Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.
Otolaryngol Head Neck Surg. 2010 Sep;143(3):405-12. doi: 10.1016/j.otohns.2010.05.022.
To determine if variations in common treatments for benign paroxysmal positional vertigo (BPPV) affected efficacy.
Prospective, pseudo-randomized study.
Outpatient practice in a tertiary care facility.
Patients (n = 118) with unilateral BPPV of the posterior canal, including 13 patients with BPPV of the lateral canal, were tested at a tertiary care center on one of five interventions: canalith repositioning maneuver (CRP), CRP plus home exercise, modified CRP, CRP for patients with involvement of two semicircular canals, and self-CRP home exercise. Self-CRP was also compared to previously published data on efficacy of the Brandt Daroff exercise. Main outcome measures were vertigo intensity and frequency, presence/absence of Dix-Hallpike responses, Vestibular Disorders Activities of Daily Living Scale (VADL), and computerized dynamic posturography.
Vertigo intensity and frequency and Dix-Hallpike responses decreased significantly, and posturography and VADL improved significantly from pre- to post tests. No other significant changes were found. The groups did not differ significantly. Vertigo intensity and frequency were not strongly related at pretest but were related at post-test. Length of illness and age did not influence the results.
However the head is moved, as long as it is moved rapidly enough and through the correct planes in space, repositioning treatments are likely to be effective. Therefore, clinicians have a range of choices in selecting the treatment best suited for each patient's unique needs.
确定良性阵发性位置性眩晕（BPPV）常见治疗方法的差异是否会影响疗效。
前瞻性、拟随机研究。
三级医疗保健机构的门诊。
患有单侧后半规管 BPPV 的患者（n = 118），包括 13 例外侧半规管 BPPV 患者，在三级医疗中心接受以下五种干预措施之一的测试：耳石复位手法（CRP）、CRP 加家庭运动、改良 CRP、涉及两个半规管的 CRP 以及家庭 CRP 运动。家庭 CRP 也与 Brandt Daroff 运动疗效的先前发表数据进行了比较。主要观察指标为眩晕强度和频率、Dix-Hallpike 反应的存在/缺失、前庭疾病日常生活活动量表（VADL）和计算机动态姿势描记术。
眩晕强度和频率以及 Dix-Hallpike 反应明显降低，姿势描记术和 VADL 从测试前到测试后明显改善。未发现其他显著变化。各组之间无显著差异。测试前，眩晕强度和频率相关性不强，但测试后相关性较强。疾病持续时间和年龄对结果没有影响。
无论头部如何移动，只要移动速度足够快，并且在空间中通过正确的平面，定位治疗都可能有效。因此，临床医生在为每位患者选择最适合其独特需求的治疗方法时有多种选择。
