鼓室内注射糖皮质激素治疗联合前庭康复训练对梅尼埃病的疗效研究

Study on the efficacy of intratympanic corticosteroid injection combined with vestibular rehabilitation training for treating Meniere's disease

摘要:

目的 探讨鼓室内注射糖皮质激素联合前庭康复训练治疗梅尼埃病的疗效。方法 选取2022年6月—2023年12月陕西中医药大学第二附属医院耳鼻喉科就诊的82例梅尼埃病患者，按随机数字表法分为观察组和对照组，各41例。对照组接受鼓室内注射糖皮质激素治疗，观察组在此基础上联合前庭康复训练。患者治疗前后进行耳蜗电图测试、纯音听阈测试、眩晕残障程度评定量表（DHI）、Berg平衡量表（BBS）、焦虑自评量表（SAS），并随访6个月判断预后。结果 两组患者治疗前耳蜗电图阳性率比较，差异无统计学意义（P >0.05）；观察组治疗后耳蜗电图阳性率低于对照组（P <0.05）。观察组治疗前后听阈的差值高于对照组（P <0.05）。观察组治疗前后DHI、BBS、SAS评分的差值均高于对照组（P <0.05）。两组患者控制率比较，差异无统计学意义（P >0.05），观察组基本控制率高于对照组（P <0.05）。结论 鼓室内注射糖皮质激素联合前庭康复训练治疗梅尼埃病比单纯鼓室内注射糖皮质激素疗效更佳，可显著改善患者的眩晕症状、提升听力和平衡功能，值得在临床中推广使用。

Abstract:

Objective To explore the efficacy of intratympanic corticosteroid injections combined with vestibular rehabilitation training for treating Meniere's disease.Methods Eighty-two patients with Meniere's disease who visited the Department of Otorhinolaryngology at the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from June 2022 to December 2023 were randomly divided into an observation group and a control group, with 41 patients in each. The control group received intratympanic corticosteroid injections, while the observation group received combined vestibular rehabilitation training in addition to the injections. Tests including electrocochleography, pure tone audiometry, the Dizziness Handicap Inventory (DHI), the Berg Balance Scale (BBS), and the Self-Rating Anxiety Scale (SAS) were conducted before and after treatment, and a 6-month follow-up was performed to assess the prognosis.Results There was no statistically significant difference in the electrocochleography positivity rate between the control group and the observation group prior to treatment (P > 0.05). Following treatment, a statistically significant difference was observed between the two groups (P < 0.05), with the observation group exhibiting a lower electrocochleography positivity rate compared to the control group. The changes in hearing threshold, DHI scores, BBS scores, and SAS scores before and after treatment were significantly greater in the observation group than in the control group (P < 0.05). No significant difference was noted in the overall control rate between the two groups (P > 0.05); however, a statistically significant difference was found in the basic control rate (P < 0.05), with the observation group achieving a higher basic control rate than the control group.Conclusion Intratympanic corticosteroid injection combined with vestibular rehabilitation training is more effective than intratympanic corticosteroid injection alone in the treatment of Meniere's disease. It significantly improves patients' vertigo symptoms, hearing, and balance function, and is worth promoting for clinical use.