The value of high intensity stimulation training of semicircular canal of SRM-Ⅳ vertigo diagnosis and treatment system in the rehabilitation of vestibular neuritis
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摘要: 目的 评价SRM-Ⅳ眩晕诊疗系统半规管高强刺激训练在前庭神经炎康复治疗中的价值。方法 对2020年1月—2022年1月在石家庄市人民医院耳鼻咽喉头颈外科治疗的68例前庭神经炎患者，进行自发眼震、甩头试验以及SRM-Ⅳ眩晕诊疗系统的自发眼震、旋转试验检查。将68例患者随机分为对照组、治疗1组、治疗2组。对照组应用药物治疗，治疗1组给予药物治疗和前庭康复训练，治疗2组在药物治疗、前庭康复训练基础上，于发病1周后增加半规管高强刺激训练。3组分别在治疗2周、1个月时，通过旋转试验转阴率、DHI评分进行疗效比较。结果 自发眼震结合甩头试验检查明确发病侧别80.9%，经SRM-Ⅳ眩晕诊疗系统的自发眼震和旋转试验检查明确发病侧别100%，差异有统计学意义(P< 0.05)；治疗2组在治疗2周、1个月旋转试验转阴率与对照组和治疗1组比较，差异均有统计学意义(P< 0.05、2周χ2=6.474、1个月χ2=6.245)；治疗2组在治疗2周、1个月DHI评分与对照组和治疗1组比较，差异均有统计学意义(P< 0.05、2周F=13.578、1个月F=28.599)。结论 SRM-Ⅳ眩晕诊疗系统半规管高强刺激训练在前庭神经炎康复治疗中具有一定的作用，其操作简单，患者耐受性、依从性好，值得临床推广。Abstract: Objective To evaluate the value of high intensity stimulation training of semicircular canal of SRM-Ⅳ vertigo diagnosis and treatment system in the rehabilitation of vestibular neuritis.Methods To analyze 68 patients with vestibular neuritis treated in Department of Otorhinolaryngology Head and Neck Surgery, Shijiazhuang People's Hospital from January 2020 to January 2021, conduct spontaneous nystagmus and head toss test, and perform spontaneous nystagmus and rotation test of SRM-Ⅳvertigo system, compare the positive rate of the side of disease was between the two. To randomly divide 68 patients into treatment group 1, 2 and control group, the control group with drugs, treatment group 1 with drugs and vestibular rehabilitation training exercise, treatment group 2 with additional high intensity stimulation training of semicircular canal at one week after onset, on the basis of drug therapy and vestibular rehabilitation training exercise. At 2 weeks and 1 month, through swivel chair test negative rate, DHI score, compare the efficacy of the three groups.Results Spontaneous nystagmus combined with head toss test confirmed 80.9% of the side of the disease, spontaneous nystagmus and rotation test of SRM-Ⅳ vertigo system confirmed 100%, the difference is statistically significant(P< 0.05). Compared with the control group and the treatment group 1, the negative conversion rate of the rotation test in the treatment group 2 at the second week and the first month of treatment, the difference is statistically significant(P< 0.05, the second week χ2=6.474, the first month χ2=6.245); the DHI score of treatment group 2 was statistically significant compared with that of control group and treatment group 1 at the second week and first month of treatment(P< 0.05, the second weekF=13.578, the first monthF=28.599).Conclusion SRM-Ⅳ vertigo diagnosis and treatment system semicircular canal high intensity stimulation training has a certain role in the rehabilitation treatment of vestibular neuritis. It is simple to operate, patient tolerance and compliance are good, and it is worth promoting.
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Key words:
- vestibular neuritis /
- rotation test /
- vestibular rehabilitation
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表 1 年龄、性别、病变侧别、病程、治疗前CP值、治疗前DHI值的比较
X±S 组别 例数 男性/例(%) 年龄/岁 左侧/例(%) 病程/d 治疗前CP 治疗前DHI 对照组 22 12(54.5) 47.95±9.04 10(45.5) 2.27±1.20 34.00±8.69 68.73±2.27 治疗1组 23 13(56.5) 47.49±8.92 8(34.8) 2.30±1.33 33.78±9.98 67.13±2.88 治疗2组 23 10(43.5) 48.30±9.00 12(52.2) 2.17±1.27 34.00±10.40 67.22±2.87 F 0.049 0.069 0.004 2.474 χ2 0.906 1.434 P 0.636 0.952 0.488 0.934 0.996 0.092 
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表 2 治疗2周和1个月时3组SRM-Ⅳ旋转试验结果比较
例(%)，X±S 组别 总例数 治疗前CP值 治疗2周 治疗1个月 阴性 阳性 阴性 阳性 对照组 22 34.00±8.69 7(31.8) 15(68.2) 13(59.1) 9(40.9) 治疗1组 23 33.78±9.98 11(47.8) 12(52.2) 17(73.9) 6(26.1) 治疗2组 23 34.00±10.40 16(69.6) 7(30.4) 21(91.3) 2(8.7) F 0.004 χ2 6.474 6.245 P 0.996 0.039 0.044
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表 3 治疗2周和1个月时3组DHI评分各年龄段占比
例(%) 组别 总例数 治疗2周 治疗1个月 ≤30岁 30~60岁 >60岁 ≤30岁 30~60岁 >60岁 对照组 22 0(0) 10(45.5) 12(54.5) 2(9.1) 12(54.5) 8(36.4) 治疗1组 23 4(17.4) 9(39.1) 10(43.5) 7(30.4) 10(43.5) 6(26.1) 治疗2组 23 7(30.4) 8(34.8) 8(34.8) 13(56.5) 8(34.8) 2(8.7)
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表 4 治疗前、治疗2周和1个月时3组DHI评分比较
组别 例数 治疗前DHI 治疗2周 治疗1个月 对照组 22 68.73±2.27 62.36±3.89 58.45±9.74 治疗1组 23 67.13±2.88 54.61±13.541) 46.35±13.771) 治疗2组 23 67.22±2.87 44.17±14.521)2) 31.30±12.261)2) F 2.474 13.578 28.599 P 0.092 <0.001 <0.001 与对照组比较，1)P < 0.01；与治疗1组比较，2)P < 0.01。
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