Objective To study the value of oral Betahistine combined with changing sleeping position in re-ducing the recurrence of a single-ear canal benign paroxysmal positional vertigo (BPPV) with successful Epley reposi-tion.Methods The sleep situation was retrospectively studied in 117 elderly patients with BPPV of single-ear posterior semicircular canal,aged (62.1±8.2) in mean.The patients were required to determine the dominant side of sleeping posi-tion.All the patients received detailed medical history enquiry and physical examination of the nervous system,includ-ing posture and gait,eye movements,Dix-Hallpike test,and supine roll test.The patients were randomly divided into three groups:the control group (35 patients,treated by improved Epley reposition),treatment group A (40 patients,im-proved Epley reposition and changing sleeping position),treatment group B (42 patients,improved Epley reposition com-bined with Betahistine and changing sleeping position).Then,the recurrence rates of the three groups were analyzed.Results Among the 117 patients,the right side of the Dix-Hallpike test was positive for 74 patients,and the left Dix-Hallpike test was positive for 43 patients.When they sleep,61 patients used to right lateral position,and 32 patients used to left lateral position,with 21 patients of customary supine position.In the 117 patients with unilateral Dix-Hall-pike test positive,the affected ear and sleeping position were on the same side in 80 patients,including 54 on the right side and 26 on the left side.The affected ear and sleeping position were in the different sides in 16 patients,in which 10 of right lateral position showed positive results in left Dix-Hallpike test,and 6 of left lateral position showed positive re-sults in right Dix-Hallpike test.Among 21 patients of supine position,14 were positive in Dix-Hallpike test of the right side,and 7 were positive in Dix-Hallpike test of the left side.The affected ear showed a positive correlation with the ipsi-lateral sleeping position (r=0.367,P<0.01).After treatment,5 patients in treatment group A (12.50%) and 4 patients in treatment group B (9.52%) suffered recurrence,with no statistically significant difference between the two groups (P>0.05),which were both significantly lower than 11 patients (31.43%) in the control group (P<0.05).Conclusion In pa-tients with single-ear canal BPPV,there is a correlation between the affected ear and partial side of sleeping position.Changing their sleeping position combined with oral Betahistine may has certain value to prevent BPPV.%目的 研究口服敏使朗合并改变睡姿对单侧耳后半规管良性阵发性位置性眩晕(BPPV)患者手法复位成功后减少复发的价值.方法 回顾性分析117例单侧耳后半规管BPPV老年患者的睡眠史,患者平均年龄(62.1±8.2)岁,均要求能确定优势侧睡姿.所有患者均详细询问病史并进行神经系统体格检查,包括姿势和步态、眼球运动、Dix-Hallpike试验、仰卧侧头位试验等.117例患者按随机数表分为三组,对照组35例采取改良Epley复位,治疗A组40例采取改良Epley复位结合改变睡姿,治疗B组42例采取改良Epley复位结合敏使朗及改变睡姿,分析三组复发率.结果 117例患者中,右侧Dix-Hallpike试验阳性74例,左侧Dix-Hallpike试验阳性43例.睡眠时,64例习惯右侧卧位,32例习惯左侧卧位,21例习惯仰卧位.在117例单侧Dix-Hallpike试验阳性患者中,患耳与睡姿在同侧者80例,其中54例右侧,26例左侧;16例患耳与睡姿在不同侧,其中10例右侧卧位者左侧Dix-Hallpike试验阳性,6例左侧卧位者右侧Dix-Hallpike试验阳性,21例仰卧位患者中,14例右侧Dix-Hallpike试验阳性,7例左侧Dix-Hallpike试验阳性.患耳与同侧睡姿呈正相关(r=0.367,P<0.01).治疗后对照组患者复发11例,复发率为31.43%,治疗A组患者复发5例,复发率为12.50%,治疗B组患者复发4例,复发率为9.52%,治疗A组和B组的复发率均低于对照组,差异均有统计学意义(P<0.05),而治疗A组和治疗B组的复发率比较差异无统计学意义(P>0.05).结论 单侧耳后半规管良性阵发性位置性眩晕患耳与睡姿的偏侧性具有相关性,改变睡姿和联合口服敏使朗对预防良性阵发性位置性眩晕可能有一定价值.
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