He P, Xu X R, Jin Z G, Liu Y H, Zhai L H
Vertigo Clinical Research Center of Aerospace, General Hospital of Air Force, Beijing, 100142, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Apr 20;30(8):598-601. doi: 10.13201/j.issn.1001-1781.2016.08.003.
To compare the therapeutic efficacy and the recurrence rate between the simple repositioning method and the reposition manoeuvre plus medication in the treatment of horizontal semicircular canal otolith benign paroxysmal positional vertigo (HSC-BPPV). Sixty-two patients diagnosed with otolith HSC-BPPV by roll maneuver test were randomly divided into canalith repositioning group (32 patients) and reposition plus drug treatment group (30 patients). Patients in the canalith repositioning group were treated only with Barbecue reposition maneuver; patients in the reposition plus drug treatment group were treated firstly with Barbecue reposition maneuver and then were given Alprostadil, Cinepazide and Betahistine drug treatment. Both groups were evaluated after 7 days and 28 days treatment, and the recurrence rate was analyzed after 3 months. After 7 days of the treatment , the recovery rate of the two groups was 62.5% and 73.3%, respectively. There's no significant difference between the two groups. However, the total effective power of the reposition plus drug treatment group was 96.7%, which was significantly higher than that of the canalith repositioning group (75.0%) (χ²=5.858, <0.05). There were 8 patients in the canalith repositioning group showed changes of BBPV types after treatment, while only 1 patient in the reposition plus drug treatment group showed lesion changes. The difference was statistically significant (χ²=4.061, <0.05). After 28 days of the treatment, the recovery rate and the total effective power of the two groups was 100%, respectively. There is no statistical difference in the total effective rate between the two groups. After 3 months follow-up, 2 patients in the canalith repositioning group (6.25%) and in the reposition plus drug treatment group (6.67%) showed BBPV recurrence, and no significant difference in the recurrence rate was found between the two groups (>0.05). The repositioning maneuver is the preferred method for treating HSC BPPV. Canalith reposition maneuver plus medication has no obvious effect on the recovery rate and the recurrence rate, it only increases the effective rate and reduces the changes of the BBPV types.
比较单纯复位法与复位手法联合药物治疗水平半规管耳石症良性阵发性位置性眩晕（HSC - BPPV）的疗效及复发率。将62例经滚转试验确诊为耳石症HSC - BPPV的患者随机分为耳石复位组（32例）和复位加药物治疗组（30例）。耳石复位组患者仅接受Epley复位手法治疗；复位加药物治疗组患者先接受Epley复位手法治疗，然后给予前列地尔、桂哌齐特和倍他司汀药物治疗。两组在治疗7天和28天后进行评估，并在3个月后分析复发率。治疗7天后，两组的恢复率分别为62.5%和73.3%。两组之间无显著差异。然而，复位加药物治疗组的总有效率为96.7%，显著高于耳石复位组（75.0%）（χ² = 5.858，P < 0.05）。耳石复位组有8例患者治疗后出现BPPV类型改变，而复位加药物治疗组仅1例患者出现病变改变。差异有统计学意义（χ² = 4.061，P < 0.05）。治疗28天后，两组的恢复率和总有效率均分别为100%。两组总有效率无统计学差异。3个月随访后，耳石复位组有2例患者（6.25%）和复位加药物治疗组有2例患者（6.67%）出现BPPV复发，两组复发率无显著差异（P > 0.05）。复位手法是治疗HSC BPPV的首选方法。耳石复位手法联合药物治疗对恢复率和复发率无明显影响，仅提高了有效率并减少了BPPV类型的改变。
