前庭康复治疗前庭性偏头痛：系统评价与荟萃分析
Vestibular Rehabilitation for Vestibular Migraine: A Systematic Review and Meta-Analysis.
文献信息
| PMID | 42709655 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lindsay Booth |
| 作者单位 | Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估前庭康复（VR）对前庭性偏头痛（VM）成人患者报告结局指标的影响。
检索数据库： 检索了Medline、Embase和Scopus从建库至2025年5月的文献。并进行了额外的引文检索。
方法： 采用系统评价和荟萃分析优先报告条目（PRISMA）2020指南。纳入评估VR在根据ICHD-3或等效标准诊断的VM成人患者中的原始研究。主要结局是眩晕障碍量表（DHI）和活动特异性平衡信心量表（ABC）的变化。采用混合效应模型进行荟萃分析。
结果： 共纳入7项研究，包含272名参与者。所有研究均显示VR后DHI改善，单项研究的治疗效果范围为减少-10.57至-44.7分。荟萃分析显示，DHI汇总减少-23.97（95% CI：-33.31至-14.62；P<0.0001），具有临床意义。异质性较高（I2=96%），可能由于患者选择、疾病持续时间、VR持续时间、辅助治疗、结局评估时机以及VR方案差异所致。漏斗图不对称提示存在小样本效应。ABC有改善报告，但未达到临床显著阈值。
结论： 基于纳入的研究，VR与VM患者DHI的临床有意义降低相关；然而，对平衡的影响可能无临床显著性。异质性、数据有限以及现有结局证据质量中等至低，凸显了未来开展采用标准化VR方案和结局的大型前瞻性研究的重要性。
英文摘要
OBJECTIVE: To evaluate the impact of vestibular rehabilitation (VR) on patient-reported outcome measures in adults with vestibular migraine (VM).
DATABASES REVIEWED: Medline, Embase, and Scopus were reviewed from database inception to May 2025. Additional citation searches were performed.
METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were used. Primary studies assessing VR in adults with VM diagnosed using ICHD-3 or equivalent criteria were included. The primary outcome was the change in the Dizziness Handicap Inventory (DHI) and the Activity-Specific Balance Confidence Scale (ABC). Mixed-effects modeling was used for the meta-analysis.
RESULTS: Seven studies comprising 272 participants were included. All studies demonstrated improvement in DHI following VR, with individual study treatment effects ranging from -10.57 to -44.7 points reduction. Meta-analysis showed a clinically significant pooled DHI reduction of -23.97 (95% CI: -33.31 to -14.62; P<0.0001). Heterogeneity was high (I2=96%), potentially due to patient selection, duration of disease, duration of VR, adjunctive therapies, timing of outcomes assessment, and VR protocol differences. Funnel plot asymmetry suggested small-study effect. Improvements in the ABC were reported but did not meet clinically significant thresholds.
CONCLUSION: On the basis of the included studies, VR is associated with clinically meaningful reductions in DHI among VM patients; however, effects on balance may not be clinically significant. Heterogeneity, limited data, as well as moderate and low quality of evidence for the available outcomes, highlight the importance of future large prospective studies with standardized VR protocols and outcomes.