目的 探討甲鈷胺聯(lián)合強(qiáng)的松治療前庭神經(jīng)炎的臨床效果。方法 采用回顧性、隨機(jī)、對(duì)照研究方法，2012年8月—2017年1月選擇在陜西省楊凌示范區(qū)醫(yī)院診治的前庭神經(jīng)炎患者158例作為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法分為觀察組與對(duì)照組各79例。對(duì)照組給予強(qiáng)的松治療，口服，5～10 mg/次，10～60 mg/d。觀察組在對(duì)照組治療的基礎(chǔ)上給予甲鈷胺1mL靜脈推注，1次/d。都治療觀察3個(gè)月。比較兩組的臨床療效、前庭功能和炎癥因子水平。結(jié)果 觀察組與對(duì)照組的總有效率分別為98.7%和89.9%，觀察組顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后兩組的日?；顒?dòng)前庭功能障礙等級(jí)量表（VADL）、眩暈殘障程度量表（DHI）評(píng)分都顯著低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組治療后的上述評(píng)分都顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組與對(duì)照組的白介素-6（IL-6）水平都顯著低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組也顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組在治療期間都未出現(xiàn)嚴(yán)重不良反應(yīng)，未影響到治療的進(jìn)行。結(jié)論 甲鈷胺聯(lián)合強(qiáng)的松治療前庭神經(jīng)炎能有效改善患者的臨床癥狀，提高治療療效，不會(huì)增加不良反應(yīng)的發(fā)生，其作用效果可能與下調(diào)炎癥因子表達(dá)有關(guān)。

Objective To investigate the clinical effect and observation of mecobalamin combined with prednisone in the treatment of vestibular neuritis. Methods Used a retrospective, randomized, controlled study method, From August 2012 to January 2017, 158 patients with vestibular neuritis in our hospital diagnosis and treatment were selected as the research object, all the patients were divided into observation group and control group with 79 patients in each group accorded to randomly. The control group was given prednisone treatment, the observation group was given mecobalamin combined with prednisone treatment, all patients were observed for 3 months. The clinical efficacy, vestibular function and inflammatory factors were compared between the two groups. Results The total effective rates in the observation group and the control group were 98.7% and 89.9%, respectively. The observation group was significantly higher than that of the control group (P<0.05). There were no serious adverse reactions occurred in the two groups during the treatment period, and there was no effect on the treatment. After treatment, the DHI scores and VADL scores in the two groups were significantly lower than those before the treatment (P<0.05), and the above scores in the observation group after treatmetn were significantly lower than those in the control group (P<0.05). After treatment, the IL-6 values of the observation group and the control group were (6.44 ±4.31) pg/mL and (12.87 ±4.00) pg/mL, respectively, which were significantly lower than those of before treatment of (30.55 ±5.33) pg/mL and (30.29 ±6.12) pg/mL (P<0.05), and the observation group was also significantly lower than that of the control group (P<0.05). Conclusion The mecobalamin combined with prednisone in the treatment of vestibular neuritis can effectively improve the clinical symptoms of the patients, improve the curative effect, it has no severe adverse reaction, the effect may be related to down-regulate the expression of inflammatory factors.