低频振动剪切应激治疗单侧前庭功能低下患者的疗效分析

doi:10.6040/j.issn.1673-3770.0.2024.308

摘要/Abstract

摘要： 目的探讨低频振动剪切应激治疗单侧前庭功能低下患者的疗效。方法选择被诊断为单侧前庭功能低下的患者152例。所有患者既往病史均为前庭神经元炎且伴有眩晕后遗症。根据治疗方法将其分为低频振动治疗组、前庭康复治疗组,每组各76例。低频振动治疗组于患侧乳突进行100 Hz 低频振动,前庭康复治疗组则给予常规康复训练。两组患者均持续治疗2周。治疗前及治疗后的第2周复诊完成相关评分测试。采用头晕残障功能评分(dizziness handicap inventory, DHI)及眩晕视觉模拟评分(visual vertigo analogue scale, VVAS),其中DHI评分分别计算三个子维度得分即躯体评分(DHI-P)、情感评分(DHI-E)、功能评分(DHI-F)以及总分DHI-T),评价低频振动治疗在单侧前庭功能低下患者中眩晕康复的作用。结果按照DHI总分改善18分以上为有效,对研究所得数据进行统计分析后,得出低频振动治疗组和前庭康复治疗组的总有效率分别为77.63%、82.89%,差异无统计学意义(P=0.415);低频振动治疗和前庭康复组治疗前及治疗后的DHI-P、DHI-E、DHI-F、DHI-T 以及VVAS评分比较,差异有统计学意义(P均<0.01)。结论经乳突低频振动与常规康复训练的疗效差异无统计学意义,且不会引起明显副作用。但前庭康复锻炼对康复师以及康复场地均有较高要求,而低频振动治疗法克服了上述局限,且可行性更高,易于普遍开展。

关键词: 低频振动, 剪切应激, 前庭功能低下, 眩晕

Abstract: Objective To investigate the effect and value of low frequency vibration on vestibular rehabilitation in patients with unilateral vestibular dysfunction. Methods From July, 2019 to December, 2023, all patients admitted to the Department of Otolaryngology Head and Neck Surgery of our Hospital with a history of vestibular neuritis and sequelae of vertigo were diagnosed with unilateral vestibular dysfunction. 152 patients were randomly divided into low-frequency vibration therapy group and vestibular rehabilitation therapy group, excluding patients with poor medical compliance and lost to follow-up, there were 76 cases in each group. The patients in the low-frequency vibration treatment group were treated with 100 Hz low-frequency vibration through the affected side mastoid for 2 weeks. Patients in the vestibular rehabilitation treatment group were received routine rehabilitation training for 2 weeks. The relevant score tests were performed before treatment and at the 2nd week after treatment. We performed a comparative statistical analysis of the Dizziness Handicap Inventory(DHI)and the Visual Vertigo Analogue Scale(VVAS)before and after treatment, respectively. The DHI score was calculated with three sub-dimensions, namely soma score(DHI-P), emotion score(DHI-E), function score(DHI-F)and total score(DHI-T), and then to evaluate the value of low-frequency vibration therapy on vertigo rehabilitation in patients with unilateral vestibular dysfunction. Results The total DHI score improvement of more than 18 points was effective. The total effective rate was 77.63% in the low-frequency vibration treatment group and 82.89% in the vestibular rehabilitation group, with no statistical significance(P=0.415). There were significant differences in the scores of DHI-P, DHI-E, DHI-F, DHI-T and VVAS in the pre-treatment and post-treatment scores between the low-frequency vibration treatment and vestibular rehabilitation groups(P<0.01). Conclusion The effective rates between the two groups of low-frequency vibration delivered to the mastoid process and the conventional vestibular rehabilitation exercises in improving vertigo symptoms are equivalent, and low-frequency vibration delivered to the mastoid process has no other adverse effects on patients. However, compared with vestibular rehabilitation exercises that require professional rehabilitators and professional sites, low-frequency vibration therapy for vertigo rehabilitation in patients with unilateral vestibular dysfunction is simple to operate, has no special site requirements, and has little difficulty in technician training.

Key words: Low-frequency vibration, Shear stress, Vestibular hypofunction, Vertigo

中图分类号:

R764.35

赵真,郑贵亮,王俊,张丙文. 低频振动剪切应激治疗单侧前庭功能低下患者的疗效分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 23-28.

ZHAO Zhen, ZHENG Guiliang, WANG Jun, ZHANG Bingwen. Analysis of the curative efficacy of low-frequency vibration shear stress on patients with unilateral vestibular dysfunction[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 23-28.

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