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经皮耳迷走神经刺激联合甲磺酸倍他司汀治疗梅尼埃病:一项随机对照试验。

Meniere Disease treated with transcutaneous auricular vagus nerve stimulation combined with betahistine Mesylate: A randomized controlled trial.

机构信息

Department of Traditional Chinese Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.

Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China.

出版信息

Brain Stimul. 2023 Nov-Dec;16(6):1576-1584. doi: 10.1016/j.brs.2023.10.003. Epub 2023 Oct 13.

Abstract

BACKGROUND

Meniere Disease is a clinical condition defined by hearing loss, tinnitus, and aural fullness symptoms, there are currently no any medications approved for its treatment.

OBJECTIVE

To determine whether taVNS as an adjunctive therapy could relieve symptoms and improve the quality of life in patients with Meniere disease.

METHODS

In this Single-center, single blind, randomized trial, participants were assigned to transcutaneous auricular vagus nerve stimulation (taVNS) group and sham taVNS group. The primary outcome measures comprised Tinnitus Handicap Inventory, Dizziness Handicap Inventory, Pure Tone Auditory, Visual analogue scale of aural fullness. Secondary outcome measures comprised the 36-Item Short Form Health Survey, video head impulse test, and the caloric test.

RESULTS

After 12 weeks, the THI (-11.00, 95%CI, -14.87 to -7.13; P < 0.001), DHI (-47.26, 95%CI, -50.23 to -44.29; P < 0.001), VAS of aural fullness (-2.22, 95%CI, -2.95 to -1.49; P<0.01), and Pure Tone Thresholds (-7.07, 95%CI, -9.07 to -5.06; P<0.001) were significantly differed between the two groups. In addition, SF36(14.72, 95%CI, 11.06 to 18.39; P < 0.001), vHIT (RD, 0.26, 95 % CI, -0.44 to -0.08, RR, 0.43, 95 % CI, 0.22 to 0.83, P < 0.01), and the caloric test (RD, -0.24, 95 % CI, -0.43 to -0.04, RR, 0.66, 95 % CI, 0.44 to 0.95, P = 0.02) have significant difference between two group, respectively.

CONCLUSIONS

These findings suggest that taVNS combined with Betahistine Mesylate relieve symptoms and improve the quality of life for patients with Meniere Disease. taVNS can be considered an adjunctive therapy in treatment of Meniere Disease.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05328895.

摘要

背景

梅尼埃病是一种以听力损失、耳鸣和耳闷为特征的临床病症,目前尚无任何药物被批准用于其治疗。

目的

评估经皮耳迷走神经刺激(taVNS)作为辅助疗法是否可以缓解梅尼埃病患者的症状并改善其生活质量。

方法

这是一项单中心、单盲、随机临床试验,参与者被分配到经皮耳迷走神经刺激(taVNS)组和假 taVNS 组。主要结局指标包括耳鸣残疾量表、眩晕残疾量表、纯音听阈、耳闷视觉模拟量表。次要结局指标包括 36 项简短健康调查问卷、视频头脉冲试验和冷热试验。

结果

12 周后,taVNS 组在耳鸣残疾量表(-11.00,95%CI,-14.87 至-7.13;P<0.001)、眩晕残疾量表(-47.26,95%CI,-50.23 至-44.29;P<0.001)、耳闷视觉模拟量表(-2.22,95%CI,-2.95 至-1.49;P<0.01)和纯音听阈(-7.07,95%CI,-9.07 至-5.06;P<0.001)方面的评分均显著低于假 taVNS 组。此外,SF36(14.72,95%CI,11.06 至 18.39;P<0.001)、视频头脉冲试验(RD,0.26,95%CI,-0.44 至-0.08,RR,0.43,95%CI,0.22 至 0.83,P<0.01)和冷热试验(RD,-0.24,95%CI,-0.43 至-0.04,RR,0.66,95%CI,0.44 至 0.95,P=0.02)的评分也存在显著差异。

结论

这些发现表明,taVNS 联合甲磺酸倍他司汀可缓解梅尼埃病患者的症状并提高其生活质量。taVNS 可作为梅尼埃病治疗的辅助疗法。

试验注册

ClinicalTrials.gov 标识符:NCT05328895。

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