天麻眩晕宁颗粒联合阿司匹林治疗后循环缺血性眩晕的效果及神经保护机制探讨

Effect and neuroprotective mechanism of Tianma Xuanyunning granule plus aspirin on patients with posterior circulation ischemic vertigo

目的:观察天麻眩晕宁颗粒联合阿司匹林治疗后循环缺血性眩晕患者的效果,并对其神经保护机制进行初探。方法:将110例后循环缺血性眩晕患者按照随机数字表法分为对照组(55例)和观察组(55例)。对照组给予阿司匹林肠溶片口服,观察组在对照组基础上给予天麻眩晕宁颗粒,对比两组的临床效果、眩晕评定量表的评分系统(Dizziness Assessment Rating Scale,DARS)评分、不良反应、随访6个月眩晕复发情况,监测椎-基底动脉平均血流速度、神经生物学标志物水平。结果:观察组的总有效率显著高于对照组(P<0.05);治疗7 d、治疗14 d与对照组相比,观察组患者眩晕程度DARS评分均显著降低(P<0.05);治疗后,观察组的左侧椎动脉(Left Vertebral Artery,LVA)、基底动脉(Basilar Artery,BA)、右侧椎动脉(Right Vertebral Artery,RVA)明显高于对照组(P<0.05),血清中S100钙结合蛋白-β(Specific Protein 100-β,S100-β)、同型半胱氨酸(Homocysteine,Hcy)水平明显低于对照组(P<0.05)。两组患者未见不良反应,复发率差异无统计学意义(P>0.05)。结论:天麻眩晕宁颗粒联合阿司匹林对后循环缺血性眩晕具有良好的控制效果,其机制可能与通过改善后循环血供以保护脑神经元有关。

Objective:To observe the effect of Tianma Xuanyunning granule(天麻眩晕宁颗粒)plus aspirin in the treatment of patients with posterior circulation ischemic vertigo,and to explore its neuroprotective mechanism.Methods:110 patients with posterior circulation ischemic vertigo were divided into control group(55 cases)and observation group(55 cases)according to random number table.The control group was given aspirin enteric-coated tablet orally,and the observation group was given Tianma Xuanyunning granule on the basis of the control group.The clinical effect,DARS score,adverse reactions,and recurrence of vertigo in the 6-month follow-up were compared between the two groups.The vertebrobasilar mean blood flow velocity and neurobiological markers were monitored.Results:The effective rate in the observation was significantly higher than the control group(P<0.05).Compared with the control group,the DARS score of vertigo degree in the observation group was significantly decreased at 7 d and 14 d(P<0.05).After treatment,the contents of LVA,BA,RVA in the observation group were significantly higher than those in the control group(P<0.05),and the levels of S100-βand Hcy in serum were significantly lower than those in the control group(P<0.05).No adverse reactions were found between 2 groups,but there was no significant difference in recurrence rate(P>0.05).Conclusion:Tianma Daxinning granule combined with aspirin has a good control effect on posterior circulation ischemic vertigo,the mechanism may be related to the protection of brain neurons by improving posterior circulation blood supply.