川芎清脑颗粒治疗椎基底动脉供血不足致脑性眩晕的临床观察

Clinical observation on Chuanxiong qingnao particles in the treatment of vertebra-basilar ischemic vertigo

目的观察川芎清脑颗粒治疗椎基底动脉供血不足致脑性眩晕的临床效果。方法选取湖南中医药大学第一附属医院2013年2—6月135例椎基底动脉供血不足脑性眩晕患者，随机数字表法将患者分为观察组（85例）和对照组（50例）。观察组使用川芎清脑颗粒治疗，对照组使用晕痛定胶囊治疗，疗程均为4周。观察2组治疗前后症状、体征、经颅多普勒超声、血液流变学指标。结果观察组的总有效率为97．6％（83／85），明显高于对照组[80．0％（40／50）]，差异有统计学意义（P〈0．05）。治疗后观察组眩晕、头痛、耳鸣、恶心、头重等症状的总有效率与对照组比较[100．0％（38／38）比81．8％（18／22），100．0％（30／30）比83．3％（15／18），100．0％（6／6）比75．0％（3／4），85．7％（6／7）比75．0％（3／4），75．0％（3／4）比50．0％（1／2）]，差异均有统计学意义（P〈0．05或P〈0．01）。观察组治疗后多普勒超声大脑中动脉、大脑前动脉血流速度与治疗前比较[（13±3）mm／s比（23±4）mm／s，（8．2±2．2）mm／s比（3．8±3．2）mm／s]，差异均有统计学意义（均P〈0．01）。治疗后观察组大脑中动脉、大脑前动脉血流速度明显低于对照组[分别为（25±4）、（13．2±3．5）mm／s]（P〈0．05）。观察组治疗后低切、高切、中切全血比黏度与治疗前比较I（4．6±0．3）mPa／s比（3．0±0．2）mPa／s，（12．0±1．1）mPa／s比（13．6±1．1）mPa/s，（14．2±1．6）mPa／s比（17．1±1．9）mPa／s]，差异均有统计学意义（均P〈0．05）；治疗后观察组低切、高切、中切全血比黏度指标低于对照组[分别为（4．8±0．3）、（12．6±1．1）、（15．0±1．7）mPa／s]，差异均有统计学意义（均P〈0．05）。结论川芎清脑颗粒对椎基底动脉供血不足的脑性眩晕有显著疗效，症状改善明显。

Objective To explore clinical efficacy of Chuanxiong qingnao particles in the treatment of cerebral vertigo Caused by vertebrobasilar insufficiency. Methods All 135 patients of vertebra-basilar ischemie vertigo in the first affiliated hospital of Hu＇nan Chinese medicine university from February 2013 to June 2013 were selected and divided into observation group （85 ceases） and control group （50 ceases）, observation group was given Chuanxiong qingnao particles, and control group was given halo carbamazepine capsules, course of treatment of two groups were 4 weeks. Symptoms, Doppler ultrasound results and blood rheology before and after treatment of two groups were observed. Results The total effective rate in the observation group was 97.6% （83/85）, significantly higher than that in the control group [80.0% （40/50） ] ; the difference was statistically significant （P 〈 0.05） ; the total effective rate of vertigo, tinnitus, nausea, heavy head in observation group after treatment were significantly better than those in the control group [ 100.0% （38/38） vs 81.8% （ 18/22）, 100.0% （30/30） vs 83.3%（15/18） ,100.0% （6/6） vs 75.0% （3/4）,85.7% （6/7） vs 75.0% （3/4）,75.0% （3/4） vs 50.0% （1/2） ] （P 〈 0.05 or P 〈 0.01 ）. There were significant differences on blood flow velocity of middle cerebral artery and anterior cerebral artery in observation group after treatment[ （13 ±3） mm/s vs （23 ±4） mm/s, （8.2 ± 2.2） mrn/s vs （3.8 ± 3.2） mm/s ] （P 〈 0.05 ）. Blood flow velocity of middle cerebral artery and anterior cerebral artery in observation group after treatment were lower than those of control group [ （ 25 ± 4 ） , （ 13.2 ± 3.5 ） mm/s ] （ P 〈 0.05 ）. There were significant differences on whole blood viscosity of low, high and midst shear in observation group after treatment[ （4.6 ±0.3） mPa/s vs （3.0 ±0.2） mPa/s, （ 12.0 ± 1.1 ） mPa/s vs （ 13.6 ± 1.1 ） mPa/s, （ 14.2 ± 1.6） mPa/s vs （ 17.1 ± 1.9） mPa/s ] （P 〈 0.05 ）. Whole blood viscosity of low, high and midst shear in observation group after treatment were lower than those in control group [ （4.8 ± 0.3）, （12.6 ± 1.1）, （15.0 ± 1.7） mPa/s] ; there were significant differences （P 〈0.05）. Conclusion Chuanxiong qingnao particles in the treatment of cerebral vertigo caused by vertebrobasilar insufficiency is effective and safe.