益气养血通窍法治疗BPPV复位后残余症状的疗效评价

发布时间：2018-03-30 11:01

  本文选题：BPPV　切入点：益气养血通窍法　出处：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:探讨益气养血通窍法治疗良性阵发性位置性眩晕(BPPV)复位成功后残余症状的疗效。材料与方法:选取2014年4月至2015年4于辽宁中医药大学附属医院耳鼻喉科住院部就诊的BPPV症患者60例,中医辨证为上气不足型。其中男25例,女35例,男女比例为1:1.4,平均年龄为54.1±15.6岁。管石症54例(其中后半规管结石占42例;水平半规管结石12例,上半规管结石0例),水平半规管嵴冒结石症患者6例。并将以上患者随机分为治疗组和对照组,每组30例。治疗组与对照组均在SRM-Ⅳ型眩晕诊疗仪成功复位后开始服用药物,疗程为2周。治疗组采用益气养血通窍法给予补中益气汤加减汤剂口服(组成:黄芪30g,人参9g,当归15g,陈皮12g,升麻10g,柴胡10g,白术15g,石菖蒲10g,炙甘草10g。150ml/次2/d)2周,对照组给予甲磺酸倍他司汀片口服(12mg/次,3次/d)2周。对BPPV患者分别于复位后和药物治疗后2周,采用眩晕障碍量表(中文版)(DHI)评估患者躯体、情感、功能状态;采用汉密尔顿焦虑量表(HAMA)评估患者的焦虑状态;于复位后及药物治疗后2周采用o VEMP检查评估治疗前后振幅的改变来评价椭圆囊的功能。从主观量表及客观检查两方面来评价益气活血通窍法治疗BPPV复位后残余症状的作用。结果:1.治疗组和对照组复位后DHI总评分、躯体(P)、情感(E)、功能(F),各亚组评分相比较差异无统计学意义(p0.05);药物治疗2周后治疗组和对照组较复位后DHI总评分、躯体(P)、情感(E)、功能(F),各亚组评分较复位前均有改善,差异有统计学意义(p0.05);药物治疗2周后治疗组DHI总评分以躯体(P)、情感(E)、功能(F)亚组的评分均低于对照组(p0.05)。2.治疗组和对照组复位后HAMA评分比较差异无统计学意义(p0.05);药物治疗2周后观察组和对照组HAMA评分均较复位前有改善(p0.05);药物治疗2周后治疗组HAMA评分低于对照组(p0.05)。3.治疗组和对照组复位后o VEMP的振幅均高于标准值,而治疗组与对照相比较差异无统计学意义(p0.05);药物治疗2周后治疗组和对照组前后比较o VEMP振幅略有下降,差异有统计学意义(p0.05);药物治疗2周后治疗组与对照组o VEMP振幅比较,差异有统计学意义(p0.05)。结论:1.治疗组与对照组对上气不足型BPPV复位后的的残余症状均有治疗作用。2.以益气养血通窍法为治疗原则的治疗组疗效优于西药干预的对照组。
[Abstract]:Objective: to investigate the curative effect of tonifying qi and nourishing blood and dredging orifices on residual symptoms after successful reduction of benign paroxysmal positional vertigo (BPPVV). Materials and methods: selected from April 2014 to April 2015, Department of Otorhinolaryngology, affiliated Hospital of Liaoning University of traditional Chinese Medicine. 60 inpatients with BPPV's disease, There were 25 males and 35 females, the ratio of male to female was 1: 1.4, the average age was 54.1 卤15.6 years. 54 cases of tracheolithiasis (42 cases of posterior semicircular canal stone, 12 cases of horizontal semicircular canal stone), There were 0 cases of upper semicircular canal stones and 6 cases of horizontal semicircular canal crest calculus. The above patients were randomly divided into treatment group and control group with 30 cases in each group. The treatment group and control group were treated with drugs after the successful reduction of SRM- 鈪，

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