清开灵注射液联合血栓通对椎基底动脉供血不足性眩晕经颅多普勒及血液流变学指标的影响

Effect of Qingkailing injection combined with Xueshuantong on TCD and hemorheology in vertebrobasilar insufficiency vertigo

目的观察清开灵注射液联合血栓通对椎基底动脉供血不足(VB I)性眩晕经颅多普勒(TCD)及血液流变学指标的影响。方法将VB I性眩晕96例随机分为3组,治疗组32例予清开灵注射液20mL,注射用血栓通冻干粉针0.45 g,均每日1次静脉滴注;对照1组32例单纯予注射用血栓通冻干粉针0.45g,每日1次静脉滴注。对照2组32例予盐酸倍他司汀注射液20 mg,每日1次静脉滴注。3组均以7 d为1个疗程,观察用药前后TCD及血液流变学指标变化。结果①治疗后治疗组和对照1组全血黏度、血浆黏度、全血还原黏度(低切)及全血还原黏度(高切)与本组治疗前比较均降低(P<0.05),治疗2组全血黏度、全血还原黏度(低切)及全血还原黏度(高切)与本组治疗前比较均降低(P<0.05);治疗后治疗组与对照1组全血黏度、全血还原黏度(低切)及全血还原黏度(高切)组间比较差异有统计学意义(P<0.05),与对照2组全血黏度及全血还原黏度(低切)组间比较差异有统计学意义(P<0.05)。治疗后对照1组与对照2组全血黏度(切变率1.00)(1/s)及全血还原黏度(低切)组间比较差异有统计学意义(P<0.05)。②治疗后治疗组左椎动脉(LVA)、右椎动脉(RVA)及基底动脉(BA)的收缩期血流速(Vs)、舒张期血流速(Vp)与本组治疗前比较均增加(P<0.05);治疗后治疗组与对照1组LVA、RVA及BA的Vs、Vp组间比较差异有统计学意义(P<0.05),与对照2组LVA、RVA的Vs和BA的Vp比较差异有统计学意义(P<0.05)。治疗后对照1组与对照2组BA的Vs及LVA、RVA及BA的Vp比较差异有统计学意义(P<0.05)。结论清开灵注射液联合血栓通治疗VB I性眩晕能改善脑部血流速度和血液流变学指标,疗效优于单纯血栓通及盐酸倍他司汀注射液。

Objective To observe the effect of Qingkailing injection combined with Xueshuantong on TCD and hemorheology in vertebrobasilar insufficiency vertigo.Methods 96 patients with vertebrobasilar insufficiency vertigo were randomly divided into three groups.32 patients in treatment group were treated by Qingkailing injection,20mL combined with Xueshuantong,freeze-dry powder,0.45 g,intravenous drip.32 patients in control group 1 were treated by simple Xueshuantong,freeze-dry powder,0.45 g,intravenous drip once a day.32 patients in control group 2 were treated by Betahistine hydrochloride injection,20 mg,intravenous drip once a day.The course was seven days in three groups.The changes of TCD and hemorheology were observed before and after treatment.Results The blood viscosity,plasma viscosity,whole blood reduced viscosity（low shear） and whole blood reduced viscosity（high shear） after treatment were reduced compared with those before treatment in treatment group and control group 1（P0.05）.There were significant differences between treatment group and control group1 on blood viscosity,whole blood reduced viscosity（low shear） and whole blood reduced viscosity（high shear） after treatment（P0.05）.There were significant differences between treatment group and control group 2 on blood viscosity and whole blood reduced viscosity（low shear） after treatment（P0.05）.There was obvious difference between control group 1 and control group 2 on blood viscosity and whole blood reduced viscosity（low shear）after treatment（P0.05）.LVA,RVA,Vs and Vp of BA after treatment were increased in comparison with those before treatment group in treatment group（P0.05）.There were significant differences between treatment group and control group 1 on LVA,RVA,Vs and Vp of BA after treatment（P0.05）.There were significant differences between treatment group and control group 2 on LVA,Vs of RVA and Vp of BA after treatment（P0.05）.There were significant differences between control group 1 and 2 on Vs of BA,LVA RVA and Vp of BA after treatment（P0.05）.Conclusion Combination of Qingkailing injection and Xueshuantong can improve brain blood flow and hemorheology on the treatment of vertebrobasilar insufficiency vertigo,therapeutic effect was more than simple Xueshuantong and Betahistine hydrochloride injection.