The Efficacy Of Oresol And Midodrine Hydrochloride In The Treatment Of Children With Vasovagal Syncope

Objiective To explore the efficacy of midodrine hydrochloride and oresol on the treatment of vasovagal syncope(VVS) in children.Methods Forty-eight children with unexplained syncope and prodromata(21male,27female,aged6-17yrs,mean 11.21±3.13yrs) were randomly assigned into 3 groups.They were health education group, oresol group and midodrine hydrochloride group,respectively.Oresol group comprised children given oresol as first-line therapy in addition to health education,and midodrine hydrochloride group comprised patients given midodrine hydrochloride on base of oresol group.Repeat head-up tilt testing(HUTT) and follow-up of least 6 months were conducted to evaluate the therapeutic effectiveness,side effects of midodrine and the change of haemodynamics in treating VVS in children.Results①The HUTT-based effective rate of 3 group was respectively 20%(2/10),60.9%(14/23)and 80%(12/15).It was significantly higher in cases of midodrine hydrochloride group and oresol group than that of health education group(P＜0.05).However,there was no significant difference in the HUTT-based effective rate between oresol group and midodrine hydrochloride group(P＞0.05).②During the follow-up period, the recurrence rate of syncope was significantly lower in midodrine hydrochloride group than in other two groups(P＜0.05).However,there was no significant difference in the recurrence rate of syncope between health education and oresol groop(P＞0.05).③There was no statistic difference in hemodynamics index(HR,SBP,DBP) on supine between before and after treatment in 3 groups.After midodrine hydrochloride therapy,the effects of midodrine hydrochloride on changes in systolic and diastolic pressures and heart rate,between upright begining and supine positions,were statistically significant(P＜0.05).Conclusion①The efficacy of midodrine hydrochloride and oresol on the treatment VVS is superior to simple health education.②To some extent,health education and oresol can prevent syncope attack of patients with VVS,but midodrine hydrochloride treatment can significantly reduce the recurrence of syncope in patients with VVS.③Midodrine hydrochloride do not change the basic heart rate and blood pressure in supine position,no special side effects.④Midodrine can stable hemodynamic changes with body position changes.Health education and oresol are conventional therapies for VVS in children.The efficacy can be enhanced by supplement midodrine hydrochlorate, furthermore,which is effective and safe in treating VVS in children.