中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
10期
768-771
,共4页
头晕%焦虑%抑郁%躁狂%心因性头晕
頭暈%焦慮%抑鬱%躁狂%心因性頭暈
두훈%초필%억욱%조광%심인성두훈
Dizziness%Anxiety%Depression%Mania%Psychogenic dizziness
目的 提高对心因性头晕的认识,为今后正确处理该类头晕患者积累经验.方法 收集海军总医院神经内科就诊的208例心因性头晕患者临床资料,总结其临床症候特点与治疗方法.结果 208例患者(女152例,男56例)发病年龄17 ～ 77岁,平均52岁,以中年女性居多.根据临床症候特点及治疗转归,分为焦虑-抑郁状态型[176例(84.6％)]、转换性障碍型[18例(8.7％)]、躁狂状态型[14例(6.7％)]三大类.心因性头晕患者焦虑自评量表(SAS)、抑郁自评量表(SDS)、Bech-Rafaelsen躁狂量表评分可有不同程度的异常.焦虑-抑郁状态型患者使用提高兴奋性递质相关药物疗效好,转换性障碍型患者经诱导暗示治疗后可有明显缓解,情感稳定剂对躁狂状态型患者疗效好.结论 神经内科就诊的心因性头晕患者以中年女性居多,总体可分为焦虑-抑郁状态型、转换性障碍型、躁狂状态型三大类,临床症候及实验室检查有其各自特点,治疗策略有所不同.
目的 提高對心因性頭暈的認識,為今後正確處理該類頭暈患者積纍經驗.方法 收集海軍總醫院神經內科就診的208例心因性頭暈患者臨床資料,總結其臨床癥候特點與治療方法.結果 208例患者(女152例,男56例)髮病年齡17 ～ 77歲,平均52歲,以中年女性居多.根據臨床癥候特點及治療轉歸,分為焦慮-抑鬱狀態型[176例(84.6％)]、轉換性障礙型[18例(8.7％)]、躁狂狀態型[14例(6.7％)]三大類.心因性頭暈患者焦慮自評量錶(SAS)、抑鬱自評量錶(SDS)、Bech-Rafaelsen躁狂量錶評分可有不同程度的異常.焦慮-抑鬱狀態型患者使用提高興奮性遞質相關藥物療效好,轉換性障礙型患者經誘導暗示治療後可有明顯緩解,情感穩定劑對躁狂狀態型患者療效好.結論 神經內科就診的心因性頭暈患者以中年女性居多,總體可分為焦慮-抑鬱狀態型、轉換性障礙型、躁狂狀態型三大類,臨床癥候及實驗室檢查有其各自特點,治療策略有所不同.
목적 제고대심인성두훈적인식,위금후정학처리해류두훈환자적루경험.방법 수집해군총의원신경내과취진적208례심인성두훈환자림상자료,총결기림상증후특점여치료방법.결과 208례환자(녀152례,남56례)발병년령17 ～ 77세,평균52세,이중년녀성거다.근거림상증후특점급치료전귀,분위초필-억욱상태형[176례(84.6％)]、전환성장애형[18례(8.7％)]、조광상태형[14례(6.7％)]삼대류.심인성두훈환자초필자평량표(SAS)、억욱자평량표(SDS)、Bech-Rafaelsen조광량표평분가유불동정도적이상.초필-억욱상태형환자사용제고흥강성체질상관약물료효호,전환성장애형환자경유도암시치료후가유명현완해,정감은정제대조광상태형환자료효호.결론 신경내과취진적심인성두훈환자이중년녀성거다,총체가분위초필-억욱상태형、전환성장애형、조광상태형삼대류,림상증후급실험실검사유기각자특점,치료책략유소불동.
Objective To accumulate clinical experience and to directe clinical work.Methods A total of 208 patients with psychogenic dizziness from department of neurology of Navy General Hospital of PLA were included in the study.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Bech-Rafaelsen mania rating scale (BRMS) were used for the evaluation.Results Among all the patients aged from 17 to 77 (the average age:52),152 were female and 56 were male.There were 3 types according to different clinical features and therapy prognosis:anxiety and depression type (176 cases,84.6％),hysteria type(18 cases,8.7％) and mania type(14 cases,6.7％).The drugs increasing the concentration of excitatory had a good therapeutic efficacy on anxiety and depression type.Alluding cure had notable effect on hysteria type and mood stabilizer had notable effect on mania type.Conclusions Women tended to have psychogenic dizziness.It can be divided into three types:anxiety and depression type,hysteria type and mania type.Clinical symptoms and laboratory examination of each type have their own characteristics,and treatment strategies are also different.
