眩晕患者的行为类型量化分析

doi:10.6040/j.issn.1673-3770.0.2019.030

摘要/Abstract

摘要： 目的

探讨眩晕患者的行为类型与眩晕发作的关系，以及不同行为类型对患者症状的影响。

方法

回顾性调查2017年12月~2018年12月在青岛市立医院东院耳鼻喉科行前庭功能检查/以眩晕为主诉就诊的56例患者(实验组)的临床资料，并以60例既往无眩晕发作的健康人作为正常对照组。实验组采用眩晕量表（DHI）、A型行为类型量表（TABP）进行测评，对照组采用TABP进行测评。比较眩晕患者之间不同行为类型所占比例与正常对照组之间的差异，分析不同行为类型对耳源性眩晕患者的影响。

结果

实验组眩晕患者中的A型行为类型和偏A型行为类型所占比例达46.43%，而对照组中A型行为类型和偏A型行为类型仅占23.33%，两者差异具有统计学意义( $χ 2$ =6.839，Ρ<0.05)，眩晕患者的A型行为类型所占比例明显高于正常对照组。A型行为类型患者的眩晕程度，与非A型行为类型患者相比，差异无统计学意义（ $χ 2$ =0.020，Ρ>0.05）。

结论

眩晕患者中A型行为类型所占比例显著高于无眩晕发作的正常人群，提示眩晕患者更倾向具有A型行为。但典型A型行为类型患者眩晕所带来的症状对其情绪、生活影响未明显高于其他行为类型患者。

关键词: 眩晕, 行为类型, 治疗结局

Abstract: Objective

To investigate the relationship between behavior patterns and vertigo in patients experiencing vertigo, and the relationship between different behavior patterns and symptoms.

Methods

This retrospective study was conducted in 56 patients with vertigo at the Department of Otolaryngology of Eastern Qingdao Municipal Hospital from December 2017 to December 2018. Sixty people with no previous vertigo were recruited as the control group. The participants were evaluated with the Dizziness Handicap Inventory（DHI） and Type A Behavior Pattern (TABP) scale. The control group was evaluated using only TABP scale. We compared the proportion of different behavior patterns between vertigo patients and the control group, and then analyzed the influence of different behavior patterns on otogenic vertigo symptoms.

Results

The proportion of Type A behavior and tendency to Type A behavior was 46.43% in the vertigo patients and 23.33% in the individuals without vertigo. The difference between the two groups was statistically significant ( $χ 2$ = 6.839, Ρ <0.05). The proportion of Type A behaviors in patients with vertigo was significantly higher than that in the control group. The degree of dizziness in patients with Type A behavior was not statistically significant compared with patients with non-Type A behavior ( $χ 2$ =0.020, Ρ >0.05).

Conclusion

The proportion of Type A behavior in vertigo patients with vertigo was significantly higher than that in the normal perple without vertigo attacks, suggesting that patients with vertigo are more likely to have Type A behavior. However, the symptoms of Type A behavior in patients with vertigo did not have a greater impact on their emotions and life compared with other behavioral pattern types.

Key words: Vertigo, Behavior pattern, Treatment outcome

中图分类号:

R764

李传硕,李永团,曹海南,张孟璐. 眩晕患者的行为类型量化分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 32-36.

Chuanshuo LI,Yongtuan LI,Hainan CAO,Menglu ZHANG. Quantitative analysis of behavior pattern in vertiginous patients[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 32-36.

参考文献 28

1	吴子明, 张素珍 . 前庭症状国际分类与解析[J]. 中华耳科学杂志, 2015, 13(1): 187-189. doi:10.3969/j.issn. 1672-2922.2015.01.39 . doi: 10.3969/j.issn. 1672-2922.2015.01.39
2	张成钢, 王现, 吴佳倩 . A型行为研究应用于实践的探讨[J]. 健康教育与健康促进, 2016, 11(4): 281-284. doi: 10.16117/j.cnki.31-1974/r.201604093
	ZHANG Chenggang , WANG Xian , WU Jiaqian . Study and practice on application of type a behavior[J]. Health Education and Health Promotion, 2016, 11(4): 281-284. doi: 10.16117/j.cnki.31-1974/r.201604093 . doi: 10.16117/j.cnki.31-1974/r.201604093
3	黄伟, 杨明施, 肖雪辉, 等 . A型行为与心电图ST-T缺血性改变、冠状动脉病变的关系[J]. 中国临床心理学杂志, 2015, 23(5): 861-864. doi:10.16128/j.cnki.1005-3611.2015.05.024 . doi: 10.16128/j.cnki.1005-3611.2015.05.024
	HUANG Wei , YANG Mingshi , XIAO Xuehui , et al . Type A behavior and electrocardiogram ST-t ischemic change and coronary artery lesion[J]. Chinese Journal of Clinical Psychology, 2015, 23(5): 861-864. doi:10.16128/j.cnki.1005-3611.2015.05.024 . doi: 10.16128/j.cnki.1005-3611.2015.05.024
4	李杰, 方齐, 王红菊, 等 . A型行为、生活事件与脑血管病的关系[J]. 中国继续医学教育, 2016, 8(15): 33-34. doi:10.3969/j.issn.1674-9308.2016.15.021 . doi: 10.3969/j.issn.1674-9308.2016.15.021
	LI Jie , FANG Qi , WANG Hongju , et al . The relationship of type a behavior and life events to cerebrovascular disease[J]. China Continuing Medical Education, 2016, 8(15): 33-34. doi:10.3969/j.issn.1674-9308.2016.15.021 . doi: 10.3969/j.issn.1674-9308.2016.15.021
5	Jacobson GP , Newman CW . The development of the dizziness handicap inventory[J]. Arch Otolaryngol Head Neck Surg, 1990, 116(4): 424-427.doi: 10.1001/archotol. 1990.01870040046011 . doi: 10.1001/archotol. 1990.01870040046011
6	张祎, 刘博, 王拥军, 等 . 头晕评价量表中文版信度和效度分析[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(9): 738-743. doi:10.3760/cma.j.issn.1673-0860.2015.09.008 . doi: 10.3760/cma.j.issn.1673-0860.2015.09.008
	ZHANG Yi , LIU Bo , WANG Yongjun , et al . Analysis of reliability and validity of the Chinese Version of Dizziness Handicap Inventory (DHI)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2015, 50(9): 738-743. doi:10.3760/cma.j.issn.1673-0860.2015.09.008 . doi: 10.3760/cma.j.issn.1673-0860.2015.09.008
7	丁雷, 刘畅, 王嘉玺, 等 . 眩晕残障程度评定量表(中文版)的评价[J]. 中华耳科学杂志, 2013, 11(2): 228-230. doi:10.3969/j.issn.1672-2922.2013.02.014 . doi: 10.3969/j.issn.1672-2922.2013.02.014
	DING Lei , LIU Chang , WANG Jiaxi , et al . An evaluaiton of the dizziness handicap inventory (Chinese version)[J]. Chinese Journal of Otology, 2013, 11(2): 228-230. doi:10.3969/j.issn.1672-2922.2013.02.014 . doi: 10.3969/j.issn.1672-2922.2013.02.014
8	Whitney SL , Wrisley DM , Brown KE, et al . Is perception of handicap related to functional performance in persons with vestibular dysfunction?[J]. Otol Neurotol, 2004, 25(2): 139-143.doi: 10.1097/00129492-200403000-00010 . doi: 10.1097/00129492-200403000-00010
9	张伯源, 梁煌 . A 型行为模式及其评估方式(综述)[J]. 外国心理学, 1984(3): 35-38,31.
10	张伯源 . 心血管病人的心身反应特点的研究: Ⅱ.对冠心病人的行为类型特征的探讨[J]. 心理学报, 1985, 17(3): 314-321.
	ZHANG Boyuan . Psychophysiological reaction in cardiovascular disease: ⅱ. a study on the behavior pattern of coronary heart disease patients[J]. Acta Psychologica Sinica, 1985, 17(3): 314-321.
11	李桂芳, 王春华, 张淑贞, 等 . 体位限制对手法复位后良性阵发性位置性眩晕的疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 42-45. doi:10.6040/j.issn.1673-3770.0.2017.266 . doi: 10.6040/j.issn.1673-3770.0.2017.266
	LI Guifang , WANG Chunhua , ZHANG Shuzhen , et al . Curative effect of postural restriction on benign paroxysmal positional vertigo after manual reduction[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(6): 42-45. doi:10.6040/j.issn.1673-3770.0.2017.266 . doi: 10.6040/j.issn.1673-3770.0.2017.266
12	Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in meniere's disease[J]. Otolaryngol Head Neck Surg, 1995, 113(3): 181-185. doi:10.1016/s0194-5998(95)70102-8 . doi: 10.1016/s0194-5998(95)70102-8
13	Nola G , Mostardini C , Salvi C , et al . Validity of Italian adaptation of the Dizziness Handicap Inventory (DHI) and evaluation of the quality of life in patients with acute dizziness[J]. Acta Otorhinolaryngol Ital, 2010, 30(4): 190. doi: 10.1111/j.1467-873X.2011.00573.x . doi: 10.1111/j.1467-873X.2011.00573.x
14	Jarlsäter S , Mattson E . Test of reliability of the dizziness handicap inventory and the activities-specific balance confidence scale for use in Sweden[J]. Advances in Physiotherapy, 2003, 5(3): 1. doi:10.1080/140381-90300878 . doi: 10.1080/140381-90300878
15	Vereeck L , Truijen S , Wuyts F , et al . Test-retest reliability of the Dutch version of the Dizziness Handicap Inventory[J]. B-ENT, 2006, 2(2): 75-80. doi: 10. 1142/9789812773456_0087 . doi: 10. 1142/9789812773456_0087
16	修世国, 邢东升, 胡玮, 等 . 眩晕障碍量表在 BPPV 患者生活质量评估中的应用[J]. 听力学及言语疾病杂志, 2014, 22(1): 48-52. doi:10.3969/j.issn.1006-7299.2014.01.013 . doi: 10.3969/j.issn.1006-7299.2014.01. 013
	Shiguo XIU , XING Dongsheng , HU Wei , et al . The application of DHI scale to evaluation of quality of life in patients with benign paroxysmal positional vertigo[J]. Journal of Audiology and Speech Pathology, 2014, 22(1): 48-52. doi:10.3969/j.issn.1006-7299.2014.01. 013 . doi: 10.3969/j.issn.1006-7299.2014.01. 013
17	王利一, 彭好, 黄魏宁, 等 . 良性阵发性位置性眩晕患者眩晕残障评定量表分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(8): 595-597. doi:10.13201/j.issn.1001-1781.2016.08.002 . doi: 10.13201/j.issn.1001-1781.2016.08.002
	WANG Liyi , PENG Hao , HUANG Weining , et al . Application of the dizziness handicap inventory in the patients with benign paroxysmal positional vertigo[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(8): 595-597. doi:10.13201/j.issn.1001-1781.2016.08.002 . doi: 10.13201/j.issn.1001-1781.2016.08.002
18	农应全, 梅晓峰, 吴嗣杰, 等 . 原发性良性阵发性位置性眩晕患者内耳微循环障碍与毛细胞功能关系的初步探讨[J]. 广西医科大学学报, 2015, 32(5): 752-754. doi:10.16190/j.cnki.45-1211/r.2015.05.018 . doi: 10.16190/j.cnki.45-1211/r.2015.05.018
19	曹莉梅, 蒋宾 . 心理应激、A 型行为与急性脑卒中关系的研究[J]. 脑与神经疾病杂志, 2015, 23(4): 256-259.
	CAO Limei , JIANG Bin . The study of the relationship between type A behavior, psychological stress and acute brain stroke[J]. Journal of Brain and Nervous Diseases, 2015, 23(4): 256-259.
20	于新军, 孙宝梅 . 良性阵发性位置性眩晕病因学研究[J]. 北京医学, 2017, 39(8): 770-773. doi:10.15932/j.0253-9713.2017.08.005 . doi: 10.15932/j.0253-9713.2017.08.005
	YU Xinjun , SUN Baomei . Etiology analysis of benign paroxysmal positional vertigo[J]. Beijing Medical Journal, 2017, 39(8): 770-773. doi:10.15932/j.0253-9713.2017.08.005 . doi: 10.15932/j.0253-9713.2017.08.005
21	吴子明, 孙新宇 . 眩晕领域应重视精神心理性眩晕[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(12): 1006-1008. doi:10.13201/j.issn.1001-1781.2016.12.022 . doi: 10.13201/j.issn.1001-1781.2016.12.022
	WU Ziming , SUN Xinyu . Pysician should pay attention to psycholigical dizziness in vertigo clinic[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(12): 1006-1008. doi:10.13201/j.issn.1001-1781.2016.12.022 . doi: 10.13201/j.issn.1001-1781.2016.12.022
22	刘博, 左丽静, 段金萍, 等 . 外周性眩晕患者的精神心理评估[J]. 首都医科大学学报, 2011, 32(6): 733-736. doi:10.3969/j.issn.1006-7795.2011.06.004 . doi: 10.3969/j.issn.1006-7795.2011.06.004
	LIU Bo , ZUO Lijing , DUAN Jinping , et al . Psychological analysis on patients with vertigo[J]. Journal of Capital Medical University, 2011, 32(6): 733-736. doi:10.3969/j.issn.1006-7795.2011.06.004 . doi: 10.3969/j.issn.1006-7795.2011.06.004
23	侯小兵, 任同力, 张毅博 . 69例梅尼埃病伴耳鸣的发病特点及影响因素[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 37-40.
	HOU Xiaobing , REN Tongli , ZHANG Yibo . Characteristics of tinnitus and the related influencing factors in patients with Meniere's disease[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 37-40.
24	Monzani D , Casolari L , Guidetti G , et al . Psychological distress and disability in patients with vertigo[J]. J Psychosom Res, 2001, 50(6): 319-323. doi: 10.1016/S0022-3999(01)00208-2 . doi: 10.1016/S0022-3999(01)00208-2
25	Eckhardt-Henn A , Breuer P , Thomalske C , et al . Anxiety disorders and other psychiatric subgroups in patients complaining of dizziness[J]. J Anxiety Disord, 2003, 17(4): 369-388. doi: 10.1016/s0887-6185(02)00226-8 . doi: 10.1016/s0887-6185(02)00226-8
26	周湘荃, 赵青, 庄雄 . 心理干预在眩晕症患者中的运用[J]. 现代医药卫生, 2015, 31(18): 2843-2844,2845. doi:10.3969/j.issn.1009-5519.2015.18.049 . doi: 10.3969/j.issn.1009-5519.2015.18.049
27	邢娟丽, 韩鹏, 徐宁, 等 . 认知行为疗法对围绝经期良性阵发性位置性眩晕患者心理的影响[J]. 北京医学, 2018, 40(11): 1036-1039. doi:10.15932/j.0253-9713.2018.11.008 . doi: 10.15932/j.0253-9713.2018.11. 008
	XING Juanli , HAN Peng , XU Ning , et al . Psychological effects of cognitive behavioral therapy on patients with benign paroxysmal positional vertigo during perimenopause[J]. Beijing Medical Journal, 2018, 40(11): 1036-1039. doi:10.15932/j.0253-9713.2018.11. 008 . doi: 10.15932/j.0253-9713.2018.11. 008
28	邢娟丽, 康伟, 闫小妮, 等 . 认知行为疗法对围绝经期良性阵发性位置性眩晕患者生活质量的影响[J]. 北京医学, 2018, 40(8): 766-768. doi:10.15932/j.0253-9713.2018.08.013 . doi: 10.15932/j.0253-9713.2018.08.013
	XING Juanli , KANG Wei , YAN Xiaoni , et al . Influences of cognitive behavior therapy on the life quality of perimenopause women with benign paroxysmal positional vertigo[J]. Beijing Medical Journal, 2018, 40(8): 766-768. doi:10.15932/j.0253-9713.2018.08.013 . doi: 10.15932/j.0253-9713.2018.08.013

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