指压合谷治疗耳石症患者复位成功后头晕恶心的效果

doi:10.3760/cma.j.cn441417-20241227-14029

摘要/Abstract

摘要：

目的　观察指压合谷治疗耳石症患者复位成功后头晕恶心的效果。方法　选取单县中心医院2022年6月至2024年5月收治的耳石症复位后存在头晕恶心症状的104例患者进行随机对照试验，其中男25例，女79例，年龄30～82岁，病程3 h～2周。采用随机数字表法将其分为观察组和对照组，各52例。观察组男13例，女39例，平均年龄63.6岁。对照组男12例，女40例，平均年龄63.8岁。观察组在手法复位后即刻指压合谷3 min，随后静坐休息。对照组仅进行常规手法复位后静坐休息。比较两组复位后以及复位后30 min可视物例数、眩晕障碍量表（DHI）和前庭症状指数（VSI）评分。采用χ²检验和t检验进行统计分析。结果　复位后30 min，观察组可视物例数为37例（占比71.15%），对照组可视物例数为23例（占比44.23%），差异有统计学意义（P<0.05）；观察组DHI、VSI评分分别为（30.49±6.40）分、（29.32±4.70）分，对照组分别为（37.76±6.29）分、（34.78±4.94）分，差异均有统计学意义（均P<0.05）。结论　指压合谷在减轻耳石症患者复位成功后头晕恶心症状方面具有良好的效果。

关键词: 头晕, 眩晕, 恶心, 合谷, 穴位按压, 耳石症

Abstract:

Objective　To observe the therapeutic effect of acupressure at Hegu point in the treatment of dizziness and nausea in patients with benign paroxysmal positional vertigo after successful reduction. Methods　One hundred and four patients with dizziness and nausea after reduction for benign paroxysmal positional vertigo in Shanxian Central Hospital from June 2022 to May 2024 were selected for the randomized controlled trial, including 25 males and 79 females; they were 30 to 82 years old, with a disease course ranging from 3 h to 2 weeks. They were divided into an observation group and a control group by the random number table method, with 52 cases in each group. The observation group had 13 males and 39 females, with an average age of 63.6 years. The control group had 12 males and 40 females, with an average age of 63.8 years. The observation group took acupressure at Hegu point for 3 minutes immediately after manual reduction, and then the patients sat quietly for rest. The control group only sat quietly for rest after routine manual reduction. The numbers of the patients who could see objects and the scores of the Dizziness Handicap Inventory (DHI) and the Vestibular Symptom Index (VSI) immediately after reduction and 30 min after the reduction were compared between the two groups by χ² and t tests. Results　Thirty min after the reduction, the number of the patients who could see objects in the observation group was 37 cases (accounting for 71.15%), and that in the control group was 23 cases (accounting for 44.23%), with a statistical difference (P<0.05). The scores of DHI and VSI in the observation group were 30.49±6.40 and 29.32±4.70, and the scores in the control group were 37.76±6.29 and 34.78±4.94, respectively, with statistical differences (both P<0.05). Conclusion　Acupressure at Hegu point has good clinical effect in relieving the symptoms of dizziness and nausea in patients with benign paroxysmal positional vertigo after successful reduction.

Key words: Dizziness, Nausea, Hegu point, Acupoint pressing, Benign paroxysmal positional vertigo

鹿时刚张腾.

指压合谷治疗耳石症患者复位成功后头晕恶心的效果 [J]. 国际医药卫生导报, 2025, 31(14): 2435-2438.

Lu Shigang, Zhang Teng.

Effect of acupressure at Hegu point in treatment of dizziness and nausea in patients with benign paroxysmal positional vertigo after successful reduction [J]. International Medicine and Health Guidance News, 2025, 31(14): 2435-2438.

参考文献

[1]汪晓锋,周燚,苏文玲,等.主观视觉垂直线/水平线对良性阵发性位置性眩晕患者耳石器功能的评估作用[J].中国耳鼻咽喉头颈外科, 2022, 29(1): 37-51. DOI:10.16066/j.1672-7002.2022.01.009.

[2]Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology[J]. Neurology, 2008, 70(22): 2067-2074. DOI: 10.1212/01.wnl.0000313378.77444.ac.

[3]Helminski JO, Zee DS, Janssen I, et al. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review[J]. Physical Therapy, 2010, 90(5): 663-678. DOI: 10.2522/ptj.20090071.

[4]姚琦,潘晓峰,潘宋斌,等.金纳多治疗良性阵发性位置性眩晕复位成功后残余头晕症状的疗效评估[J].中华耳科学杂志, 2020, 18(5): 897-901. DOI: 10.3969/j.issn.1672-2922.2020.05.017.

[5]张洪,曾萍,李小英.不同复位手法治疗良性阵发性位置性眩晕复位后残余症状的效果[J].郑州大学学报(医学版), 2023, 58(5): 685-688. DOI:10.13705/j.issn.1671-6825.2022.10.048.

[6]曾智本,吴新风.三联疗法联合倍他司汀治疗耳石症复位后残余头晕的效果观察[J].实用临床医药杂志, 2024, 28(13): 92-97. DOI:10.7619/jcmp.20233966.

[7]李庆彬,刘言祥,赵博.眩晕项贴联合半夏白术天麻汤加减对肝火上炎型耳石症复位后残余眩晕的临床疗效观察[J].临床和实验医学杂志, 2024, 23(5): 481-485. DOI:10.3969/j.issn.1671-4695.2024.05.009.

[8]李红艳.前庭康复训练联合甲磺酸倍他司汀在耳石症患者中的应用研究[J].中国疗养医学, 2021, 30(6): 633-634. DOI:10.13517/j.cnki.ccm.2021.06.024.

[9]鹿时刚,刘国存.指压合谷穴治疗全口义齿初戴者恶心的效果观察[J].中国基层医药, 2022, 29(7): 985-988. DOI:10.3760/cma.j.cn341190-20210423-00498.

[10]吴子明,王丹丹.国际巴拉尼学会BPPV诊断新标准解读及2007７版美国耳鼻咽喉头颈外科学会BPPV诊疗指南更新要点[J].听力学及言语疾病杂志, 2017, 25(5): 448-449. DOI:10.3969／j.issn.1006-7299.2017.05.002.

[11]Dix MR, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system[J].Proc R Soc Med, 1952, 45(6): 341-354. DOI:10.1177/003591575204500604.

[12]王位,刘茜茜,陈亨平,等.针刺联合益气活血汤治疗气虚血瘀型耳石症复位后残余头晕30例[J].浙江中医杂志, 2025, 60(1): 51-52. DOI:10.3969/j.issn.0411-8421.2025.01.024.

[13]Loos E, Van Stiphout L, Lucieer F, et al. The evolution of vestibular function and health-related quality of life in bilateral vestibulopathy[J]. Sci Rep, 2025, 15(1): 7476. DOI:10.1038/s41598-025-92109-2.

[14]Yan S, Gao P, Wu W.Role of comprehensive vestibular rehabilitation based on virtual reality technology in residual symptoms after canalith repositioning procedure[J]. J Int Adv Otol, 2024, 20(3): 272-278. DOI:10.5152/iao.2024.231393.

[15]Mandalà M, Salerni L, Nuti D. Benign positional paroxysmal vertigo treatment: a practical update[J]. Curr Treat Options Neurol, 2019, 21(12): 66. DOI:10.1007/s11940-019-0606-x.

[16]孙永奇.老年人良性阵发性位置性眩晕的诊断与治疗[J].国际医药卫生导报, 2023, 29(18): 2532-2535. DOI:10.3760/cma.j.issn.1007-1245.2023.18.005.

[17]杨强.手法复位联合药物治疗耳石症的疗效[J].医疗装备, 2017, 30(1): 148-149. DOI: 10.3969/j.issn.1002-2376.2017.01.103.

[18]徐磊,李晓炎,邱培森,等. 104例良性阵发性位置性眩晕诊治体会[J].中国实验诊断学, 2019, 23(3): 494-496. DOI:10.3969/j.issn.1007-4287.2019.03.046.

[19]高翠婷,贾龙飞.合谷穴临床应用规律古代文献研究[J].亚太传统医药, 2019, 15(8): 154-157. DOI: 10.11954/ytctyy.201908051.

[20]赵彦萍,陈媛媛,方继良,等.应用磁共振波谱研究针刺合谷穴前额叶神经递质Glu与GABA相关性[J].世界科学技术-中医药现代化, 2022, 24(6): 2464-2471. DOI:10.11842/wst.20210526008.

[21]王利一,高波,黄魏宁.耳石症患者复位治疗成功后头晕观察[J].山东大学耳鼻喉眼学报, 2014, 28(4): 20-21, 25.

[22]曹丙慧.合谷穴注射地塞米松预防妇科腹腔镜手术后恶心呕吐的效果[J].检验医学与临床, 2023, 20(8): 1157-1160. DOI:10.3969/j.issn.1672-9455.2023.08.032.

[23]Liu R, Luo Y, Ma J, et al. Traditional Chinese medicine for functional gastrointestinal disorders and inflammatory bowel disease: narrative review of the evidence and potential mechanisms involving the brain-gut axis[J]. Front Pharmacol, 2024, 15: 1444922. DOI:10.3389/fphar.2024.1444922.

[24]沈雪勇.经络腧穴学[M].北京:中国中医药出版社, 2016.

[25]许淑鱼,张帅,刘欣媛,等.不同时辰电针合谷即时效应和脑功能连接差异[J/OL].世界科学技术-中医药现代化,1-15[2024-12-27].http://kns.cnki.net/kcms/detail/11.5699.R.20250107.1130.002.html.

[26]李虹虹,林雯雯,张丽霞.三阴交、合谷穴揿针联合关元穴灸法对药物流产患者的临床疗效研究[J].中国性科学, 2021, 30(11): 125-128. DOI: 10.3969/j.issn.1672-1993.2021.11.038.

[27]蒋妮珊,李凤连,蓝英,等.黄豆袋热敷联合合谷穴按摩在产程活跃期中的镇痛效果[J].广西医学, 2024, 46(5): 702-709. DOI:10.11675/j.issn.0253-4304.2024.05.16