阶梯式认知行为疗法联合前庭功能锻炼治疗持续性姿势-知觉性头晕的效果

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[Abstract] Objective：To evaluate the clinical efficacy of stepwise cognitive behavioral therapy （CBT） combined with vestibular function exercises in the treatment of persistent postural-perceptual dizziness （PPPD）. Method： A total of86 patients with PPD were treated atthe Fifth People's Hospital of Zhongshan from April toApril 2O25.They were randomly divided into control group -43 ，onlymedication） and experimental group （n=43， medication + stepwise CBT combined with vestibular function exercises），both receiving treatment for 6 weeks. The frequencyand duration of vertigo atacks，SAS and SDS scores，dizziness handicap inventory （DHI） scores and the Pitsburgh sleepquality index （PSQI） scores before and after treatment between the two groups were compared. Result： In the 6th week of treatment，the number of vertigo attacks in the experimental group was less than that in the control group，and the duration of vertigo atacks was shorter than that in the control group （ P <0.05）. After 6 weeks of treatment，the SAS and SDS scores of the experimental group were lower than those of the control group （ P <0.05）.After 6 weeks of treatment，the DHI and PSQI scores of the experimental group werelower than those of the control group ）.Conclusion：Stepwise CBT combined with vestibular function exercises can effectively reduce vertigo attacks，improve anxiety and depression，reduce disability，and enhance sleep quality in PPPD patients， showing better therapeutic effects thanmedicationalone.

[Keywords] Persistent postural-perceptual dizzinessStepwise cognitive behavioral therapy Vestibular function exerciseDegree of vertigo disabilitySleep quality

First-author's address： Department of Otolaryngology， Fifth People's Hospital of Zhongshan， Zhongshan528415，China

doi：10.3969/j.issn.1674-4985.2025.32.007

持续性姿势－知觉性头晕（persistent postural-perceptual dizziness，PPPD）是近年来由Barany 学会明确定义的一种慢性前庭功能障碍性疾病，其临床特征主要表现为持续超过3个月的非旋转性头晕或不稳感，在直立姿势或复杂视觉环境中症状加重[]。（剩余6860字）