Huang Hsiao-Han, Chen Chih-Chung, Lee Hsun-Hua, Chen Hung-Chou, Lee Ting-Yi, Tam Ka-Wai, Kuan Yi-Chun
From the School of Medicine, Taipei Medical University, Taipei, Taiwan (H-HH); Dizziness and Balance Disorder Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (C-CC, H-HL, T-YL); Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (C-CC, H-HL, T-YL, Y-CK); Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan (C-CC, H-HL, T-YL, Y-CK); Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (C-CC, H-HL, T-YL, Y-CK); Department of Neurology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan (H-HL); Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (H-CC); Center for Evidence-Based Health Care, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan (H-CC, Y-CK); Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (H-CC); Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan (K-WT); Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (K-WT); Division of General Surgery, Department of Surgery, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (K-WT); and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (Y-CK).
Am J Phys Med Rehabil. 2024 Jan 1;103(1):38-46. doi: 10.1097/PHM.0000000000002301. Epub 2023 Jun 1.
This study aimed to evaluate the efficacy of vestibular rehabilitation in vestibular neuritis.
A randomized controlled trial was collected from MEDLINE, Embase, Cochrane Library, PEDro, LILACS, and Google Scholar before May 2023.
This study included 12 randomized controlled trials involving 536 patients with vestibular neuritis. Vestibular rehabilitation was comparable with steroids in dizziness handicap inventory score at the first, sixth, and 12th months (pooled mean differences: -4.00, -0.21, and -0.31, respectively); caloric lateralization at the third, sixth, and 12th months (pooled mean difference: 1.10, 4.76, and -0.31, respectively); and abnormal numbers of vestibular-evoked myogenic potentials at the first, sixth, and 12th months. Patients receiving a combination of rehabilitation and steroid exhibited significant improvement in dizziness handicap inventory score at the first, third, and 12th months (mean difference: -14.86, pooled mean difference: -4.63, mean difference: -9.50, respectively); caloric lateralization at the first and third months (pooled mean difference: -10.28, pooled mean difference: -8.12, respectively); and numbers of vestibular-evoked myogenic potentials at the first and third months (risk ratios: 0.66 and 0.60, respectively) than did those receiving steroids alone.
Vestibular rehabilitation is recommended for patients with vestibular neuritis. A combination of vestibular rehabilitation and steroids is more effective than steroids alone in the treatment of patients with vestibular neuritis.
本研究旨在评估前庭康复治疗在前庭神经炎中的疗效。
在2023年5月之前，从MEDLINE、Embase、Cochrane图书馆、PEDro、LILACS和谷歌学术中收集了一项随机对照试验。
本研究纳入了12项随机对照试验，涉及536例前庭神经炎患者。在前庭康复治疗与类固醇治疗的比较中，在第1、6和12个月时，头晕残障量表评分相当（合并平均差异分别为-4.00、-0.21和-0.31）；在第3、6和12个月时，冷热试验眼震优势偏向相当（合并平均差异分别为1.10、4.76和-0.31）；在第1、6和12个月时，前庭诱发肌源性电位异常数量相当。接受康复治疗与类固醇联合治疗的患者在第1、3和12个月时，头晕残障量表评分有显著改善（平均差异分别为-14.86、合并平均差异为-4.63、平均差异为-9.50）；在第1和3个月时，冷热试验眼震优势偏向有改善（合并平均差异分别为-10.28、合并平均差异为-8.12）；在第1和3个月时，前庭诱发肌源性电位数量有改善（风险比分别为0.66和0.60），均优于单独接受类固醇治疗的患者。
推荐对前庭神经炎患者进行前庭康复治疗。在前庭神经炎患者的治疗中，前庭康复与类固醇联合治疗比单独使用类固醇更有效。
