The Therapy Based on Traditional Chinese Medicine for Otolithiasis

Abstract

Background: Otolithiasis (also named benign paroxysmal positional vertigo, BPPV) is one of the most common illness for hospital visits. Residual dizziness and recurrence after reduction are problems for the treating BPPV with Western medicine. Traditional Chinese medicine (TCM) has shown obvious superiority in the treating BPPV. Here, we explore the curative effect of the theory of dizziness of TCM in treating BPPV. Methods: 183 BPPV patients were randomly divided into 3 groups: Reset group (RG) 61 cases, Traditional Chinese Medicine group (TG) 61 cases, and Reset plus Traditional Chinese medicine group (R+TG) 61 cases. RG received machine reset. TG was given the therapy based on the theory of dizziness of TCM. R+TG received machine reset plus the therapy of TCM. All patients, before and on 1th day, 7th day, and 14th day of treatment, were evaluated with the dizziness handicap inventory (DHI) for the physical (P), functional (F) and emotional (E) state. The efficacy of the different therapy in the treatment of mild, moderate, and severe BPPV has been observed. Follow up for 6 months, we record and compare the ratio of patients with residual dizziness and the recurrence of BPPV for the three groups. Serum levels of vitamin D, estrogen, and calcium and phosphorus ions were detected and compared between the groups of BPPV patients, dizziness non-BPPV patients, and non-dizziness patients. Results: The DHI score of the three groups, compared with which before treatment, RG (p < 0.05), TG (p < 0.01), and R+TG (p < 0.01), decreased significantly on the 7th day of treatment; R+TG decreased more significantly than RG (p < 0.05). The DHI scores of the three groups, on the 14th day of treatment, were significantly lower than those before treatment (p < 0.01). On the 7th day of treatment, compared with the same period of RG, the score of item E of TG and R+TG, decreased significantly (p < 0.05). Patients of mild BPPV responded well to the three kinds of the therapy; For the patients of moderate BPPV, on the 7th day of treatment, assessed by DHI, the effect showed significant improve for RG (p < 0.05), TG (p < 0.01) and R+TG (p < 0.01). For the patients of severe BPPV, on the 7th day of treatment, the effect of RG, assessed with DHI, showed no improvement (p > 0.05), while TG (p < 0.05) and RG+TG (p < 0.01) showed effective. The incidence of residual dizziness between the three groups show significantly different on the 2nd week (x² = 7.635, p = 0.022) and the 1th month (x² = 7.502, p = 0.023) of treatment; The incidence of RG was higher than those of TG and R+TG. The recurrence rates of BPPV of the three groups were significantly different on the end of 2nd month (x² = 8.528, p = 0.014), 4th month (x² = 13.287, p = 0.001), and 6th month (x² = 12.587, p = 0.002) of treatment. The recurrence rates of TG and R+TG were lower than that of RG. There was no significant difference in recurrence rate and residual dizziness occurrence rate between TG and R+TG. There were differences in serum vitamin D and estrogen levels between the group of BPPV patients, dizziness non-BPPV patients, and non-dizziness patients; There was no difference in calcium and phosphorus ion levels between the three groups. Conclusions: Compared with therapy of RG, TG and R+TG showed more effective in treating BPPV; They can significantly improve patient's bad mood, reduce the proportion of residual dizziness, and reduce the recurrence rate. TCM and TCM plus reset have better efficacy in treating moderate and severe BPPV. The specificity of abnormal changes in serum vitamin D and estrogen for BPPV patients needs be further study.