补阳还五汤加减治疗气虚血瘀型眩晕疗效及对患者脑血流动力学、血浆神经肽Y、D-二聚体水平的影响

Curative effect of modified Buyang Huanwu decoction in the treatment of vertigo due to Qi deficiency and blood stasis and the influence on cerebral hemodynamics,plasma NPY and D-D levels

目的:研究补阳还五汤加减治疗气虚血瘀型眩晕的疗效及对脑血流动力学、血浆神经肽Y(NPY)、D-二聚体(D-D)水平的影响。方法:选择99例气虚血瘀型眩晕患者,随机数字表法分为对照组(49例)和研究组(50例),前者给予常规治疗,后者在其基础上给予补阳还五汤加减治疗。比较两组患者治疗前后中医症候积分、脑血流动力学、血液流变学指标以及血浆NPY、D-D水平,并评估疗效和安全性。结果:研究组与对照组治疗有效率比较,差异有统计学意义(P<0.05);治疗前两组患者各项中医症候积分比较,均无统计学差异(P>0.05),治疗后研究组与对照组比较,均有统计学差异(P<0.05);治疗前两组患者脑血流动力学指标比较,均无统计学差异(P>0.05),治疗后研究组和对照组比较,均有统计学差异(P<0.05);治疗前两组患者血液流变学指标比较,均无统计学差异(P>0.05),治疗后研究组与对照组比较,均有统计学差异(P<0.05);治疗前两组患者血浆NPY、D-D水平比较,均无统计学差异(P>0.05),治疗后研究组与对照组比较,均有统计学差异(P<0.05);两组均无明显不良反应发生。结论:补阳还五汤应用于气虚血瘀型眩晕患者安全有效,可促进其临床症状的改善,该药的作用机制可能与改善脑血流动力学,降低血液黏稠度和血浆NPY、D-D水平有关。

Objective:To study the curative effect of modified Buyang Huanwu decoction in the treatment of vertigo due to Qi deficiency and blood stasis,and the influence on cerebral hemodynamics,plasma neuropeptide Y(NPY)and D-dimer(D-D)levels.Methods:99 patients with vertigo due to Qi deficiency and blood stasis were selected.According to random number table method,they were divided into control group(49 cases)and study group(50 cases).Patients in the control group were given conventional treatment,and on this basis,patients in the study group were treated with modified Buyang Huanwu decoction.TCM syndrome scores,cerebral hemodynamic indexes,hemorheological indexes,plasma NPY and D-D levels before and after treatment were compared between the two groups.Meanwhile,the efficacy and safety were evaluated.Results:There was a statistical difference in response rate between the two groups(all P<0.05).Before treatment,there were no statistical differences in TCM syndrome scores,cerebral hemodynamic indexes,hemorheological indexes,plasma NPY and D-D levels between the two groups(all P>0.05).After treatment,all of the above indexes showed statistical differences between the two groups(all P<0.05).No obvious adverse reactions were observed in the two groups.Conclusion:Buyang Huanwu decoction is safe and effective in the treatment of patients with vertigo due to Qi deficiency and blood stasis.It can promote the improvement of clinical symptoms,which may be related to improving cerebral hemodynamics,and reducing blood viscosity as well as plasma NPY and D-D levels.