手法复位联合天麻素及康复治疗对老年良性阵发性位置性眩晕患者的临床疗效

Clinical efficacy of manual reduction combined with gastrodin and rehabilitation in treatment of benign paroxysmal positional vertigo in the elderly

摘要:

目的 探讨手法复位联合天麻素及康复治疗对老年良性阵发性位置性眩晕(BPPV)患者的临床疗效。方法 选取2016年9月至2018年2月就诊于辽宁省金秋医院耳鼻咽喉科、神经内科及老年综合科等确诊的老年BPPV患者90例作为研究对象。随机数表法分为A、B两组,各45例。A组给予强迫体位治疗与天麻素治疗,B组给予手法复位联合天麻素及康复治疗。比较2组患者的临床疗效,眩晕障碍积分,基底动脉(BA)、左椎动脉(LVA)、右椎动脉(RVA)最大血流速度。采用SPSS 15.0统计学软件进行数据分析,并分别采用χ²检验或t检验对2组数据进行比较。结果 B组总有效率显著高于A组,差异有统计学意义[53.33％(24/45) vs 91.11％(41/45),P＜0.05]。2组患者治疗后眩晕残障量表积分均较治疗前显著下降,差异有统计学意义(P＜0.05)；治疗后B组眩晕残障量表积分显著低于A组,差异有统计学意义[(17.3±3.3) vs (24.2±4.1), P＜0.05]。与治疗前相比,2组患者治疗后RVA、LVA、BA最大血流速度均显著提高,差异有统计学意义(P＜0.05)；治疗后B组RVA、LVA、BA最大血流速度显著高于A组,差异有统计学意义(P＜0.05)。结论 手法复位联合天麻素及康复治疗能显著提高老年BPPV患者临床疗效,改善其临床症状。

Abstract:

Objective To investigate the clinical efficacy of manual reduction combined with gastrodin and rehabilitation in the treatment of benign paroxysmal positional vertigo (BPPV) in the elderly patients. Methods A total of 90 BPPV elderly patients diagnosed in the Otolaryngology, Neurology and Geriatrics Departments of our hospital from September 2016 to February 2018 were prospectively recruited in this study. They were randomly divided into group A and group B, with 45 cases in each group. The patients of group A were treated with gastrodin and forced posture, while those from group B were given gastrodin treatment combined with manual reduction and rehabilitation. The clinical efficacy, vertigo score, and maximum blood flow velocity of basilar artery (BA), left vertebral artery (LVA) and right vertebral artery (RVA) were compared between the 2 groups. SPSS statistics 15.0 was used to perform the statistical analysis. Chi-square test or Student′s t test was employed for comparison between two groups. Results The total effective rate was 53.33%(24/45) in group A, and 91.11%(41/45) in group B, and the rate was significantly higher in group B than group A (P<0.05). The score of vertigo disability scale was obviously decreased in both groups after treatment, and statistical difference was seen between them[(17.3±3.3) vs (24.2±4.1), P＜0.05]. The treatment improved the maximum blood flow velocities of BA, LVA and RVA in the both group (P<0.05), and the changes in group B were more significant than those in group A (P<0.05). Conclusion Manual reduction combined with gastrodin and rehabilitation can obviously improve the clinical efficacy and clinical symptoms in treatment of elderly BPPV.