颈复康颗粒联合长春西汀治疗发作期椎动脉型颈椎病32例疗效观察

Effect of Jingfukang Granules Associated with Vinpocetine on the Verte bral Artery Type of Cervical Spondylosis in the Attack Stage:an Observation on 32 Cases

目的观察颈复康颗粒联合注射用长春西汀治疗发作期椎动脉型颈椎病(CSA)的临床疗效并探讨其作用机理。方法 62例患者随机分为治疗组(32例)和对照组(30例)。对照组予注射用长春西汀30mg静脉滴注,治疗组在此基础上口服颈复康颗粒,每次10g,每日3次,两组均治疗2周后观察患者临床疗效和药物起效时间;比较治疗前后椎动脉深度(VA)、基底动脉(BA)、血管搏动指数(PI)和血浆内皮素(ET)和一氧化氮(NO)的变化。结果治疗组总有效率为90.6%,对照组为70.0%,治疗组临床疗效优于对照组(P<0.05);治疗组有效病例起效时间较对照组快,大多于3天内控制症状(P<0.05);两组治疗后VA流速较治疗前显著升高(P<0.01),PI较治疗前显著降低(P<0.01),治疗后治疗组各项血流动力学指标改善明显优于对照组(P<0.05或P<0.01);两组治疗后血清NO水平较治疗前显著升高(P<0.01),ET水平较治疗前显著降低(P<0.01),与对照组治疗后比较,治疗组血清NO、ET水平改善均优于对照组(P<0.05)。结论颈复康颗粒联合注射用长春西汀治疗发作期CSA临床疗效确切,其治疗机理与改善发作期CSA患者椎-基底动脉系统血流动力学状态和降低血浆ET水平及提高NO水平有关。

Objective To observe the clinical effect and to discu ss the mechanism of Jingfukang Granule（Granule for cervical spondylosis） associated with vinpoc etine for intravenous infusion on the vertebral artery type of cervical spondylo sis（CSA） in the attack stage.Methods Sixty-two cases were randomized into a control group（30 cases） and a treatment group（32 cases）.The control group wa s treated with vinpocetine 30mg for intravenous infusion,the tr eatment group was given Jingfukang Granule additionally for oral taking,10g eac h time,3 times a day.The course of treatment was of 2 weeks.Then,the clinica l effect and the time of effect initiation of the two groups were observed,the dep th of vertebral artery（VA） and the changes of basilar artery（BA）,vascular pul sation index（PI）,plasma endothelin（ET）,and nitric oxide（NO） afte r treatment were observed.Results The total effective rate of the treatment group and the control group was 90.6% and 70.0%,respectively.The effect of the treatment group was superior to that of the control group（P〈0.05）.The time of effect initiation of the treatment group was earlier than that of the control group,it was mostly within 3 days that the symptoms were stopped in development（P〈0.05）.The blood flow in VA of both groups was significantly increased after treatment（P〈0.01）,PI was significantly decreased（P〈0.01）,while the improvement of all indices of the treatment group was significantly superior to that of the control grou p（P〈0.01 or P〈0.05）.The level of NO of both groups was significantly increased（P〈0.01） and the level of ET was significantly decreased（P〈0.01）.Co mpared wit h the control group after treatment,the levels of NO and ET of the treatment gr oup were both significantly different（P〈0.05）.Conclusion Jingfukang Granule associated with vinpocetine is effective for CSA.Its functional mechanism is co rrelated with the improvement of haemodynamics of vertebral-basilar artery,the decrease of plasma ET,and increase of NO of the CSA patients in the attack stag e.