桂哌齐特对椎-基底动脉供血不足所致眩晕的疗效观察

Effects of cinepazide on vertigo induced by vertebral-basilar insufficiency

目的观察桂哌齐特治疗椎-基底动脉供血不足(vertebral-basilar insufficiency,VBI)所导致眩晕的疗效,探讨其作用机制。方法将72例VBI所致眩晕的病人随机分为治疗组36例、对照组36例,治疗组采用桂哌齐特注射液320 mg加入5%葡萄糖注射液250 mL或氯化钠注射液250 mL中,iv,gtt,qd×14 d;对照组予复方丹参注射液20 mL加入5%葡萄糖注射液250 mL或氯化钠注射液250 mL中,iv.gtt,qd×14 d,并口服倍他司汀片,每次1片,tid。观察并比较2组治疗前后临床疗效、经颅多普勒超声、脑干诱发电位的变化。结果2组疗效经Ridit分析,有显著差异(P<0.05),其中治疗组的痊愈率达到53%,明显高于对照组的31%;颈性眩晕评分治疗组从3.6±s 1.1提高到12.7±2.3,对照组从4.2±1.5提高到11±3,2组治疗前后均具有非常显著差异(P<0.01),治疗组和对照组比较有显著差异(P<0.05);经颅多普勒超声观察到2组治疗后收缩期峰值流速(PSV)、舒张末期流速(EDV)、时间平均流速(TAV)、血管搏动指数(PI)、阻力指数(RI)均显著改善(P<0.05或P<0.01),2组治疗后差值未见显著差异(P>0.05)。脑干诱发电位观察到治疗组治疗后Ⅰ、Ⅲ、Ⅴ波PL,Ⅰ～Ⅲ、Ⅰ～Ⅴ波IPL均明显改善(P<0.05),Ⅲ～Ⅴ波IPL改变未见显著差异(P>0.05);而对照组治疗后Ⅰ、Ⅲ波PL、Ⅰ～Ⅴ波IPL均明显改善(P<0.05),Ⅴ波PL、Ⅰ～Ⅲ、Ⅲ～Ⅴ波IPL未见显著改善(P>0.05)。2组比较显示治疗组Ⅴ波PL和Ⅰ～Ⅲ波IPL改善程度显著优于对照组,有显著差异(P<0.05)。结论桂哌齐特在改善循环的同时早期保护神经功能,是治疗VBI所致眩晕的有效药物。

AIM To investigate the effects and mechanism of cinepazide on vertigo induced by vertebralbasilar insufficiency （VBI）. METHODS Seventy-two patients with vertigo induced by VBI were randomized into two groups： 36 patients in treatment group were administered with cinepazide （320 mg, iv, gtt, qd） and 36 patients in control group were given salvia mihiorrhiza （20 mL, iv, gtt, qd） combined with betahistine mesylate （6 mg, po tid） for 14 days. The clinical effects were observed by Transcranial Doppler （TCD） and brainstem auditory evoked potential （BAEP） before and after treatments. RESULTS There was significant difference of clinical efficacy between two groups （P 〈 0.05）. Recovery rate in treatment group （53 % ） was superior to that in control group （31%）. The Evaluation Scale for Cervical Vertigo improved from 3.6 ± s 1.1 to 12.7 ± 2.3 in treatment group, and from 4.2 ± 1.5 to 11 ± 3 in control group, the improvement were significant difference in both groups after the treatments （P 〈 0.01 ）. Values of PSV, EDV, TAV, PI and RI by TCD improved significantly in both groups after treatments （P 〈 0.05 or P 〈 0.01 ）, and there were no remarkable difference between the two groups （P 〈 0.05）. Peak latency （PL） of Ⅰ、Ⅲ、Ⅴ wave and inter peak latency （IPL） of Ⅰ～Ⅴ,Ⅲ～Ⅴ wave improved significantly in treatment group （P 〈 0.05）, and PL of I , m wave and IPL of I -V wave improved significantly in control group （P 〈 0.05）. The improvement degree of BAEP （PL of V wave and IPL of Ⅰ～Ⅲ wave） in treatment group was better than that in control group （P 〈 0.05）. CONCLUSION Cinepazide has a good effect on the vertigo induced by VBI, and it can improve cerebral circulation and protect nervous system early.