Volume 03 Issue 04-2023
68
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
68-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
In addition to affecting the receptors of the inner ear, betahistine has an effect on the H3 receptors of the vestibular
nuclei located in the medulla oblongata. Experimental work on animals has shown an increase in the level of serotonin
in the medulla oblongata. This leads to a decrease in the activity of the vestibular nuclei, a decrease in their excitability
and the cessation of dizziness. Thus, a vestibulodepressive effect is manifested.
KEYWORDS
betahistine, receptors, serotonin.
Research Article
RESULTS OF HYPOTENSIVE THERAPY IN PATIENTS WITH VESTIBULAR
DYSFUNCTION
Submission Date:
April 14, 2023,
Accepted Date:
April 19, 2023,
Published Date:
April 24, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue04-10
U.S. Khasanov
Researcher Tashkent Medical Academy, Uzbekistan
N.A. Akhunjhanov
Researcher Tashkent Medical Academy, Uzbekistan
Sh.A. Makhamadaminova
Researcher Tashkent Medical Academy, Uzbekistan
U.P. Abdullaev
Researcher Tashkent Medical Academy, Uzbekistan
D.A. Jumanov
Researcher Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 04-2023
69
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
68-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
INTRODUCTION
The wide prevalence of arterial hypertension [AH], the
life-threatening nature of its organ complications,
especially in the brain, make this problem one of the
most urgent in clinical medicine [1,5,7,8]. At the same
time, it should be noted that most studies on cerebral
complications of hypertension refer to strokes. As for
pre-stroke cerebrovascular disorders (DCVR) against
the background of AH, they are much less covered. The
existing literature reflecting vestibular disorders in
patients with HD is presented mainly on the basis of
prescription, stage of HD, but without taking into
account cerebrovascular disorders. As for the
information about in-depth otoneurological studies in
patients with HD with CVD, including the reflection of
their dynamics against the background of the use of
modern antihypertensive drugs, they are extremely
few [4,9].
Given the above, the purpose of this work was to
study the vestibular function of hypertensive patients
(AH) before and after treatment with modern
antihypertensive drugs.
MATERIAL AND RESEARCH METHODS
Under our supervision there were 79 patients with GB
with DCVR. Among the sick men were 71, women - 8,
their age ranged from 23 to 70 years. The duration of
the disease varied from 1 to 15 years. According to the
structure of the LCVR, the patients were distributed as
follows: with initial manifestations of inferiority of the
cerebral blood supply (NPNKM) - 20 patients, with
hypertensive encephalopathy (HE) - stage I. - 20, with
GE-IIst. - 20 patients. In 19 patients with HE, episodes of
transient cerebrovascular accidents (TIMC) were
noted. Patients underwent an examination of the
general somatic (cardiological), neurological and ENT
status according to standard methods. The study of
vestibular function, in addition to the clinical method,
included caloric tests and electronystagmography
according to the method of N.S. Blagoveshchenskaya
(1990).
In addition, patients underwent echoencephaloscopy
(EchoES),
rheoencephalography
(REG)
and
electroencephalography (EEG) according to generally
accepted methods to verify the diagnosis of LCVR.
Of the 79 patients, 40 were prescribed ACE inhibitors
(mainly Vasotec at a dose of 5-10 mg/day) and 39
patients were prescribed calcium antagonists (AC);
Norvasc (up to 10 mg/day) or Corinfar (up to 30
mg/day). The duration of treatment was 21-30 days.
The results obtained between intervention groups
were not statistically significant, and therefore are
presented in a generalized form.
RESULTS AND DISCUSSION
An analysis of patients' complaints after treatment
showed that if 51 out of 79 patients complained of
dizziness before treatment, after treatment 32 of them
noted a decrease in intensity, frequency, and even
complete disappearance of dizziness. Moreover, the
positive dynamics in patients with NPCM was much
higher (up to 100%) than in patients with HE-I (85%) and
HE-II (60%). The smallest dynamics of vertigo was
noted in HE with MIMC (less than 40%).
The dynamics of objective symptoms was somewhat
different. In particular, spontaneous nystagmus was
persistently retained only in one patient out of three
cases of HE with PNMK.
The instability was more firmly held in the Romberg
position. So, in patients with NPLMC, instability in the
simple Romberg position after treatment persisted in 1
Volume 03 Issue 04-2023
70
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
68-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
of 3 patients, in sensitized in 2 of 6 patients, flank gait
disturbance persisted in 1 of 3 examined. With GE-I Art.
instability in the simple Romberg position after
treatment remained in 3 out of 6 patients, in sensitized
in 5 out of 9 examined. Violation of the flank gait
remained in 3 out of 6 patients. In patients with GE-II
Art. instability in the simple Romberg position
continued to remain in 5 out of 8 examined patients,
and in the sensitized position in 6 out of 8 patients. In
patients with HE with PNMK, instability after treatment
remained in 6 out of 8, and in sensitized patients in 7
out of 12 patients.
The results of the study of the excitability of the
vestibular analyzer according to the caloric test
showed its positive dynamics in 2/3 of the examined,
regardless of the nature of the pathology. So, in 26 (out
of 65) patients with positive dynamics, initially 6 had
increased excitability, 7 had decreased excitability, 4
patients had no responses, and 9 had asymmetric
reactions. In 39 patients, there was a tendency to
improve the state of excitability of the vestibular
analyzer, but it was statistically unreliable. The
percentage of positive dynamics also depended on the
severity of LCVR. So, in cases with NPNKM, excitability
recovered to normal in 64.3% of patients, with GE-I st. -
in 50%, GE-II st. - in 33.3%, and in HE with PNMK - in 21.1%
of patients (P>0.05).
The dependence of the dynamics of LCVR on the
degree of its severity was also confirmed by the data of
neurophysiological studies. In particular, by the end of
the course of treatment, the normalization of the tone
of the cerebral vessels according to the REG occurred
in 22.5% to 37% of cases, depending on the severity of
the CVR. At the same time, in the group as a whole, the
pulse blood filling of the cerebral vessels according to
the rheographic index (RI) increased by an average of
13-15% (P<0.05). So, if this indicator (RI) in patients with
NPNKM improved by 13%, then in patients with GE-II st.
by 8% (P<0.01).
According to EchoES, pronounced signs of intracranial
pressure (ICP) that occurred in 15.5-20% of patients
moved to other (moderate, mild) gradations. The
number of patients with normal ICP doubled (from 30
to 60%). All indicators were statistically significant
(P<0.05).
The dynamics of EEG changes was less noticeable and
was expressed mainly by a decrease in the severity of
cerebral changes. Normalization of the EEG was noted
in less than 10% of patients, which must be taken for
granted, because. normalization of EEG parameters is
a long process (from 1 to 6 months or more).
Thus, it can be concluded that ACE inhibitors and
calcium antagonists have, along with a high
hypotensive
and
a
certain,
mediated
cerebrovasoactive effect, which confirms the literature
(2,3,5,6,8) and our previous information (7). This
process is also reflected in the manifestation of the
dynamics of otoneurological symptoms of CVD in GB.
At the same time, in our opinion, the normalization of
excitability in the group of patients with increased
excitability is apparently due to the restoration of the
balance of cortical processes and, accordingly, the
normalization of its inhibitory function to the labyrinth.
In individuals with a decrease in reactivity, the
restoration of normal excitability depends not only on
the restoration of the balance of cortical processes,
but also on improving the nutrition of the labyrinth
receptors and the pathways of the vestibular analyzer.
We believe that in order to achieve better results,
antihypertensive therapy should be long-term and
combined with periodic courses of neurometabolic
and antioxidant therapy.
Volume 03 Issue 04-2023
71
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
68-71
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
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