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[摘要]
目的 探讨甲钴胺联合强的松治疗前庭神经炎的临床效果。方法 采用回顾性、随机、对照研究方法,2012年8月—2017年1月选择在陕西省杨凌示范区医院诊治的前庭神经炎患者158例作为研究对象,根据随机数字表法分为观察组与对照组各79例。对照组给予强的松治疗,口服,5~10 mg/次,10~60 mg/d。观察组在对照组治疗的基础上给予甲钴胺1mL静脉推注,1次/d。都治疗观察3个月。比较两组的临床疗效、前庭功能和炎症因子水平。结果 观察组与对照组的总有效率分别为98.7%和89.9%,观察组显著高于对照组,差异有统计学意义(P<0.05)。治疗后两组的日常活动前庭功能障碍等级量表(VADL)、眩晕残障程度量表(DHI)评分都显著低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);观察组治疗后的上述评分都显著低于对照组,差异有统计学意义(P<0.05)。治疗后观察组与对照组的白介素-6(IL-6)水平都显著低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);观察组也显著低于对照组,差异有统计学意义(P<0.05)。两组在治疗期间都未出现严重不良反应,未影响到治疗的进行。结论 甲钴胺联合强的松治疗前庭神经炎能有效改善患者的临床症状,提高治疗疗效,不会增加不良反应的发生,其作用效果可能与下调炎症因子表达有关。
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[Abstract]
Objective To investigate the clinical effect and observation of mecobalamin combined with prednisone in the treatment of vestibular neuritis. Methods Used a retrospective, randomized, controlled study method, From August 2012 to January 2017, 158 patients with vestibular neuritis in our hospital diagnosis and treatment were selected as the research object, all the patients were divided into observation group and control group with 79 patients in each group accorded to randomly. The control group was given prednisone treatment, the observation group was given mecobalamin combined with prednisone treatment, all patients were observed for 3 months. The clinical efficacy, vestibular function and inflammatory factors were compared between the two groups. Results The total effective rates in the observation group and the control group were 98.7% and 89.9%, respectively. The observation group was significantly higher than that of the control group (P<0.05). There were no serious adverse reactions occurred in the two groups during the treatment period, and there was no effect on the treatment. After treatment, the DHI scores and VADL scores in the two groups were significantly lower than those before the treatment (P<0.05), and the above scores in the observation group after treatmetn were significantly lower than those in the control group (P<0.05). After treatment, the IL-6 values of the observation group and the control group were (6.44 ±4.31) pg/mL and (12.87 ±4.00) pg/mL, respectively, which were significantly lower than those of before treatment of (30.55 ±5.33) pg/mL and (30.29 ±6.12) pg/mL (P<0.05), and the observation group was also significantly lower than that of the control group (P<0.05). Conclusion The mecobalamin combined with prednisone in the treatment of vestibular neuritis can effectively improve the clinical symptoms of the patients, improve the curative effect, it has no severe adverse reaction, the effect may be related to down-regulate the expression of inflammatory factors.
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