中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2012年
10期
799-803
,共5页
章燕幸%吴承龙%肖桂荣%钟芳芳
章燕倖%吳承龍%肖桂榮%鐘芳芳
장연행%오승룡%초계영%종방방
眩晕%物理治疗技术%半规管%治疗结果
眩暈%物理治療技術%半規管%治療結果
현훈%물리치료기술%반규관%치료결과
Vertigo%Physical therapy modalities%Semicircular canals%Treatment outcome
目的 对后半规管良性阵发性位置性眩晕三种自我治疗手法(改良Epley法、改良Semont法和Brandt-Daroff法)进行临床疗效和复发率的对比研究.方法 168例患者随机抽签法分为四组,改良Epley组45例,改良Semont组43例,Brandt-Daroff组40例和对照组40例,对照组仅给予药物治疗不使用复位法.比较四组治疗1周和1个月时的疗效、不良反应发生率以及6个月时的复发率,并对四组达到治愈所需的时间进行比较.结果 改良Epley法治疗1周时疗效优于其他三组,差异具有统计学意义(x2=8.55、23.23及44.00,P值均＜0.01),1个月疗效优于Brandt-Daroff法(x2=8.42,P＜0.05).改良Semont法1周疗效优于对照组(x2=14.49,P＜0.01),1个月疗效与对照组比较差异无统计学意义(x2=0.01,P＞0.05).Brandt-Daroff法疗效较差,1周和1个月疗效与对照组比较,差异均无统计学意义(x2=3.35及0.18,P值均＞0.05).Kaplan-Meier生存曲线比较四组的治愈时间,经Log-rank检验分析,改良Epley组治愈时间短于其他三组,差异具有统计学意义(x2=10.850、25.779及35.085,P值均＜0.01).眩晕、恶心、呕吐、心悸等不良反应的发生率在三个物理治疗组间差异无统计学意义.治疗6个月时四组的复发率比较,差异无统计学意义(x2=4.076,P=0.253).Logistic回归分析显示,年龄和治疗前病程长短是复发的独立预测因素,而复位方法、性别、患侧、病因和发病次数等与复发无关.结论 改良Epley法在快速缓解后半规管良性阵发性位置性眩晕症状方面优于改良Semont法和Brandt-Daroff法,可作为反复发作患者的一线治疗选择,但该方法并不能降低复发率.
目的 對後半規管良性陣髮性位置性眩暈三種自我治療手法(改良Epley法、改良Semont法和Brandt-Daroff法)進行臨床療效和複髮率的對比研究.方法 168例患者隨機抽籤法分為四組,改良Epley組45例,改良Semont組43例,Brandt-Daroff組40例和對照組40例,對照組僅給予藥物治療不使用複位法.比較四組治療1週和1箇月時的療效、不良反應髮生率以及6箇月時的複髮率,併對四組達到治愈所需的時間進行比較.結果 改良Epley法治療1週時療效優于其他三組,差異具有統計學意義(x2=8.55、23.23及44.00,P值均＜0.01),1箇月療效優于Brandt-Daroff法(x2=8.42,P＜0.05).改良Semont法1週療效優于對照組(x2=14.49,P＜0.01),1箇月療效與對照組比較差異無統計學意義(x2=0.01,P＞0.05).Brandt-Daroff法療效較差,1週和1箇月療效與對照組比較,差異均無統計學意義(x2=3.35及0.18,P值均＞0.05).Kaplan-Meier生存麯線比較四組的治愈時間,經Log-rank檢驗分析,改良Epley組治愈時間短于其他三組,差異具有統計學意義(x2=10.850、25.779及35.085,P值均＜0.01).眩暈、噁心、嘔吐、心悸等不良反應的髮生率在三箇物理治療組間差異無統計學意義.治療6箇月時四組的複髮率比較,差異無統計學意義(x2=4.076,P=0.253).Logistic迴歸分析顯示,年齡和治療前病程長短是複髮的獨立預測因素,而複位方法、性彆、患側、病因和髮病次數等與複髮無關.結論 改良Epley法在快速緩解後半規管良性陣髮性位置性眩暈癥狀方麵優于改良Semont法和Brandt-Daroff法,可作為反複髮作患者的一線治療選擇,但該方法併不能降低複髮率.
목적 대후반규관량성진발성위치성현훈삼충자아치료수법(개량Epley법、개량Semont법화Brandt-Daroff법)진행림상료효화복발솔적대비연구.방법 168례환자수궤추첨법분위사조,개량Epley조45례,개량Semont조43례,Brandt-Daroff조40례화대조조40례,대조조부급여약물치료불사용복위법.비교사조치료1주화1개월시적료효、불량반응발생솔이급6개월시적복발솔,병대사조체도치유소수적시간진행비교.결과 개량Epley법치료1주시료효우우기타삼조,차이구유통계학의의(x2=8.55、23.23급44.00,P치균＜0.01),1개월료효우우Brandt-Daroff법(x2=8.42,P＜0.05).개량Semont법1주료효우우대조조(x2=14.49,P＜0.01),1개월료효여대조조비교차이무통계학의의(x2=0.01,P＞0.05).Brandt-Daroff법료효교차,1주화1개월료효여대조조비교,차이균무통계학의의(x2=3.35급0.18,P치균＞0.05).Kaplan-Meier생존곡선비교사조적치유시간,경Log-rank검험분석,개량Epley조치유시간단우기타삼조,차이구유통계학의의(x2=10.850、25.779급35.085,P치균＜0.01).현훈、악심、구토、심계등불량반응적발생솔재삼개물리치료조간차이무통계학의의.치료6개월시사조적복발솔비교,차이무통계학의의(x2=4.076,P=0.253).Logistic회귀분석현시,년령화치료전병정장단시복발적독립예측인소,이복위방법、성별、환측、병인화발병차수등여복발무관.결론 개량Epley법재쾌속완해후반규관량성진발성위치성현훈증상방면우우개량Semont법화Brandt-Daroff법,가작위반복발작환자적일선치료선택,단해방법병불능강저복발솔.
Objective To compare the efficacy and recurrence rates of modified Epley maneuver,modified Semont maneuver and Brandt-Daroff maneuver in patients with posterior canal benign paroxysmal positional vertigo(PC-BPPV).Methods One hundred and sixty-eight patients with unilateral PC-BPPV were included in the study,which were divided into four groups randomly,45 with modified Epley maneuver ( group 1 ),43 with modified Semont maneuver( group 2 ),and 40 with Brandt-Daroff maneuver( group 3 ).There were 40 controls without physical therapy technique( group 4) included. The efficacy after one week and one month,the time to recovery,the frequency of side effects and recurrence rates among the four groups were evaluated.Results The efficacy of modified Epley maneuver was superior to the other three groups after one week ( x21,2 =8.55,P ＜ 0.05 ; x21,3 =23.23,P ＜ 0.01 ; x21,4 =44.00,P ＜ 0.01 ) and to the Brandt-Daroff maneuver at follow-up evaluation after one month ( x2 =8.42,P ＜ 0.05 ). The efficacy of modified Semont maneuver was superior to the control groups after one week ( x2 =14.49,P ＜ 0.01 ),but there was no difference between the two groups after one month ( x2 =0.01,P ＞ 0.05 ).The efficacy of Brandt-Daroff maneuver was not different with the control group at one week and one month follow-up evaluation ( x2 =3.35,P ＞ 0.05 ; x2 =0.18,P ＞ 0.05). Kaplan-Meier testing showed that the time to recovery was significantly shorter in the modified Epley group. The frequency of side effects was not significantly different among the three physical therapy groups.There was no difference in the frequency of recurrence among the four groups ( x2 =4.076,P =0.253 ).Duration of illness before self-treatment and age were the independent predictors of recurrence.Conclusions The modified Epley maneuver is more effective for selft-reatment of PC-BPPV than modified Semont maneuver and Brandt-Daroff maneuver.Daily routine of self-treatment does not prevent the recurrence of PC-BPPV.
