Sato Go, Matsuda Kazunori, Matsuoka Momoyo, Fukuda Junya, Morita Yuka, Takahashi Kuniyuki, Horii Arata, Takeda Noriaki
a Department of Otolaryngology , University of Tokushima School of Medicine , Tokushima , Japan.
b Department of Otolaryngology , Yashima General Hospital , Tokushima , Japan.
Acta Otolaryngol. 2019 Jul;139(7):593-597. doi: 10.1080/00016489.2019.1612531. Epub 2019 May 20.
Regarding the relationship between psychiatric disorders and dizziness, anxiety is the most frequently seen psychiatric disorder in dizzy patients. We compared the effects of anti-anxious benzodiazepines (loflazepate) and anti-vertiginous cholinergic antagonist (diphenidol) on the subjective symptoms in chronic vestibular patients with secondary anxiety. Forty-three patients who had chronic dizziness lasting more than three months due to organic vestibular diseases with secondary anxiety. Anxiety was evaluated by the State-Trait Anxiety Inventory (STAI). Subjective handicaps due to dizziness were assessed by the validated questionnaire consisted of 14 questions that were categorized into two physical and three emotional factors. During the initial six months of the study, 21 patients were treated by anti-anxious benzodiazepines (loflazepate, 2 mg/day) for four weeks, whereas anti-vertiginous cholinergic antagonist (diphenidol, 75 mg/day) was used for four weeks for other 22 patients during the later six months-period. Subjective handicaps and STAI were compared between pre- and post-treatment. Loflazepate improved not only three emotional factors and state anxiety but also one of the physical factors. Diphenidol improved two physical factors but no emotional factors nor state and trait anxiety. Targeting for comorbid anxiety was beneficial for subjective symptoms of chronic dizziness with secondary anxiety.
关于精神障碍与头晕之间的关系，焦虑是头晕患者中最常见的精神障碍。我们比较了抗焦虑苯二氮䓬类药物（氯氟䓬乙酯）和抗眩晕胆碱能拮抗剂（地芬尼多）对伴有继发性焦虑的慢性前庭疾病患者主观症状的影响。43例因器质性前庭疾病伴继发性焦虑而患有持续超过3个月慢性头晕的患者。焦虑通过状态-特质焦虑量表（STAI）进行评估。头晕导致的主观障碍通过一份经过验证的问卷进行评估，该问卷由14个问题组成，分为两个身体因素和三个情绪因素。在研究的最初6个月，21例患者接受抗焦虑苯二氮䓬类药物（氯氟䓬乙酯，2毫克/天）治疗4周，而在随后的6个月期间，另外22例患者接受抗眩晕胆碱能拮抗剂（地芬尼多，75毫克/天）治疗4周。比较治疗前后的主观障碍和STAI。氯氟䓬乙酯不仅改善了三个情绪因素和状态焦虑，还改善了一个身体因素。地芬尼多改善了两个身体因素，但未改善情绪因素以及状态和特质焦虑。针对共病焦虑对伴有继发性焦虑的慢性头晕主观症状有益。
