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[前庭康复对梅尼埃病慢性失衡患者的疗效]

[The effectiveness of vestibular rehabilitation in Ménière's disease patients with chronic imbalance].

作者信息

Zhuang Yu, Wu Peixia, Li Wenyan, Xi Shuxin

机构信息

Clinical Center of Vertigo and Balance Disorders,Eye and ENT Hospital of Fudan University,Shanghai,200031,China.

Department of Medical Management,Eye and ENT Hospital of Fudan University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Sep;36(9):675-678;684. doi: 10.13201/j.issn.2096-7993.2022.09.005.

Abstract

To observe the effectiveness of vestibular rehabilitation in Ménière's disease patients with chronic imbalance. Forty-five Ménière's disease patients with chronic imbalance treated in vertigo specialist clinic of Eye and ENT Hospital of Fudan University from December 2020 to December 2021 were enrolled. Patients were divided randomly into two groups, 23 patients in experimental group and 22 patients in control group. Both groups received routine outpatient treatment, and the experimental group received an additional vestibular rehabilitation for 8 weeks. All patients were evaluated with dizziness handicap inventory (DHI) at baseline and 8-week follow-up, and the incidence of fall was calculated. The occurrence of adverse events during the study was also recorded. There was no significant difference in baseline data between the two groups (>0.05). During the study, 1 patient were lost to follow-up and 2 patients dropped out. A total of 42 patients completed the study. Intentionality analysis was performed on lost follow-up patients. After 8 weeks of the treatment, there were significant statistically differences in difference values of DHI and DHI-F scores(=-30.22±3.78, =-13.09±4.85, =-2.799, <0.05; =-12.43±1.46, =-4.55±2.17, =-3.043, <0.05), while no significant difference was showed in the difference values of DHI-P and DHI-E scores(>0.05). There was no significant difference in incidence of fall between two groups(>0.05), but the incidence of experimental group decreased significantly compared with that before treatment(4.35% vs 34.78%, =4.973, <0.05). No serious adverse event was reported in the two groups. Vestibular rehabilitation can improve the balance function and reduce risk of fall in Ménière's disease patients with chronic imbalance. Therefore, it is worthy of clinical application.

摘要

观察前庭康复训练对梅尼埃病慢性失衡患者的疗效。选取2020年12月至2021年12月在复旦大学附属眼耳鼻喉科医院眩晕专病门诊就诊的45例梅尼埃病慢性失衡患者。将患者随机分为两组,实验组23例,对照组22例。两组均接受常规门诊治疗,实验组额外接受8周的前庭康复训练。所有患者在基线及随访8周时采用头晕残障量表(DHI)进行评估,并计算跌倒发生率。记录研究期间不良事件的发生情况。两组基线数据差异无统计学意义(>0.05)。研究期间,1例患者失访,2例患者退出。共42例患者完成研究,对失访患者进行意向性分析。治疗8周后,DHI及DHI-F评分差值有显著统计学差异(=-30.22±3.78,=-13.09±4.85,=-2.799,<0.05;=-12.43±1.46,=-4.55±2.17,=-3.043,<0.05),而DHI-P及DHI-E评分差值差异无统计学意义(>0.05)。两组跌倒发生率差异无统计学意义(>0.05),但实验组跌倒发生率较治疗前显著降低(4.35% 对34.78%,=4.973,<0.05)。两组均未报告严重不良事件。前庭康复训练可改善梅尼埃病慢性失衡患者的平衡功能,降低跌倒风险。因此,值得临床应用。

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本文引用的文献

1
[Vestibular rehabilitation in patients with vestibular peripheral vertigo].[前庭周围性眩晕患者的前庭康复治疗]
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.
2
[Interpretation of clinical practice guideline: Ménière's disease (2020)].[临床实践指南解读:梅尼埃病(2020年)]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 May;35(5):385-390. doi: 10.13201/j.issn.2096-7993.2021.05.001.
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Vestibular drop attacks in Ménière's disease.梅尼埃病中的前庭性发作。
J Vestib Res. 2021;31(5):389-399. doi: 10.3233/VES-201502.
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[Clinical characteristics analysis of patients with Meniere's disease and vestibular migraine].梅尼埃病与前庭性偏头痛患者的临床特征分析
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Sep;34(9):820-823. doi: 10.13201/j.issn.2096-7993.2020.09.012.
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Otolaryngol Head Neck Surg. 2020 Apr;162(2_suppl):S1-S55. doi: 10.1177/0194599820909438.
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Advances in Vestibular Rehabilitation.前庭康复进展
Adv Otorhinolaryngol. 2019;82:164-169. doi: 10.1159/000490285. Epub 2019 Jan 15.

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