| ObjectiveAs nowadays vertigo is one of the most common symptoms, to provide clinical evidences for the comprehensive treatment of vertigo based on combination of disease and syndrome, a clinical study had been conducted in which researchers adopted vestibular symptom index(VSI), vertigo symptom scale-short form(VSS-SF) and dizziness handicap inventory(DHI) to evaluate the clinical effect of this therapy.Methods198 patients who are diagnosed cervical vertigo, vertebro-basilar artery insufficiency or benign positional paroxysmal vertigo in the emergency department or neurology outpatient of Guangdong Provincial Hospital of TCM were randomly divided into two groups. The experimental group was received the comprehensive treatment based on combination disease and syndrome including western medicine, traditional Chinese medicine granule, intravenous Chinese patent medicine, balance acupuncture and heating medicinal pillow, while the control group was treated by western medicine alone. The score of VSI, VSS-SF and DHI was counted at different time points and analyzed in the end through the statistical software SPSS17.0 to evaluate the efficacy of the treatment.Results1. The largest proportion of Chinese medicine syndrome is the wind-phlegm syndrome (62.6%);2. After treated or three months, the total effective rate of the experimental team ranked above the control team, and the difference was significant (P<0.05).3. The differences of scores of VSI (Z=-1.841,P=0.066>0.05) and VSS-SF Z=-0.982, P=0.326>0.05)were not statistically significant between two groups before treatment. Analysis of variance of repeated measures indicated that the scores of VSI (F=382.802, P=0.000<0.05) and VSS-SF (F=294.652, P=0.000 < 0.05) were significantly decreasing after treated, but the downward tendencies of VSI (F=0.790, P=0.375>0.05) and VSS-SF (F=2.637, P=0.106> 0.05) was not statistically significant between two groups. At the end of treatment or after one month or after three months, the score of VSI of the experiment group was lower (P<0.05), so was the score of VSS-SF after one month or two months or three months (P<0.05)4. According to DHI before treatment, the extent of dizziness was mild (0-30 points), moderate (31-60 points), severe (61-100 points). (1) In the mild group, the difference of DHI was not statistically significant before treatment (t=0.399, P=0.682>0.05) or at the end of treatment (t=-0.976, P=0.335> 0.05) or after three months (Z=-1.805, P=0.071> 0.05) and statistically significant after 1 month (Z=-1.976, P=0.048<0.05) between two teams. The analysis of variance of repeated measures indicated that DHI of patients with mild extent of dizziness was significantly decreasing after treated (F=44.926, P=0.000<0.05), but there were not significant differences in terms of the decreasing tendency of scores of DHI between two teams (F=2.155, P=0.151>0.05). (2) In the moderate group, the difference of DHI was not statistically significant before treatment (t=1.565, P=0.121>0.05).At the end of treatment (t=-2.333, P=0.022<0.05) or after 1 month (Z=-2.555, P=0.011 <0.05) and three months (Z=-3.633, P=0.000<0.05), the score of DHI in the treatment team was markedly different as compare to the control team. The analysis of variance of repeated measures indicated that the score of DHI of patients with moderate extent of dizziness was significantly decreasing after treated (F=348.110, F=0.000<0.05) and it was significantly different in terms of the decreasing tendency of scores of DHI between the experimental team and the control team (F=7.794, P=0.006< 0.05). (3) In the severe group, the difference of DHI was not statistically significant before treatment (Z=-0.028, P=0.977>0.05). At the end of treatment (t=-1.541, P=0.130> 0.05) or after 1 month (t=-0.580, P=0.565>0.05) and three months (Z=-1.057, P=0.290>0.05), there was not significant difference between two teams. The analysis of variance of repeated measures indicated that the score of DHI of patients with severe extent of dizziness was significantly decreasing after treated (F=156.560, P=0.000<0.05), but there were not significant differences in terms of the decreasing tendency of scores of DHI between two teams (F=0.940, P=0.337>0.05).5. (1) Before treatment and after 3 months, scores of VSI, VSS-SF and three content domains of DHI were not significantly different among the wind-phlegm syndrome, the deficiency of qi and blood syndrome and weakness of kidney essence syndrome (P>0.05). (2) In terms of scores of VSI, VSS-SF and three content domains of DHI, the differences were not statistically significant among cervical vertigo, VBI and BPPV (P>0.05) after 3 months.6. After 3 months, complications and the recurrence rate of dizziness had no statistical differences between two teams (x2=2.424, P=0.120>0.05) Conclusion1. No matter therapies in the experimental group or the control group could improve the dizziness, but the total effective rate of the former was more effective at the end of treatment or after 3 months. However, the decreasing tendencies of VSI and VSS-SF were not statistically significant between two groups.2. For patients with moderate extent of vertigo, the improvement of quality of life in the experimental group with comprehensive treatment was more excellent than that in the team with western medicine alone. For patients with mild extent of vertigo, the improvement of living quality in the experimental team was more excellent than that in the control team after 1 month, but there were not significant differences in terms of the decreasing tendency of scores of DHI between two teams within three months after treatment. For patients with severe extent of vertigo, the clinical efficiency was equivalent between the experimental group and the control group.3. In the experimental group, the efficacy after 3 months was equivalent among patients with the wind-phlegm syndrome, deficiency of qi and blood syndrome and weakness of kidney essence syndrome or patients who were diagnosed as cervical vertigo, VBI and BPPV.4. The comprehensive treatment based on disease and syndrome could optimize the therapy of vertigo. |
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