。第一组(I组)每天服用敏使朗三次:16毫克,至少服用4周,然后8毫克,至少服用8周。第二组(II组)每天服用敏使朗两次:24毫克,最多服用4周,然后12毫克,至少服用8周。考虑了访谈数据和额外检查(视频眼震图和姿势描记法)的数据。
在4周和12周后,后一组比第一组更常出现较小的平衡系统紊乱和眩晕。治疗12周后,第二组更多患者报告症状“完全消失”。在视频眼震图和姿势描记法检查中观察到结果有显著改善。
与每天三次服用16毫克4周和8毫克8周的治疗相比,每天两次服用24毫克4周和12毫克8周的治疗耐受性更好,且产生的积极效果更高。