To investigate the clinical efficacy of betahistine mesylate combined with oxiracetam in the treatment of patients with posterior circulation ischemic vertigo (PCIV).

This prospective study included 80 patients with PCIV who were treated at our hospital between June 2022 and June 2024. The patients were randomly assigned into two groups: the observation group (40 cases, treated with betahistine combined with oxiracetam) and the control group (40 cases, treated with betahistine monotherapy). After two weeks of treatment, the following were assessed: vertigo symptom scores [Electronystagmography (ENG) score, Visual Vertigo Analogue Scale (VVAS), and Sheikh Control Scale (SCS)], imaging indicators, and serum-related factors.

After treatment, the nystagmogram score and Visual Vertigo Analog Scale (VVAS) score of the observation group were (3.08±0.86) and (37.13±3.26) points, respectively, which decreased significantly, while the Situational Vertigo Scale (SCS) score was (82.55±7.89) points, which increased significantly (P<0.05). The average blood flow velocities of the basilar artery and vertebral artery in the observation group were significantly higher than those in the control group (P<0.05). The serum levels of endothelin-1 (ET-1) and platelet-derived growth factor-BB (PDGF-BB) decreased, and the level of nerve growth factor (NGF) increased, with the observation group showing a better effect than the control group (P<0.05). The observation group experienced 2 cases of nausea and vomiting, 2 cases of rash, 2 cases of drowsiness, and 4 cases of dizziness, while the control group had 1 case of nausea and vomiting, 1 case of rash, and 1 case of dizziness, with no drowsiness reported. The incidence of adverse reactions was higher in the observation group than in the control group (χ²=4.501, P=0.034)(P<0.05).

Betahistine mesylate combined with oxiracetam significantly improves symptoms in patients with PCIV, enhances hemodynamics, and modulates serum factors, demonstrating promising clinical application potential.