Objective To investigate the clinical efficacy of Tianshu Tablets combined with topiramate for the treatment of patients with vestibular migraine (VM). Methods A total of 102 patients with VM were selected, and they were randomly divided into observation group or control group, with 51 cases in each group. The observation group received Tianshu Tablets combined with topiramate for treatment, whereas the control group was treated with topiramate, for a 3⁃month course of treatment. Pre⁃ and post⁃treatment vertigo episode, Dizziness Handicap Inventory (DHI) score, parameters related to cervical vestibular evoked myogenic potential (cVEMP), and levels of serum vascular endothelial function indices with respect to calcitonin gene⁃related peptide (CGRP), endothelin 1 (ET⁃1), nitric oxide (NO), as well as matrix metalloproteinase 9 (MMP9) level, clinical total effective rate after treatment and the occurrence status of adverse reactions during treatment were compared between patients of the two groups. Results After treatment, both groups exhibited decreased frequency of vertigo episode, shortened vertigo duration, and decreased VAS score for vertigo, various dimensions scores of DHI and total score for vertigo as compared with before treatment; furthermore, the observation group yielded lower or shorter indices as above as compared with the control group (P<0.05). After treatment, patients of both groups obtained increased left and right p13⁃n23 amplitude of cVEMP, reduced bilateral amplitude asymmetry as compared with before treatment, and the observation group depicted larger left and right p13⁃n23 amplitude of cVEMP, and smaller bilateral amplitude asymmetry as compared with the control group (P<0.05). After treatment, the levels of serum CGRP, ET⁃1, NO, and MMP9 of both groups were decreased as compared with before treatment, and the observation group expressed lower levels as above as compared with the control group (P<0.05). After treatment, the observation group interpreted a higher clinical total effective rate as compared with the control group (P<0.05). There was no statistically significant difference in the incidence rate of adverse reactions during treatment between the two groups (P>0.05). Conclusion The clinical efficacy of Tianshu Tablets combined with topiramate for the treatment of VM patients is superior to topiramate therapy alone, which can ameliorate vertigo episode and vestibular functions of patients, improve patients' quality of life, correct vascular endothelial function disorder, and down⁃regulate serum MMP9 level, with a favorable safety.

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