• 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院耳鼻咽喉-頭頸外科（上海，200127）;

目的　 比較單純手法復(fù)位和手法復(fù)位合并口服抗眩暈藥治療良性陣發(fā)性位置性眩暈（BPPV）的短期和長(zhǎng)期療效。 方法　 將2004年1月－2011年6月期間收治的236例BPPV患者隨機(jī)分為兩組，對(duì)照組112例采用單純手法復(fù)位，觀察組124例在手法復(fù)位基礎(chǔ)上配合口服抗眩暈藥治療，兩組均于1周和3個(gè)月后復(fù)查，并隨訪觀察1年，且比較其療效。 結(jié)果　 觀察隨訪1年后，對(duì)照組總治愈率92.86% (104/112），觀察組治愈率為93.54%（116/124），兩者比較差異無(wú)統(tǒng)計(jì)學(xué)意義。 結(jié)論　 單純手法復(fù)位和手法復(fù)位合并口服抗眩暈藥治療BPPV其療效相當(dāng)，但可作為BPPV患者的首選治療方法。
Objective　 To evaluate the short-term and long-term effect of canalith repositioning procedures with or without anti-vertigo drugs on benign paroxysmal positional vertigo (BPPV). Methods 　A total of 236 cases of BPPV that were treated with particle repositioning maneuver with medicine treatment from January 2004 to June 2011. The patients were divided into control group (112 patients, underwent canalith repositioning procedures) and observation group (124 patients, underwent canalith repositioning procedures with medication of anti-vertigo drugs). The two groups were reappraised after one week and three months respectively, and the follow-up duration was one year. Results　 The success rate was 92.86% (104/112) in the control group and 93.55%(116/124) in the observation group one year after the treatment. The difference between the two groups was not significant. Conclusion　 The effect of canalith repositioning procedures with or without anti-vertigo drugs on BPPV does not differ much from each other.

引用本文： 劉君,張奕. 良性陣發(fā)性位置性眩暈患者手法復(fù)位及合并抗眩暈藥物治療觀察. 華西醫(yī)學(xué), 2012, 27(1): 70-72. doi: 復(fù)制

1. 　中華耳鼻咽喉頭頸外科雜志編輯委員會(huì), 中華醫(yī)學(xué)會(huì)耳鼻咽喉科學(xué)分會(huì)．良性陣發(fā)性位置性眩暈的診斷依據(jù)和療效評(píng)估(2006年.貴陽(yáng))[J]. 中華耳鼻咽喉頭頸外科雜志, 2007, 42(3): 163-164．.
2. 　Epley JM. Particle repositioning for benign paroxysmal positional vertigo[J]. Otolaryngol Clin North Am, 1996, 29(2): 323-331.
3. 　Bertholon P, Trinqali S, Faye MB, et al. Prospective study of positional nystagmus in 100 consecutive patients[J]. Ann Otol Rhinol Laryngol 2006, 115(8): 587-594.
4. 　Parnes LS, McClure JA. Free-floating endolymph particles:a new operative finding during posterior semicircular canal occlusion[J]. Laryngscope, 1992, 102(9): 988-992.
5. 　Welling DB, Parnes LS, O’Brien B, et al．Particulate matter in the posterior semicircular canal[J]. Laryngoscope,1997, 107(1): 90-94.
6. 　Schuknecht HF. Cupulolithiasis[J]. Arch Otolaryngol, 1969, 90(6): 765-778.
7. 　劉秋玲, 王躍建, 周曉娓, 等. 1240例良性陣發(fā)性位置性眩暈患者手法復(fù)位治療[J]. 中華耳科學(xué)雜志, 2010, 8(4): 427-430.
8. 　郭小艷, 耿曼英, 魏秀芬. Epley法治療良性陣發(fā)性位置性眩暈60例分析[J]. 中國(guó)實(shí)用神經(jīng)疾病雜志, 2010, 13(3): 20-21.
9. 　Hilton M, Pinder D. The Epley(canalith repositioning) manoeuvre for benign paroxysmal positional vertigo[J]. Cochrane Database Syst Rev, 2004(2): CD003162.
10. 　Parne LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J]. CMAJ, 2003, 169(7): 681-693.
11. 　Neuhauser HK, Lempert T. Vertigo:epidemiologic aspects[J]. Semin Neurol, 2009, 29(5): 473-481.
12. 　Inaqaki T, Suzuki M, Otsuka K, et al. Model experiments of BPPV using isolated utricle and posterior semicircular canal[J]. Auris Nasus Larynx, 2006, 33(2): 129-34.
13. 　Welling DB, Barnes DE. Particle repositioning maneuver for benign paroxysmal positional vertigo[J]. Laryngoscope, 1994, 104(8Pt1): 946-949.
14. 　Bhattacharyya N, Baugh RF, Orvidas L, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo[J]. Otolaryngol Head Neck Surg, 2008, 139 (5 Suppl 4): 47-81.
15. 　Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2008, 70(22): 2067-2074.
16. 　Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2007, 136(5): 693-698.
17. 　Aqrawal SK, Parnes LS. Human experience with canal plugging[J]. Ann N Y Acad Sci, 2001, 942: 300-305.
18. 　Pournaras I, Kos I, Guyot JP. Benign paroxysmal positional vertigo: a series of eight singular neurectomies[J]. Acta Otolaryngol, 2008, 128(1): 5-8.
19. 　Gacek RR. Transection of the posterior ampullary nerve for the relief of benign paroxysmal positional vertigo[J]. Ann Otol Rhinol Laryngol, 1974, 83(5): 596-605.
  1. 1. 　中華耳鼻咽喉頭頸外科雜志編輯委員會(huì), 中華醫(yī)學(xué)會(huì)耳鼻咽喉科學(xué)分會(huì)．良性陣發(fā)性位置性眩暈的診斷依據(jù)和療效評(píng)估(2006年.貴陽(yáng))[J]. 中華耳鼻咽喉頭頸外科雜志, 2007, 42(3): 163-164．.
  2. 2. 　Epley JM. Particle repositioning for benign paroxysmal positional vertigo[J]. Otolaryngol Clin North Am, 1996, 29(2): 323-331.
  3. 3. 　Bertholon P, Trinqali S, Faye MB, et al. Prospective study of positional nystagmus in 100 consecutive patients[J]. Ann Otol Rhinol Laryngol 2006, 115(8): 587-594.
  4. 4. 　Parnes LS, McClure JA. Free-floating endolymph particles:a new operative finding during posterior semicircular canal occlusion[J]. Laryngscope, 1992, 102(9): 988-992.
  5. 5. 　Welling DB, Parnes LS, O’Brien B, et al．Particulate matter in the posterior semicircular canal[J]. Laryngoscope,1997, 107(1): 90-94.
  6. 6. 　Schuknecht HF. Cupulolithiasis[J]. Arch Otolaryngol, 1969, 90(6): 765-778.
  7. 7. 　劉秋玲, 王躍建, 周曉娓, 等. 1240例良性陣發(fā)性位置性眩暈患者手法復(fù)位治療[J]. 中華耳科學(xué)雜志, 2010, 8(4): 427-430.
  8. 8. 　郭小艷, 耿曼英, 魏秀芬. Epley法治療良性陣發(fā)性位置性眩暈60例分析[J]. 中國(guó)實(shí)用神經(jīng)疾病雜志, 2010, 13(3): 20-21.
  9. 9. 　Hilton M, Pinder D. The Epley(canalith repositioning) manoeuvre for benign paroxysmal positional vertigo[J]. Cochrane Database Syst Rev, 2004(2): CD003162.
  10. 10. 　Parne LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo(BPPV)[J]. CMAJ, 2003, 169(7): 681-693.
  11. 11. 　Neuhauser HK, Lempert T. Vertigo:epidemiologic aspects[J]. Semin Neurol, 2009, 29(5): 473-481.
  12. 12. 　Inaqaki T, Suzuki M, Otsuka K, et al. Model experiments of BPPV using isolated utricle and posterior semicircular canal[J]. Auris Nasus Larynx, 2006, 33(2): 129-34.
  13. 13. 　Welling DB, Barnes DE. Particle repositioning maneuver for benign paroxysmal positional vertigo[J]. Laryngoscope, 1994, 104(8Pt1): 946-949.
  14. 14. 　Bhattacharyya N, Baugh RF, Orvidas L, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo[J]. Otolaryngol Head Neck Surg, 2008, 139 (5 Suppl 4): 47-81.
  15. 15. 　Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2008, 70(22): 2067-2074.
  16. 16. 　Leveque M, Labrousse M, Seidermann L, et al. Surgical therapy in intractable benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2007, 136(5): 693-698.
  17. 17. 　Aqrawal SK, Parnes LS. Human experience with canal plugging[J]. Ann N Y Acad Sci, 2001, 942: 300-305.
  18. 18. 　Pournaras I, Kos I, Guyot JP. Benign paroxysmal positional vertigo: a series of eight singular neurectomies[J]. Acta Otolaryngol, 2008, 128(1): 5-8.
  19. 19. 　Gacek RR. Transection of the posterior ampullary nerve for the relief of benign paroxysmal positional vertigo[J]. Ann Otol Rhinol Laryngol, 1974, 83(5): 596-605.

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