和解汤联合耳穴贴压治疗少阳郁热型颈性眩晕疗效研究

Curative effect of Hejie decoction combined with auricular acupoint pressing in the treatment of Shaoyang Yure type cervical vertigo

目的:观察和解汤联合耳穴贴压治疗少阳郁热型颈性眩晕的疗效与安全性。方法:选取我院门诊部诊治的少阳郁热型颈性眩晕患者86例为研究对象,应用随机数字表以简单随机分组法分为观察组、对照组各43例,对照组予以常规西药治疗,观察组在此基础上采用和解汤联合耳穴贴压治疗,比较两组治疗有效率、治疗前后颈性眩晕症状与功能(ESOV)评分、彩色多普勒超声(TCD)下椎基底动脉血流动力学指标、血清相关指标[白介素-1β(IL-1β)、白介素-6(IL-6)、内皮素-1(ET-1)]、不良反应发生率。结果:观察组治疗有效率为95.35%,较对照组的81.40%高(P<0.05)。观察组治疗2周、治疗4周ESOV评分分别为(22.18±2.47)分、(25.13±2.56)分,高于对照组的(20.45±2.29)分、(22.76±2.35)分(P<0.05)。观察组治疗结束后左椎动脉、右椎动脉、基底动脉血流速度为(20.15±2.17)cm/s、(19.75±1.98)cm/s、(20.49±2.17)cm/s,均高于对照组的(18.96±1.93)cm/s、(16.82±1.67)cm/s、(19.47±2.03)cm/s,组间差异具有统计学意义(P<0.05)。观察组治疗后血清IL-1β(120.47±12.79)pg/ml、IL-6(0.24±0.03)pg/ml、ET-1(59.97±6.06)ng/L均低于对照组的(134.65±13.86)pg/ml、(0.35±0.07)pg/ml、(63.47±6.49)ng/L,组间具有统计学差异(P<0.05)。两组不良反应发生率分别为9.30%、4.65%,两组比较差异无统计学意义(P>0.05)。结论:和解汤与耳穴贴压联合治疗少阳郁热型颈性眩晕疗效满意,可有效改善患者椎基底动脉血流动力学,下调IL-1β、IL-6、ET-1水平,较好改善其眩晕症状,且安全性较好。

Objective:To observe the curative effect and safety of Hejie decoction combined with auricular acupoint pressing in the treatment of Shaoyang Yure type cervical vertigo.Methods:86 patients with Shaoyang Yure type cervical vertigo diagnosed and treated in the clinic of the hospital were selected as subjects.They were randomly divided into the observation group and the control group according to the random number table,43 cases in each group.The control group was treated with conventional western medicine.On this basis,the observation group was treated with Hejie decoction combined with auricular acupoint pressing.The effective rate of treatment,evaluating scores for symptoms and function of cervical vertigo(ESOV)before and after treatment,hemodynamic parameters of vertebral basilar artery under color Doppler ultrasound(TCD),serum related indicators[interleukin-1β(IL-1β),interleukin-6(IL-6),endothelin-1(ET-1)],and incidence of adverse reactions were compared between the two groups.Results:The effective rate of observation group 95.35%was significantly higher than that of the control group 81.40%(P<0.05).ESOV scores of the observation group[(22.18±2.47)points and(25.13±2.56)points]were higher than those of the control group[(20.45±2.29)points and(22.76±2.35)points]at 2 weeks and 4 weeks after treatment(P<0.05).The blood flow velocities of left vertebral artery,right vertebral artery and basilar artery of the observation group after treatment[(20.15±2.17)cm/s,(19.75±1.98)cm/s and(20.49±2.17)cm/s]were higher than those of the control group[(18.96±1.93)cm/s,(16.82±1.67)cm/s and(19.47±2.03)cm/s](P<0.05).Levels of serum IL-1β,IL-6 and ET-1 in the observation group after treatment[(120.47±12.79)pg/ml,(0.24±0.03)pg/ml,(59.97±6.06)ng/L]were significantly lower than those in the control group[(134.65±13.86)pg/ml、(0.35±0.07)pg/ml、(63.47±6.49)ng/L](P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(9.30%vs.4.65%)(P>0.05).Conclusion:The therapeutic effect of Hejie decoction combined with auricular acupoint pressing in treating Shaoyang Yure type cervical vertigo is satisfactory.It can effectively improve the vertebral basilar artery hemodynamics,down-regulate levels of IL-1β,IL-6 and ET-1,and relieve vertigo,with safety.