天麻钩藤饮联合前庭康复治疗持续性姿势-知觉性头晕的实效性随机对照试验OA

Objective:To observe the clinical efficacy of Tianma Gouteng Decoction combined with vestibular rehabilitation therapy in treating persistent postural-perceptual dizziness(PPPD).Methods:A randomized controlled trial was conducted,enrolling 140 PPPD patients who met the inclusion criteria.They were randomly divided into an experimental group and a control group of 70 cases each.Both groups received vestibular rehabilitation therapy(VRT);additionally,the experimental group received modified Tianma Gouteng Decoction,while the control group was treated with selective serotonin reuptake inhibitors(SSRIs)or serotonin-norepinephrine re-uptake inhibitors(SNRIs).At weeks 4,8,and 12 after treatment,traditional Chinese medicine syndrome scores,dizziness visual ana-logue scale(VAS)scores,Hamilton Anxiety Scale(HAMA)scores,Hamilton Depression Scale(HAMD)scores,and Dizziness Hand-icap Inventory(DHI)scores were observed.Results:(1)After 4 weeks of treatment,the TCM syndrome score in the experimental group was(24.02±3.75),lower than before treatment in this group(P<0.05).In the experimental group,the DHI score was(41.56±5.69)and the dizziness VAS score was(7.44±1.17),while the control group had a DHI score of(41.74±5.74)and a dizziness VAS score of(7.34±0.98),all of which were lower than before treatment in the respective groups(P<0.05).The control group HAMA score was(21.26±3.30)and HAMD score was(19.08±3.77),also lower than before treatment in their group(P<0.05).(2)After8 weeks of treatment,the TCM syndrome score in the experimental group was(17.49±3.32),lower than before treatment(P<0.05).The experimental group's DHI score was(28.10±6.62)and dizziness VAS score was(7.44±1.17),while the control group's DHI score was(29.15±5.90)and dizziness VAS score was(5.68±1.59);the experimental group was lower than the control group at the same period(P<0.05).The experimental group's HAMA score was(13.03±2.35)and HAMD score was(13.26±2.10),while the control group's HAMA score was(11.21±2.77)and HAMD score was(12.74±2.06);both groups were significantly lower than before treatment(P<0.05),and the control group was lower than the experimental group at the same period(P<0.05).(3)After 12 weeks of treatment,the experimental group's TCM syndrome score was(9.10±2.35),DHI score was(11.25±2.61),and dizziness VAS score was(2.84±1.36),while the control group's TCM syndrome score was(14.05±4.06),DHIscore was(12.35±2.79),and dizziness VAS score was(3.50±1.30);both groups were lower than before treatment(P<0.05),and the experimental group was lower than the control group at the same period(P<0.05).Conclusion:Real-world effective randomized controlled trials better reflect clinical practice.Tianma Gouteng Decoction combined with vestibular rehabilitation has certain advantages in improving dizziness symptoms and severity,and its effectiveness becomes more significant with longer treatment duration.