Kirtane Milind Vasant, Bhandari Anita, Narang Prashant, Santani Ravi
1Department of Otolaryngology, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra India.
Vertigo and Ear Clinic, Jaipur, Rajasthan India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1060-1068. doi: 10.1007/s12070-017-1120-7. Epub 2017 Apr 25.
Cinnarizine, is approved for nausea, vomiting, motion sickness, inner ear disorders and is considered as first-line pharmacotherapy for management of vertigo. It acts by anti-vasoconstrictor activity, reducing blood viscosity and reducing nystagmus in labyrinth. Lack of adequate literature on clinical evidence of cinnarizine and its combination (dimenhydrinate) in vertigo management prompted this review. A specific MEDLINE literature search strategy was designed combining Medical Subject Headings, free-text keywords (like cinnarizine and vertigo) using Boolean operators (1970-2016) for clinical studies, clinical reviews and meta-analyses of cinnarizine. Analyses of studies validated cinnarizine's efficacy in peripheral and central vertigo versus placebo or other therapies, and was well-tolerated by the patients recruited across different studies. Cinnarizine and/ or its combinations are favorable in management of vestibular disorders wherein cinnarizine acts predominantly peripherally on labyrinth and dimenhydrinate acts centrally on vestibular nuclei and associated centers in brainstem. Combination therapy of cinnarizine and/ or its combinations demonstrated a better safety profile than either of the mono-components, offering a viable therapeutic option in vertigo management.
桂利嗪被批准用于治疗恶心、呕吐、晕动病和内耳疾病，被视为治疗眩晕的一线药物疗法。它通过抗血管收缩活性发挥作用，降低血液粘度并减少内耳的眼球震颤。由于缺乏关于桂利嗪及其组合（茶苯海明）在眩晕治疗方面的临床证据的充分文献，促使进行了本次综述。设计了一种特定的医学文献数据库（MEDLINE）文献检索策略，结合医学主题词、自由文本关键词（如桂利嗪和眩晕），使用布尔运算符（1970 - 2016年）检索关于桂利嗪的临床研究、临床综述和荟萃分析。对研究的分析证实了桂利嗪相对于安慰剂或其他疗法在周围性和中枢性眩晕方面的疗效，并且在不同研究中招募的患者中耐受性良好。桂利嗪和/或其组合在治疗前庭疾病方面具有优势，其中桂利嗪主要在外周作用于内耳，而茶苯海明在中枢作用于前庭核及脑干中的相关中枢。桂利嗪和/或其组合的联合疗法显示出比单一成分更好的安全性，为眩晕治疗提供了一种可行的治疗选择。
