Cui Qingjia, Wang Rui, Yan Jin, Liu Fang, Chen Na, Zhang Lei, Dai Feng, Lou Ying
Department of Otolaryngology,Beijing Rehabilitation Hospital,Capital Medical University,Beijing,100144,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar;36(3):217-221. doi: 10.13201/j.issn.2096-7993.2022.03.012.
To evaluate the efficacy of vestibular rehabilitation in patients with anterior peripheral vertigo and analyze its influencing factors. From January 2018 to June 2021, 153 cases with peripheral vertigo diseases(including 47 cases of benign positional paroxysmal vertigo, 38 cases of Meniere's disease, 26 cases of sudden deafness with vertigo, 23 cases of vestibular migraine and 19 cases of vestibular neuritis) were enrolled. One hundred and three cases were treated with vestibular rehabilitation combined with drugs, and 50 cases only treated with drugs were used as controls. Self-rating scale and vertigo disorder scale were evaluated at the beginning of treatment, 4 weeks and 8 weeks, respectively. The curative effects of the two groups were tested by -test, and the independent risk factors affecting the curative effects were analyzed by multiple linear regression. There was no difference in clinical data, self-assessment scale and vertigo disorder scale between the two groups(>0.05). At 4 and 8 weeks, the scores of self-assessment scale and vertigo disorder scale in the experimental group were better than those in the control group(all <0.01), and the curative effect at 8 weeks was better than that at 4 weeks, especially the decrease of emotional score during walking and the proportion of severe vertigo disability(all <0.01). The scores of self-rating scale and vertigo disorder scale of the cases with benign positional paroxysmal vertigo and vestibular neuritis were better than Meniere's disease, vestibular migraine and sudden deafness with vertigo(<0.05). Headache(<0.05) and severe vertigo disorder before intervention(<0.01) were independent risk factors affecting the efficacy of vestibular rehabilitation. Vestibular rehabilitation combined with anti-vertigo drugs in the treatment of vestibular peripheral vertigo is better than that of only using drugs, especially in improving the degree of emotional disorder and vertigo disability. It is more suitable for benign positional paroxysmal vertigo and vestibular neuritis, while the effect of combined headache or severe vertigo is relatively poor.
评估前庭康复治疗在前庭周围性眩晕患者中的疗效并分析其影响因素。选取2018年1月至2021年6月期间153例周围性眩晕疾病患者(包括47例良性阵发性位置性眩晕、38例梅尼埃病、26例突发性聋伴眩晕、23例前庭性偏头痛和19例前庭神经炎)。103例采用前庭康复联合药物治疗,50例仅采用药物治疗作为对照。分别在治疗开始时、4周和8周进行自评量表和眩晕障碍量表评估。两组疗效采用t检验,采用多元线性回归分析影响疗效的独立危险因素。两组临床资料、自评量表和眩晕障碍量表比较差异无统计学意义(P>0.05)。在4周和8周时,试验组自评量表和眩晕障碍量表评分均优于对照组(均P<0.01),8周时疗效优于4周,尤其是行走时情绪评分下降及重度眩晕残疾比例(均P<0.01)。良性阵发性位置性眩晕和前庭神经炎患者的自评量表和眩晕障碍量表评分优于梅尼埃病、前庭性偏头痛和突发性聋伴眩晕患者(P<0.05)。头痛(P<0.05)和干预前重度眩晕障碍(P<0.01)是影响前庭康复疗效的独立危险因素。前庭康复联合抗眩晕药物治疗前庭周围性眩晕疗效优于单纯药物治疗,尤其在改善情绪障碍程度和眩晕残疾方面。更适用于良性阵发性位置性眩晕和前庭神经炎,而合并头痛或重度眩晕时效果相对较差。