Efficacy of betahistine combined with piracetam in treatment of patients with posterior circulation ischemic vertigo
Jiang Man
Liu Long
Yin Xia
Abstract：Objective To investigate the effect and safety of betahistine combined with piracetam in treatment of pa-tients with posterior circulation ischemic vertigo(PCIV).Methods A total of 92 patients who were diagnosed as PCIV in the Xinhua Hospital of Huainan Xinhua Medical Group from March 2021 to November 2022 were enrolled and divid-ed into the betahistine group(betahistine hydrochloride)and the piracetam group(betahistine hydrochloride+piracetam)by the random coin tossing method,with 46 cases in each group.The clinical efficacy,severity of vertigo symptoms(Dizziness Handicap Inventory(DHI)),mean vertebrobasilar artery flow velocity(vertebral artery(VA),basilar artery(BA),posterior cerebralartery(PCA)),serum indicators(N-terminal pro-brain natriuretic peptide(NT-proBNP),homocysteine(Hcy),D-di-mer(D-D))before and after treatment,adverse reactions and recurrence after 6 months of follow-up were compared between the groups.Results The total effective rate of the piracetam group(95.65%,44/46)was higher than that of the betahis-tine group(82.61%,38/46)and there was significant difference between the two groups(χ2=4.039,P<0.05).After 14 days of treatment,the scores of dimensions of DHI were lower in both groups than those before the treatment(all P<0.05),while the scores of physical disorder,emotional disorder and dysfunction were(11.09±2.01)points,(10.18±2.74)points and(9.55±1.23)points in the pirac-etam group,lower than(14.23±2.13)points,(11.92±2.87)points and(11.97±2.40)points in the betahistine group,and there were signif-icant differences between the two groups(t=7.262,2.974,6.086,all P<0.05).The blood flow velocities of VA,BA and PCA in the two groups were higher after 14 days of treatment than those before the treatment(all P<0.05),while the levels of the above indexes in the piracetam group were(37.95±4.23)m·s-1,(42.03±5.56)m·s-1 and(38.69±4.48)m·s-1,higher than(34.08±4.61)m·s-1,(37.36±4.82)m·s-1 and(33.31±4.29)m·s-1 in the betahistine group,and there were significant differences between the two groups(t=4.195,4.304,5.883,all P<0.05).After 14 days of treatment,the levels of NT-proBNP,HCY and D-D were lower in both groups than those before the treatment(all P<0.05),while the levels of the above indexes were(335.81±46.13)ng·mL-1,(22.23±3.23)μmol·L-1 and(0.41±0.06)mg·L-1 in the piracetam group,lower than(424.52±60.30)ng·mL-1,(26.05±3.16)μmol·L-1 and(0.50±0.08)mg·L-1 in the betahistine group,and there were signifi-cant differences between the two groups(t=7.925,5.734,6.104,all P<0.05).The total incidence of adverse reactions was 10.87%(5/46)in the piracetam group and 4.35%(2/46)in the betahistine group,with no statistically significant difference between the two groups(χ2=1.392,P=0.238).The total recurrence rate was 2.17%(1/46)in the piracetam group and 8.70%(4/46)in the betahistine group,with no statistically significant difference between the two groups(χ2=1.903,P=0.168).Conclusion Betahistine combined with piracetam has exact efficacy in treatment of patients with PCIV.It can relieve the severity of vertigo symptoms,promote the recovery of vertebrobasilar artery flow,and improve the expression levels of serum related factors,with safety and reliability.
Keywords：Posterior circulation ischemic vertigoBetahistinePiracetamClinical efficacyHemodynamics
Publication Date：2025-08-25
Online Publishing Date：2025-09-01(First online date of this platform, not the publication date of the document)
Pages：5( 765-769 )