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[良性阵发性位置性眩晕成功复位后残余头晕的干预策略:一项单中心随机对照试验]

[Intervention strategies for residual dizziness after successful repositioning maneuvers in benign paroxysmal positional vertigo: a single center randomized controlled trial].

作者信息

Wu P X, Liu J P, Wang W Q, Li H W

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Eye & ENT Hospital of Fudan University,Shanghai 230001, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jan 7;56(1):41-46. doi: 10.3760/cma.j.cn115330-20201109-00856.

Abstract

To compare the effects of different intervention strategies for the management of residual dizziness following successful canalith repositioning procedure (CRP) in patients with benign paroxysmal positional vertigo (BPPV). A total of 129 BPPV patients with residual dizziness following successful CRP were recruited during January 2019 and July 2019. They were randomly assigned into three groups with 43 cases in each group: the vestibular rehabilitation group received rehabilitation training for four weeks; betahistine group was given orally 12 mg betahistine three times a day for four weeks; and the control group had no specific treatment. The primary outcomes were daily activities and social participation assessed by the Vestibular Activities and Participation measure (VAP). Secondary outcomes includedbalance function assessed by sensory organization test (SOT) and the duration of residual symptoms. Stata15.0 software was used for statistical analysis. The scores of VAP in the three groups decreased over time, but a more significant decrease was found in vestibular rehabilitation group. Further paired comparison showed that the difference between the vestibular rehabilitation group and the control group was of statistical significance (=-3.88, χ=18.29, 0.01), while the difference between the betahistine group and the control group was not statistically significant (=-0.96, χ=1.16, =0.28). The balance function of the three groups showed a trend of recovery over time, with no significant differences between groups (χ=1.37, =2, >0.05). The median duration of residual dizziness for both vestibular rehabilitation and betahistine groups was 14 days, while that of control group was 19 days, with no significant difference between three groups[ () test; χ=1.82, =2, =0.40]. Vestibular rehabilitation can significantly improve the daily activities and social participation function in BPPV patients with residual symptoms following successful CRP, but its effects on shortening the duration of residual symptoms and promoting the recovery of balance function remain uncertain.

摘要

为比较不同干预策略对良性阵发性位置性眩晕(BPPV)患者成功进行耳石复位治疗(CRP)后残留头晕的管理效果。2019年1月至2019年7月共招募了129例CRP成功后仍有残留头晕的BPPV患者。他们被随机分为三组,每组43例:前庭康复组接受为期四周的康复训练;倍他司汀组每天口服12mg倍他司汀,共四周;对照组不进行特殊治疗。主要结局指标是通过前庭活动与参与度测量(VAP)评估的日常活动和社会参与度。次要结局指标包括通过感觉统合测试(SOT)评估的平衡功能以及残留症状的持续时间。使用Stata15.0软件进行统计分析。三组的VAP评分均随时间下降,但前庭康复组下降更为显著。进一步的配对比较显示,前庭康复组与对照组之间的差异具有统计学意义(=-3.88,χ=18.29,0.01),而倍他司汀组与对照组之间的差异无统计学意义(=-0.96,χ=1.16,=0.28)。三组的平衡功能均随时间呈恢复趋势,组间无显著差异(χ=1.37,=2,>0.05)。前庭康复组和倍他司汀组残留头晕的中位持续时间均为14天,而对照组为19天,三组之间无显著差异[()检验;χ=1.82,=2,=0.40]。前庭康复可以显著改善CRP成功后仍有残留症状的BPPV患者的日常活动和社会参与功能,但其对缩短残留症状持续时间和促进平衡功能恢复的效果仍不确定。

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