半夏白术天麻汤加减治疗眩晕(痰浊中阻型)的临床疗效及对血液流变学和血流动力学的影响

Clinical Efficacy of Using Banxia Baizhu Tianma Decoction in the Treatment of Phlegm-turbidity Moderate Resistance Type Vertigo and Its Influence on Hemorheology and Hemodynamics

目的:探讨半夏白术天麻汤加减治疗眩晕(痰浊中阻型)患者的临床疗效及对血液流变学和血流动力学的影响。方法:选取2018年1月~2020年11月明光市中医院收治的100例眩晕患者,根据治疗方式不同分为两组,对照组(n=50)接受甲磺酸倍他司汀片治疗,观察组(n=50)接受半夏白术天麻汤加减治疗,均连续治疗3周。比较两组患者临床疗效和治疗后中医证候积分、眩晕严重程度、血液流变学指标、血流动力学指标、血脂指标、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)和不良反应发生情况。结果:观察组临床治疗总有效率明显高于对照组(P<0.05)。治疗后观察组中医证候积分、眩晕障碍量表(DHI)、高低切全血粘度、血浆粘度、纤维蛋白原水平和血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、ET-1水平明显低于对照组,左右侧椎动脉和基底动脉收缩期最大流速(PSV)及血清高密度脂蛋白胆固醇(HDL-C)、CGRP水平明显高于对照组(P<0.05)。观察组不良反应发生率明显低于对照组(P<0.05)。结论:半夏白术天麻汤加减治疗眩晕(痰浊中阻型)疗效显著,可有效改善血液流变学和血流动力学,调节血脂和ET-1、CGRP水平,且安全性高,值得推广。

Objective:To investigate the clinical efficacy of using Banxia Baizhu Tianma Decoction in the treatment of patients with vertigo(phlegm-turbidity moderate resistance type)and its influence on hemorheology and hemodynamics.Methods:A total of 100 vertigo patients admitted to our hospital(January 2018 to November 2020)were selected and divided into two groups according to the random number table method.The controlled group(n=50)received Betahistine Mesylate Tablets.The observation group(n=50)received the treatment with Banxiabaizhu Tianma Decoction for 4 consecutive weeks.Clinical efficacy,TCM symptom score,vertigo severity,hemorheological indexes,hemodynamic indexes,blood lipid indexes,endothelin-1(ET-1),calcitonin gene-related peptide(CGRP)and the incidence of adverse reactions were compared between 2 groups after treatment.Results:The total effective rate of clinical treatment in the observation group was significantly higher than that of the controlled group(P<0.05).After treatment,the observation group’s TCM symptom score,vertigo disorder scale(DHI),high and low cut whole blood viscosity,plasma viscosity,fibrinogen level and serum total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C)and ET-1 levels were significantly lower than the controlled group,the maximum systolic flow velocity(PSV),serum high-density lipoprotein cholesterol(HDL-C)and CGRP levels of the left and right vertebral artery and basilar artery were significantly higher than those of the controlled group(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the controlled group(P<0.05).Conclusion:Banxia Baizhu Tianma Decoction has a significant effect in the treatment of vertigo(turbid phlegm and moderate resistance type).It can effectively improve hemorheology and hemodynamics,regulate blood lipids,ET-1 and CGRP levels,and has high safety.It is worthy of promotion.