摘要
目的 探讨药物治疗联合前庭功能训练对前庭神经炎患者平衡功能、炎症因子及氧化应激水平的影响.方法 前瞻性选取2021年2月至2023年2月唐山市人民医院前庭神经炎患者70例,依据随机数字表法将其分为对照组与训练组,每组各35例.对照组采用醋酸泼尼松、甲磺酸盐酸倍他司汀等药物治疗,训练组在对照组的基础上进行前庭功能训练.比较两组患者治疗前和治疗4周后的眩晕程度[眩晕残障程度评定量表(DHI)]、前庭功能检查参数[半规管轻瘫值(CP)和优势偏向(DP)、自发性眼震角度(SN)]、平衡功能[Berg平衡量表(BBS)、日常活动前庭功能障碍等级量表(VADL)]、前庭功能状态、脑血流速度、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及氧化应激[25羟维生素D3(25(OH)D3)、丙二醛、超氧化物歧化酶(SOD)]水平、临床疗效及不良反应发生情况.结果 治疗4周后,训练组患者的躯体性、情感性、功能性评分及DHI总分分别为(2.26±0.37)、(2.18±0.34)、(2.02±0.33)、(6.48±1.12)分,均低于对照组,差异均有统计学意义(P＜0.05).治疗4周后,训练组患者的CP、DP、SN分别为(52.75±6.45)％、(23.25±3.46)％、(0.35±0.10)°/s,均低于对照组,差异均有统计学意义(P＜0.05).治疗4周后,训练组的BBS评分为(32.36±3.02)分,明显高于对照组,VADL评分为(28.65±4.12)分,明显低于对照组,差异均有统计学意义(P＜0.05).治疗4周后,训练组的血清IL-6、TNF-α、CRP水平分别为(12.30±1.57)g/mL、(11.41±1.05)pg/mL、(10.24±2.05)mg/L,均明显低于对照组,差异均有统计学意义(P＜0.05).治疗4周后,训练组血清25(OH)D3、SOD水平为(22.03±3.02)ng/mL、(65.67±6.43)U/mL,高于对照组,丙二醛水平分别为(3.97±0.35)nmoL/mL,均明显低于对照组,差异均有统计学意义(P＜0.05).治疗4周后,训练组的基底动脉、左椎动脉、右椎动脉血流速度分别为(36.01±1.55)、(33.44±1.62)、(34.60±2.17)cm/s,均明显高于对照组,差异均有统计学意义(P＜0.05).训练组患者的总有效率为91.43％,明显高于对照组(71.43％),差异有统计学意义(P＜0.05).两组患者的总不良反应发生率比较,差异无统计学意义(P＞0.05).结论 药物治疗联合前庭神经炎治疗中前庭功能训练能够提升患者的平衡功能,改善炎症因子及氧化应激水平,值得临床推广应用.
Abstract
Objective To investigate the effect of drug therapy combination vestibular function training on balance function,inflammatory factors and oxidative stress in patients with vestibular neuritis.Methods Seventy patients with vestibular neuritis in Tangshan Peoples Hospital from February 2021 to February 2023 were prospectively selected and divided into the control group and the training group according to the random number table method,each group 35 cases.The control group was treated with drugs such as prednisone acetate and betamethasone mesylate hydrochloride,while the training group received vestibular function training on the basis of the control group.The degree of dizziness[dizziness handicap inventory(DHI)],vestibular function test parameters[canal paresis(CP),directional preponderance(DP),spontaneous nystagmus angle(SN)],balance function[Berg balance scale(BBS),vestibular dysfunction rating scale(VADL)],vestibular function status,cerebral blood flow velocity,inflammatory factors[interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP)],and oxidative stress[25 hydroxyvitamin D3(25(OH)D3),malondialdehyde,and superoxide dismutase(SOD)]levels before and after 4 weeks of treatment,clinical efficacy,and incidence of adverse reactions were compared between the two groups.Results After 4 weeks of treatment,the physical,emotional,and functional scores,as well as the total DHI score of the training group patients were(2.26±0.37),(2.18±0.34),(2.02±0.33),and(6.48±1.12)points,respectively,which were lower than those of the control group,and the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the CP,DP,and SN of patients in the training group were(52.75±6.45)％,(23.25±3.46)％,and(0.35±0.10)°/s,respectively,which were lower than those in the control group,and the differences were statistically signifi-cant(P＜0.05).After 4 weeks of treatment,the BBS score of the training group was(32.36±3.02)points,which was significantly higher than that of the control group,and the VADL score was(28.65±4.12)points,which was significantly lower than that of the control group,and the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the levels of IL-6,TNF-α,CRP in the training group were(12.30±1.57)pg/mL,(11.41±1.05)pg/mL,(10.24±2.05)mg/L,which was lower than those in the control group,and the differ-ences were statistically significant(P＜0.05).After 4 weeks of treatment,the level of serum 25(OH)D3 in the training group was(22.03±3.02)ng/mL,which was higher than that in the control group,the levels of malondialdehyde and SOD were(3.97±0.35)nmoL/mL and(65.67±6.43)U/mL,respectively,which were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the blood flow velocities of the basilar artery,left vertebral artery,and right vertebral artery in the training group were(36.01±1.55),(33.44±1.62),and(34.60±2.17)cm/s,respectively,which were significantly higher than those in the control group,and the differences were statistically significant(P＜0.05).The total effective rate of the vestibular function training group was 91.43％,which was significantly higher than that in the conventional drug treatment group(71.43％),and the difference was statistically significant(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Drug therapy combination Vestibular function training in vestibular neuritis treatment can improve the balance function of patients and improve the levels of inflammatory factors and oxidative stress.It is worth clinical promotion and application.
基金项目
河北省卫健委2022年度科研计划项目(20221821)
NETL
NSTL
万方数据