补中益气汤加减联合氟桂利嗪治疗椎-基底动脉供血不足所致眩晕临床研究
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摘要
目的:观察补中益气汤加减联合氟桂利嗪治疗椎基底动脉供血不足(VB)I所致眩晕的临床疗效。方法:选取72例因VBI导致的眩晕患者,按照随机数字表法分为对照组35例和观察组37例。2组均给予基础治疗,对照组在治疗基础上口服盐酸氟桂利嗪胶囊治疗,观察组在对照组基础上再给予补中益气汤加减治疗。对比2组临床疗效,观察患者治疗前后眩晕程度及脑动脉血流速度的变化。结果:总有效率对照组68.6%,观察组89.2%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组欧洲眩晕量表(EEV)和国际眩晕障碍量表(DH)I评分均较治疗前降低(P <0.05),且观察组EEV及DHI评分均低于对照组(P<0.05)。治疗后,对照组左右侧椎动脉(VA)与基底动脉(BA)的舒张末期流速(Vd)均较治疗前上升(P <0.05),血管阻力指数(R)I均较治疗前下降(P <0.05);观察组左右侧VA与BA的峰值流速(Vp)、Vd、平均血流速度(Vm)均较治疗前上升(P<0.05),血管搏动指数(P)I和RI均较治疗前下降(P <0.05)。与对照组治疗后比较,观察组左右侧VA与BA的Vp、Vm均较高,PI和RI均较低,差异均有统计学意义(P <0.05)。结论:补中益气汤加减联合氟桂利嗪治疗VBI所致眩晕,能有效减轻眩晕症状,改善脑动脉血流不足情况,疗效确切,值得临床推广。
Objective:To observe the clinical effect of modified Buzhogn Yiqi tang combined with flunarizine for dizziness caused by vertebrobasilar insufficiency(VBI). Methods: A total of 72 cases of patients with dizziness caused by VBI were randomly divided into the control group and the observation group,35 and 37 cases in each group respectively. Both groups were given basic treatments,the control group was additionally treated with oral administration of flunarizine hydrochloride capsules based on the above treatments,and the observation group was additionally treated with modified Buzhong Yiqi tang based on the treatment of the control group. The clinical effect in the two groups was compared, and the changes in dizziness as well as artery blood flow velocity before and after treatment were observed. Results:The total effective rate was89.2% in the observation group and 68.6% in the control group,the difference being significant(P < 0.05). After treatment,the scores of European Evaluation of Vertigo(EEV) scale and Dizziness Handicap Inventory(DHI) scale in the two groups were decreased when compared with those before treatment(P < 0.05);the above scores in the observation group were lower than those in the control group(P < 0.05). After treatment,the diastolic peak velocity(Vd) in the left and right vertebral artery(VA) as well as basilar artery(BA) in the control group were increased when compared with those before treatment(P < 0.05),while the vascular resistance indexes(RI) in the control group were decreased when compared with those before treatment (P<0.05);the peak velocity(Vp),Vd and mean velocity(Vm) in the left and right VA and BA in the observation group were increased when compared with those before treatment(P < 0.05),while pulsatility index(PI) and RI in the observation group were decreased when compared with those before treatment(P < 0.05). Compared with those in the control group after treatment,Vp and Vm in the left and right VA and BA in the observation group were higher,PI and RI in the observation group were lower,differences being significant(P < 0.05). Conclusion:The therapy of modified Buzhong Yiqi tang combined with flunarizine in treating dizziness caused by VBI can effectively reduce the symptom of dizziness and improve the cerebral vascular insufficiency,which has significant curative effect and is worthy of clinical promotion.
Objective:To observe the clinical effect of modified Buzhogn Yiqi tang combined with flunarizine for dizziness caused by vertebrobasilar insufficiency(VBI). Methods: A total of 72 cases of patients with dizziness caused by VBI were randomly divided into the control group and the observation group,35 and 37 cases in each group respectively. Both groups were given basic treatments,the control group was additionally treated with oral administration of flunarizine hydrochloride capsules based on the above treatments,and the observation group was additionally treated with modified Buzhong Yiqi tang based on the treatment of the control group. The clinical effect in the two groups was compared, and the changes in dizziness as well as artery blood flow velocity before and after treatment were observed. Results:The total effective rate was89.2% in the observation group and 68.6% in the control group,the difference being significant(P < 0.05). After treatment,the scores of European Evaluation of Vertigo(EEV) scale and Dizziness Handicap Inventory(DHI) scale in the two groups were decreased when compared with those before treatment(P < 0.05);the above scores in the observation group were lower than those in the control group(P < 0.05). After treatment,the diastolic peak velocity(Vd) in the left and right vertebral artery(VA) as well as basilar artery(BA) in the control group were increased when compared with those before treatment(P < 0.05),while the vascular resistance indexes(RI) in the control group were decreased when compared with those before treatment (P<0.05);the peak velocity(Vp),Vd and mean velocity(Vm) in the left and right VA and BA in the observation group were increased when compared with those before treatment(P < 0.05),while pulsatility index(PI) and RI in the observation group were decreased when compared with those before treatment(P < 0.05). Compared with those in the control group after treatment,Vp and Vm in the left and right VA and BA in the observation group were higher,PI and RI in the observation group were lower,differences being significant(P < 0.05). Conclusion:The therapy of modified Buzhong Yiqi tang combined with flunarizine in treating dizziness caused by VBI can effectively reduce the symptom of dizziness and improve the cerebral vascular insufficiency,which has significant curative effect and is worthy of clinical promotion.
引文
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[6]苏占清.后循环缺血抑或椎-基底动脉供血不足?[J].中华神经科杂志,2017,50(9):713-717.
[7]王蕊,赵荣生,张燕娥,等.基于指南和临床路径的椎-基底动脉供血不足住院患者用药分析与评价[J].中国临床药理学杂志,2015,31(12):1205-1208.
[8]车武强.颅外椎动脉狭窄的治疗进展[J].中国循环杂志,2017,32(3):307-309.
[9]江颖,王凯华,张永全,等.通窍活血方联合氟桂利嗪对气虚血瘀型缺血性卒中患者预后的改善作用[J].中国实验方剂学杂志,2018,24(11):156-162.
[10]孙秀玲,姜明霞.黄芪药理作用机制的研究进展[J].中医临床研究,2015,7(17):140-141.
[2]ZAIDAT O O,FITZSIMMONS B F,WOODWARD B K,et al.Effect of a balloon-expandable intracranial stent vs medical therapy on risk of stroke in patients with symptomatic intracranial stenosis:the VISSIT randomized clinical trial[J].JAMA,2015,313(12):1240-1248.
[3]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007.
[4]中华医学会神经病学分会,中华神经科杂志编辑委员会.眩晕诊治专家共识[J].中华神经科杂志,2010,43(5):369-374.
[5]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:378-380.
[6]苏占清.后循环缺血抑或椎-基底动脉供血不足?[J].中华神经科杂志,2017,50(9):713-717.
[7]王蕊,赵荣生,张燕娥,等.基于指南和临床路径的椎-基底动脉供血不足住院患者用药分析与评价[J].中国临床药理学杂志,2015,31(12):1205-1208.
[8]车武强.颅外椎动脉狭窄的治疗进展[J].中国循环杂志,2017,32(3):307-309.
[9]江颖,王凯华,张永全,等.通窍活血方联合氟桂利嗪对气虚血瘀型缺血性卒中患者预后的改善作用[J].中国实验方剂学杂志,2018,24(11):156-162.
[10]孙秀玲,姜明霞.黄芪药理作用机制的研究进展[J].中医临床研究,2015,7(17):140-141.