Goto Fumiyuki, Kaneda Shoji, Wasano Koichiro
Otolaryngology - Head and Neck Surgery, Tokai University School of Medicine, Isehara, JPN.
Otolaryngology- Head and Neck Surgery, Tokai University, Isehara, JPN.
Cureus. 2025 Jul 2;17(7):e87161. doi: 10.7759/cureus.87161. eCollection 2025 Jul.
Background Benign paroxysmal positional vertigo (BPPV) is the most common acute vertigo disorder caused by otolith displacement in the inner ear. Recurrence, particularly in older adults, poses a significant clinical challenge. Objectives This study evaluates the therapeutic effects of ryokeijutsukanto, a Kampo medicine, on BPPV when used adjunctively with the Brandt-Daroff (BD) method. Methods A prospective cohort study was conducted following the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Forty-eight BPPV patients were divided into three groups: Group A (BD method only, N=8), Group B (BD method + Kampo, N=11), and Group C (BD method + betahistine 36 mg, N=29). As Kampo, ryokeijutsukanto 7.5 mg was given three times a day before meals, divided into three doses. The BD method was performed daily, and the outcomes were measured by subjective improvement and positional nystagmus resolution. Results Positional nystagmus resolution occurred in 38.3 ± 34.5 days (Group A), 30 ± 30.2 days (Group B), and 20.8 ± 21.4 days (Group C), with no statistically significant differences between groups. Subjective improvements were observed in 55% (6/11) of patients in Group B. Conclusions While ryokeijutsukanto did not significantly impact nystagmus resolution times, it enhanced subjective outcomes and adherence, suggesting its potential as an adjunctive therapy in BPPV management.
良性阵发性位置性眩晕（BPPV）是内耳耳石移位引起的最常见的急性眩晕疾病。复发，尤其是在老年人中，构成了重大的临床挑战。目的：本研究评估汉方药物苓桂术甘汤辅助Brandt-Daroff（BD）法治疗BPPV的疗效。方法：按照STROBE（加强流行病学观察性研究报告）指南进行前瞻性队列研究。48例BPPV患者分为三组：A组（仅采用BD法，N = 8）、B组（BD法+汉方药物，N = 11）和C组（BD法+倍他司汀36mg，N = 29）。作为汉方药物，苓桂术甘汤7.5mg每日三次饭前服用，分三次给药。每天进行BD法治疗，通过主观改善和位置性眼震消失来衡量结果。结果：A组位置性眼震消失时间为38.3±34.5天，B组为30±30.2天，C组为20.8±21.4天，组间无统计学显著差异。B组55%（6/11）的患者有主观改善。结论：虽然苓桂术甘汤对眼震消失时间没有显著影响，但它提高了主观疗效和依从性，表明其在BPPV治疗中作为辅助治疗的潜力。
