Epley手法与360°手法在机械旋转椅中治疗后半规管良性阵发性位置性眩晕的比较：一项随机对照试验。
Epley maneuver versus 360° maneuver for treatment of posterior canal benign paroxysmal positional vertigo in a mechanical rotation chair: a randomized controlled trial.
文献信息
| PMID | 42781309 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Malene Hentze |
| 作者单位 | Balance and Dizziness Center, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark. |
| 期刊 | Frontiers in neurology |
| SCI 分区 | Q2 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 在采用机械旋转椅（MRC）诊断的后半规管良性阵发性位置性眩晕（BPPV）队列中，比较Epley手法与360°手法的治疗效果。
研究设计： 开放标签平行组随机对照试验。
地点： 三级大学医院门诊部。
参与者： 诊断为单侧后半规管BPPV的成人（n=102）。
干预： 参与者被随机分配接受Epley手法或360°手法治疗。随访每两周安排一次，直至治疗成功或最多给予五次治疗。通过问卷，在基线和治疗成功后评估患者报告结局指标。在3个月和6个月随访问卷中评估主观复发。
主要结局指标： 主要结局：一次治疗后的治疗成功。次要结局：获得治疗成功所需的治疗次数、眩晕障碍量表（DHI）、眩晕视觉模拟量表（VAS）、手法耐受性和主观复发。
结果： 一次治疗后的治疗成功率在两组间相当（风险差（RD）：-0.12（95%置信区间（CI）：-0.32，0.07））。各次治疗的累积治疗成功概率在两组间未见明显差异（风险比：0.77，95%CI：0.50，1.21）。两组在DHI和眩晕VAS方面均显示出具有临床意义的改善，组间无差异。主观复发率也相似。
结论： 使用MRC的Epley手法和360°手法在客观和患者报告结局方面显示出相似的治疗效果，提示手法选择具有灵活性。进一步研究应探讨治疗方案的优化以及关于复发模式的长期随访。
临床试验注册： https://clinicaltrials.gov/，标识符NCT05834452。
英文摘要
OBJECTIVE: To compare the treatment efficacy of the Epley maneuver and the 360° maneuver in a cohort diagnosed with posterior benign paroxysmal positional vertigo (BPPV) using a mechanical rotation chair (MRC).
STUDY DESIGN: Open-label parallel group randomized controlled trial.
SETTING: Tertiary university hospital-based outpatient clinic.
PARTICIPANTS: Adults (n = 102) diagnosed with unilateral posterior BPPV.
INTERVENTIONS: Participants were randomized to treatment with either the Epley- or the 360° maneuver. Follow-up visits were scheduled biweekly until treatment was successful or up to five treatments were given. By use of questionnaires, patient-reported outcome measures were assessed at baseline and after successful treatment. Subjective recurrences were assessed at 3- and 6-month follow-up questionnaires.
MAIN OUTCOME MEASURES: Primary outcome: treatment success after one treatment. Secondary outcomes: number of treatments to obtain treatment success, Dizziness Handicap Inventory (DHI), visual analogue scale (VAS) of vertigo, maneuver tolerability, and subjective recurrence.
RESULTS: Treatment success after one treatment was comparable between the groups (risk difference (RD): -0.12 (95% confidence interval (CI): -0.32, 0.07)). The cumulative probability of treatment success across treatments showed no clear difference between groups (hazard ratio: 0.77, 95% CI: 0.50, 1.21). Both groups showed clinically meaningful improvements in DHI and VAS of vertigo, with no between-group differences. Subjective recurrence rates were also similar.
CONCLUSION: Epley- and 360° maneuvers with an MRC demonstrated similar treatment efficacy across objective and patient-reported outcomes, suggesting flexibility in the maneuver choice. Further research should investigate optimization of treatment protocols and long-term follow-up regarding recurrence patterns.
CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/, identifier NCT05834452.