良性阵发性位置性眩晕的中西医结合治疗疗效观察

发布时间：2018-06-01 05:26

本文选题：良性阵发性位置性眩晕 + 手法复位　；参考：《广州中医药大学》2010年硕士论文

【摘要】： 研究背景良性阵发性位置性眩晕属于眩晕病的一种,是最常见的周围性前庭疾病之一。良性阵发性位置性眩晕患者可能采用了众多盲目检查措施,花费大量医疗费用却难以明确诊断,更不能得到有效治疗,给患者造成很大痛苦。同时,眩晕的频繁发作使患者的生活范围缩小,精神压力加大,限制了病人的活动范围。因此正确的治疗良性阵发性位置性眩晕对人们的健康至关重要。在过去的几十年内,手法复位治疗良性阵发性位置性眩晕是治疗的主要手段。手法复位短期疗效高,但存在着易复发等缺点。如何降低手法复位后,良性阵发性位置性眩晕的复发率,提高长期疗效,是我们临床应该关注的问题。本课题期望通过手法复位结合中医辨证治疗,可以提高临床疗效,减少患者复发。目的通过对良性阵发性位置性眩晕患者的临床疗效观察,对比中西医结合治疗与单纯手法复位治疗的疗效及复发情况,探讨降低良性阵发性位置性眩晕复发率的治疗途径。方法本研究共收集广东省中医院珠海医院符合纳入标准的患者28例,随机分为对照组和治疗组,在一个疗程内,治疗组给予手法复位及中医辩证治疗,第1天予手法复位,10天内给予中药汤剂治疗,对照组给予手法复位。其中后半规管良性阵发性位置性眩晕22例,给予Epley复位法治疗,水平半规管良性阵发性位置性眩晕6例,给予Barbecue翻滚法进行复位治疗。在第二天和第10天,评估治疗组与对照组的疗效及复发情况,并在三个月内随访患者的复发情况。结果符合纳入标准的28例患者中,22例为后半规管良性阵发性位置性眩晕,6例为水平半规管良性阵发性位置性眩晕。其中治疗组14例,采用手法复位法及中药辩证论治,对照组14例,采用手法复位法治疗。患者治疗前后进行疗效比较,治疗1天后,治疗组、对照组有效率分别为85.71%、78.57%。通过Fisher确切概率法得出,有效率上两组无显著性差异(P0.05)；治疗10天后复查,治疗组、对照组的有效率分别为92.86%、71.43%,复发率分别为7.14%、57.14%。通过Fisher确切概率法得出,有效率上两组无显著性差异(P0.05),复发率上两组有显著性差异(P0.05)。三个月复查情况：治疗组复发率为14.29%,对照组复发率为85.71%。通过Fisher确切概率法得出,有效率上两组有显著性差异(P0.05)。结论通过手法复位结合中医辨证治疗良性阵发性位置性眩晕,可以降低患者的复发率。
[Abstract]:Research background Benign paroxysmal positional vertigo is one of the most common peripheral vestibular diseases. The patients with benign paroxysmal positional vertigo may adopt a lot of blind examination measures and spend a lot of medical expenses but it is difficult to diagnose clearly and can not get effective treatment which causes great pain to the patients. At the same time, frequent seizures of vertigo narrow the scope of life and increase mental stress, limiting the range of activities of patients. Therefore, the correct treatment of benign paroxysmal positional vertigo is essential for human health. In the past few decades, manual reduction has been the main treatment for benign paroxysmal positional vertigo. The short-term curative effect of manual reduction is high, but it is easy to recur. How to reduce the recurrence rate of benign paroxysmal positional vertigo and improve the long-term curative effect after manual reduction is a problem we should pay attention to clinically. This paper hopes that manual reduction combined with TCM syndrome differentiation can improve the clinical efficacy and reduce the recurrence of patients. Purpose By observing the clinical curative effect of benign paroxysmal positional vertigo, comparing the curative effect and recurrence of integrated traditional Chinese and western medicine with simple manual reduction, we discussed the treatment way to reduce the recurrence rate of benign paroxysmal positional vertigo. Method In this study, 28 patients who met the inclusion criteria in Zhuhai Hospital of Guangdong traditional Chinese Medicine Hospital were randomly divided into two groups: control group and treatment group. Within a course of treatment, the treatment group was given manual reduction and Chinese medicine dialectical treatment. The first day was treated with traditional Chinese medicine decoction within 10 days of manual reduction, while the control group was treated with manual reduction. 22 cases of posterior semicircular canal benign paroxysmal positional vertigo were treated with Epley reduction and 6 cases with horizontal semicircular canal benign paroxysmal positional vertigo. On the second and tenth day, the curative effect and recurrence of the treatment group and the control group were evaluated, and the recurrence of the patients was followed up within three months. Result 22 cases of posterior semicircular canal benign paroxysmal positional vertigo and 6 cases of horizontal semicircular canal benign paroxysmal positional vertigo. Among them, 14 cases in treatment group were treated by manual reduction and dialectical treatment of traditional Chinese medicine, and 14 cases in control group were treated by manual reduction. After 1 day of treatment, the effective rates of the treatment group and the control group were 85.71 and 78.57, respectively. According to the Fisher exact probability method, there was no significant difference in the effective rate between the two groups (P 0.05). After 10 days of treatment, the effective rates of the treatment group and the control group were 92.8682.5% and 71.43, respectively. The recurrence rate was 7.14% and 57.14%, respectively. According to the exact probability method of Fisher, there was no significant difference in the effective rate between the two groups (P 0.05), but there was significant difference in the recurrence rate between the two groups (P 0.05). The relapse rate was 14.29 in the treatment group and 85.71 in the control group. According to the exact probability method of Fisher, there was significant difference in the effective rate between the two groups (P 0.05). Conclusion The treatment of benign paroxysmal positional vertigo by manual reduction combined with TCM syndrome differentiation can reduce the recurrence rate of patients.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R764

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