The Efficacy Of Medicine In The Prophylaxis Of Vestibular Migraine And The Study Of The Related Traditional Chinese Medicine Syndrome Types

Objective:Different types of medications are currently used in vestibular migraine prophylaxis,although recommendations for use are generally based on expert opinion rather than on solid data from randomized trials.We evaluated the efficacy and safety of venlafaxine,flunarizine and valproic acid in a randomized comparison trial for vestibular migraine prophylaxis.Meanwhile,the traditional Chinese medicine(TCM)syndrome types related to these drugs are summarized.Methods:Subjects were randomly allocated to one of three groups(venlafaxine group,flunarizine group,and valproic acid group).To assess the efficacy of treatment on vertigo symptoms,the following parameters were assessed at baseline and 3 months after treatment:Dizziness Handicap Inventory(DHI)scores,number of vertiginous attacks in the previous month,Vertigo Severity Score and TCM Syndrome Scale Scores.Record the subjects of traditional Chinese medicine symptoms,tongue coating,pulse condition before treatment.Adverse events also were evaluated.Results:A decrease in DHI total scores was shown following treatment with all three medications,with no obvious differences between the groups.Treatment effects differed,however,in the DHI physical,functional,and emotional domains with only venlafaxine showing a decreased effect in all of three domains.Flunarizine and valproic acid showed an effect in only one DHI domain.Venlafaxine and flunarizine showed decreased VSS scores(p=0 and p=0.03,respectively).Although valproic acid had no obvious effect on VSS(p=0.27),decreased vertigo attack frequency was observed in this group(p=0).Venlafaxine also had an effect on vertigo attack frequency(p=0)but flunarizine had no obvious effect(p=0.06).No serious adverse events were reported in the three groups.Venlafaxine is suitable for patients with liver stagnation and qi stagnation(p=0.02),flunarizine is suitable for patients with liver Yin deficiency(p=0.02),and sodium valproate is suitable for patients with liver wind inactivity(p=0.03).Conclusions:Our data confirm the efficacy and safety of venlafaxine,flunarizine and valproic acid in the prophylaxis of vestibular migraine,venlafaxine had an advantage in terms of emotional domains.Venlafaxine and valproic acid also was shown to be preferable to flunarizine in decreasing the number of vertiginous attacks,but valproic acid was shown to be less effective than venlafaxine and flunarizine to decrease vertigo severity.In terms of TCM syndrome types of vestibular migraine,venlafaxine,flunarizine and sodium valproate are respectively adapted to liver stagnation and qi stagnation,liver Yin deficiency and internal movement of liver wind.