| ObjectiveVestibular Neuritis(VN)belongs to the category of "ear vertigo" in Chinese medicine.The clinical report acupuncture can treat ear vertigo is effective.However,due to the wide range of ear vertigo,the pathogenesis and manifestation,the different symptoms,the research of the vertigo caused by vestibular neuritis is less.There is no consensus on an effective,standardized treatment plan.Research purposesThis experiment based on the theory of acupuncture and moxibustion treatment based on syndrome differentiation,aimed to evaluate the clinical effect of acupuncture combined with regular western medicine on vestibular neuritis and its influence on vestibular function and mental state through a small sample randomized controlled trial,in order to provide a safe and effective treatment method for clinical acupuncture treatment of "ear vertigo".Methods1 Goups:In this study,59 patients with vestibular neuritis diagnosed by Aerospace Vertigo Clinical Research Center,PLA Air Force General Hospital from August 2015 to January 2018,were treated with randomized controlled clinical study randomly divided into the observation group(Conventional western medicine combined with acupuncture)and the control group(Conventional Western medicine),33 cases in each group.2 Treatment:The control group:Using conventional Western medicine comprehensive treatment(I ntravenous infusion of methylprednisolone,alprostadil,cinepazide(maleic acid),intramu scular mecobalamin,once daily,oral betahistine tablets,3 times daily),1 week for a c ourse of treatment,treat 2 courses.The observation group:Based on the conventional Western medicine treatment using Baihui(GV20),Shenting(HT7),Touwei(ST8),Fengchi(GB20),Neiguan(PC6),Yifeng(SJ17),Ermen(TE21),Zhongzhu(TE3)as main acupoints,combinate with other acupoints according to different symptoms,use corresponding reinforcing and reducing manipulations of acupuncture therapy according to the actual situation,treatment times for five consecutive times for a course of with treatment,rest 2 days between the two courses.3 Observation index and time points of evaluation:Observation index:The ear Canal Paresis(CP)values,spontaneous nystagmus,the Sensory Organization Test(SOT)Score and the Vestibular Sensation(VEST)percentage in the dynamic balance system sensory integration test and vestibular symptom index(VSI)score and self-made vertigo symptom evaluation to evaluate the vestibular function,Dizziness Handicap Inventory(DHI),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)to evaluate the effects of mental state.The main observation index:SOT score and VEST percentage.Secondary observations:Spontaneous nystagmus angle,CP values,VSI score,self-made vertigo symptom evaluation scale score,DHI,SAS,SDS.Observation point:Two gro ups of patients were observed twice on the day of enrollment and two weeks after treatment.4 Follow-up visit:Two groups of patients were followed-up by outpatient or telephone for 3 months after treatment,1 times per month,follow-up visit index include Dizziness Handicap Inventory(DHI)and vestibular symptom index(VSI)score.ResultA total of 66 cases were included,3 cases were shed and removed in the observation group and 4 cases in the control group during the study period.59 cases were finally enrolled,including 30 cases in the observation group and 29 cases in the control group.1.General information:By comparing the gender,age and other demographic data,the disease side,virus infectionand other epidemiological data,the course of disease,the duration of this attack,TCM syndrome distribution and other general data of patients,there were no statistically significant difference between the two groups,and the two groups were comparable.2.Baseline analysis:Two groups of patients with total score and the score of vestibular neuritis vertigo symptom assessment scale,the CP percentage in cold and hot test,the SOT score and the VEST percentage in the functional assessment of dynamic balance,,the total score and each symptom scores in VSI scale,SAS,SDS,the total score and the scores of baseline data in DHI scale were no statistical difference,two groups of data are comparable.3.Treatment period:(1)The main observation indexBoth the observation group and the control group can obviously increase the VEST ratio and SOT score in the functional assessment of dynamic balance(all P<0.01),and the two groups after treatment in SOT score and the difference before and after the treatment in the VEST ratio and SOT score of the two groups have statistical significance(all P<0.01),indicate that the SOT scores in two groups after treatment were significantly increased,the size of VEST and SOT score ratio increases of the observation group was obviously higher than the control group;(2)Secondary observationsVestibular function index?There were 30 patients in the observation group,7 cases were cured,8 cases were treated significantly,13 cases were treated effectively,and 2 cases were invalidated and the total efficiency of observation group was 93.33%.There were 29 patients in the control group,2 cases were cured,6 cases were treated significantly,15 cases were treated effectively,6 cases were invalidated,and the total efficiency of control group was 79.31%.There were statistically significant differences between the two groups(Z=4.957,P=0.026<0.05),indicating that the curative effect of the observation group was better than the control group;?Both the observation group and the control group could significantly reduce the ocular shock anglein VNG and CP percentage in the cold and heat test(P<0.01,P<0.01,P<0.01,P<0.05),and there was no significant difference between the two groups(both P>0.05);?Patients with the observation group and the control group can significantly reduce total score in the vestibular neuritis vertigo symptom rating scale and the total score in the observation group lower than the control group significantly(P<0.05),two groups all can reduce the scores of attack degree,attack frequency,attack time,nausea and vomiting,balance disorder(P<0.01),the headache symptoms of the control group has a significantly decrease(P<0.05),the observation group was better than the control group in reducing the onset time and reducing the symptoms of balance disorder(all P<0.05);?Both the observation group and the control group can significantly reduce the VSI score(all P<0.01),there was no significant statistical difference in the two groups(P>0.05),both groups can significantly relieve balance disorders,vertigo,dizziness,nausea and vomiting symptoms(all P<0.01),the observation group can significantly reduce the visual sensitive symptom(P<0.01),two groups have no obvious differences in reduce various symptoms of VSI(all P>0.05);Mental status indicators?Both the observation group and the control group significantly reduced the score of SAS and SDS(all P<0.01),and the difference between the two groups was not statistically significant(P>0.05);?Both two groups can obviously reduce the DHI total score and each scores of the DHI(all P<0.01),after treatment and the difference before and after treatment of DHI total score,the difference before and after treatment of DHI-P,after treatment and the difference before and after treatment of DHI-E between groups had significant difference(P<0.05,P<0.01,P<0.05,P<0.01,P<0.01),indicate DHI total score and each scores of the DHI of two groups were significantly decreased after treatment,DHI total score and DHI-E score of the observation group after treatment significantly lower than the control group,DHI total score,DHI-P and DHI-E score decreased significantly greater than the control group.4.Follow-up period:(1)DHI score in the follow-up periodIn both groups,DHI scores and each scores of the DHI in the follow-up period were significantly reduced compared to before treatment(all P<0.01);In the observation group,compared with after treatmen,the total score of DHI,DHI-F and DHI-E scores can be significantly reduced after the first month of follow-up(all P<0.01),and the total score of DHI and various sub-items scores can be significantly reduced in the second and third months.(all P<0.01,except DHI-P in the second month is P<0.05),DHI-F in the 3rd month were significantly lower than those in the first month(P<0.05);In the control group,the total score of DHI and DHI-F and DHI-E scores were significantly lower than those in the follow-up period(all P<0.01);Comparing the group factors and time factors in the follow-up period between the two groups,the total score and scores of the DHI in the observation group during the follow-up period were significantly better than those in the control group(P<0.01,P<0.05,P<0.05,P<0.01),and significantly decreased over time(both P<0.01);Compared with the observation group,DHI score and DHI-E in the first months after treatment were significantly reduced(P<0.01,P<0.05),DHI total score and the score after treatment were significantly reduced in the second months(all P<0.05),and significantly reduced in the third months(P<0.01,P<0.05,P<0.05,P<0.05).(2)VSI score in the follow-up periodBoth groups were able to significantly reduce the score of VSI,dizziness,dizziness and nausea and vomiting in the follow-up period compared with those before treatment(all P<0.01).The scores of visual-sensitive symptoms in the observation group were significantly improved(P<0.01),there was no significant difference between the two groups after treatment and during follow-up period(all P>0.05);Comparing group and time factors in the follow-up period between the two groups,the VSI score and dizziness symptoms in the observation group were significantly better than those in the control group(P<0.05),VSI total scores and scores during the follow-up period,except for nausea and vomiting symptoms,all decreased significantly with time(all P<0.01);Compared with the control group at the same time,the scores of VSI was significantly reduced in the observation group at 1 month after treatment(P<0.05);the symptoms of vertigo were significantly reduced at 2 months(P<0.05),the scores of VSI was significantly decreased at 3 months(P<0.05).Conclusions1.Acupuncture combined with regular western medicine can significantly reduce th e degree of vertigo and the frequency of attacks,shorten the attack time,improve nause a and vomiting,dizziness,visual sensitivity,balance disorders and other accompanying sy mptoms in patients with vestibular neuritis,and help restore the vestibular function and improve the central compensation.2.Acupuncture combined with regular western medicine can alleviate the symptoms of vertigo while improving the state of anxiety and depression in patients with vestibular neuritis and relieving the influence of emotional factors on dizziness.3.Acupuncture combined with regular western medicine can continue to improve vertigo dysfunction and regulate bad emotional factors.It has obvious follow-up effect and is beneficial to the prognosis of patients with vestibular neuritis. |
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