宁永红 曾恒 黄锐 王颋 苏丹 杨乐 武剑云

[摘要] 目的 探究手法复位治疗对良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）患者近期治疗效果和远期复发率的影响及安全性。 方法 选取来我院耳鼻喉科门诊及住院患者122例良性阵发性位置性眩晕患者作为研究对象，分为两组，对照组59例，采用体位限制法配合药物治疗，观察组63例，根据病变部位采用适应的手法复位治疗，观察所有患者治疗1周后、2周后的临床疗效，治疗2周后电话随访并统计两组治疗有效患者在1个月、3个月及半年的累计复发率状况。 结果 在近期治疗效果上，治疗1周后，对照组总有效率为71.18%，观察组总有效率为90.48%，差异有统计学意义（P<0.05），治疗2周后，对照组总有效率为81.35%，观察组有效率为96.83%，差异有统计学意义（P<0.05）；在远期复发率上，在1个月后，对照组复发率为7.14%，观察组复发率为1.75%，差异无统计学意义（P>0.05），在3个月后，对照组复发率为19.05%，观察组复发率为5.26%，差异有统计学意义（P<0.05），在半年后，对照组复发率为28.57%，观察组复发率为7.02%，差异有统计学意义（P<0.01）；观察组有1例患者在治疗第2天无人监护情况下自我复位时，眩晕发作并滚下床，无严重外伤。 结论 根据病变部位采用适宜手法复位治疗对良性阵发性位置性眩晕患者近期治疗效果显著，远期复发率低，且安全性高，值得推广。

[关键词] 手法复位；良性阵发性位置性眩晕；近期疗效；远期复发率

[中图分类号] R764；R473.7 [文献标识码] B [文章编号] 1673-9701（2015）34-0064-03

Clinical observation of manual reduction for benign paroxysmal positional vertigo

NING Yonghong ZENG Heng HUANG Rui WANG Ting SU Dan YANG Le WU Jianyun

Department of E.N.T.， Gejiu Peoples Hospital in Yunnan Province， the Fifth Affiliated Hospital of Kunming Medical University， Gejiu 661000， China

[Abstract] Objective To explore the effects and safety of manual reduction on the short-term curative effect and long-term relapse rate for patients with benign paroxysmal positional vertigo （BPPV）. Methods A total of 122 patients with BPPV who were admitted to the E.N.T. Outpatient Clinic and Inpatient Department in our hospital were selected as research subjects. They were divided into two groups. 59 patients in the control group were given the treatment of postural restriction combined with medication. 63 patients in the observation group were given the treatment of adaptive manual restriction according to the lesion positions. The clinical effects of all the patients after 1 week and 2 weeks of treatment were observed. Telephone follow-up was performed 2 weeks after the treatment， and the accumulative relapse rates in 1 month， 3 months and half a year were statistically collected in the two groups of patients responding to the treatment. Results For the short-term curative effect， after 1 week of treatment， the total effective rate in the control group was 71.18%， and the total effective rate in the observation group was 90.48%. There was significant difference between the two groups （P<0.05）. After 2 weeks of treatment， the total effective rate in the control group was 81.35%， and the total effective rate in the observation group was 96.83%. There was significant difference between the two groups （P<0.05）； for the long-term relapse rate， after 1 month， the relapse rate in the control group was 7.14%， and the relapse rate in the observation group was 1.75%. The was no significant difference between the two groups（P>0.05）. After 3 months， the relapse rate in the control group was 19.05%， and the relapse rate in the observation group was 5.26%. There was significant difference between the two groups （P<0.05）. After half a year， the relapse rate in the control group was 28.57%， and the relapse rate in the observation group was 7.02%. There was significant difference between the two groups（P<0.01）； 1 patient in the observation group was undergone vertigo and fell off the bed during self-reduction on the second day of the treatment without monitoring， and no severe injury was detected. Conclusion Appropriate manual reduction based on the lesion positions in the treatment of the patients with BPPV has significant short-term curative effects and low long-term relapse rate. It is also with high safety and is worthy of promotion.

[Key words] Manual reduction； Benign paroxysmal positional vertigo （BPPV）； Short-term curative effect； Long-term relapse rate

良性阵发性位置性眩晕是常见的周围性前庭疾病，约占所有眩晕类型25%[1]，目前其病因及发病机制仍存在疑问。在我国，由于良性阵发性位置性眩晕的临床表现与其他很多疾病类似或者为某一疾病的伴随症状，病情初期很难引起足够重视，随着病情延长被误诊而延误诊疗[2]。研究发现[3，4]手法复位可以明显改善良性阵发性位置性眩晕患者临床症状，近期疗效显著，但对良性阵发性位置性眩晕的远期复发率效果研究较少。现报道如下。

1 资料与方法

1.1 临床资料

选取自2014年1月～2015年6月来我院耳鼻喉科门诊及住院患……