益气活血、化痰通络法治疗椎-基底动脉供血不足性眩晕的临床研究

Clinical Study of treating vertebrobasilar insufficiency dizziness with the methods of Yiqi Huoxue and eliminating phlegm and freeing channels

目的:观察中药益气活血、化痰通络法治疗椎-基底动脉供血不足(VBI)性眩晕的临床疗效,从血液流变学、头颅多普勒超声的相关指标改变,进一步研究其作用机理。方法:将符合纳入标准的100例患者随机分为两组。治疗组50例,口服益气活血、化痰通络中药;对照组50例,口服西药:甲磺酸倍他司汀片12mg,一天3次。两周为一疗程。分别比较两组治疗前后临床疗效、中医症候,并检测血液流变学指标及头颅多普勒超声的变化。结果:(1)临床疗效:治疗组总有效率为90.00%,明显优于对照组的76.00%(P<0.05)。(2)中医症候:治疗组总有效率94%,对照组总有效率80%,治疗组对中医证候的改善明显优于对照组。(3)血液流变学:对血液流变学各指标的降低治疗组明显优于对照组(P<0.05)。(4)经颅多普勒超声:治疗组对平均血流速度的提高明显优于对照组(P<0.05)。结论:益气活血、化痰通络方药治疗VBI性眩晕,服用方便、安全,疗效确切,值得临床推广。

Objective： To observe the clinical efficacy with the traditional Chinese medicine yiqi huoxue and eliminating phlegm and freeing channels methods in the treatment of vertebrobasilar insufficiency （VBI） dizziness and to further study the mechanism of action based on the change of hemorheology and transcranial doppler ultrasound. Methods： One hundred patients met the inclusion criteria were randomlydivided into treatment group and control group. Fifty patients in treatment group accepted oralyiqi huoxue and eliminating phlegm and freeing channels traditional Chinese medicine, the others in the control group accepted betahistine mesilate tablets 12mg orally 3 times/day. The period of treatment was 14 days. Clinical efficacy and traditional Chinese medicine symptoms were compared, and the change of hemorheology and transcranial doppler ultrasound were detected between the two groups before and after treatment.Results： （1） Clinical efficacy： the total effective rate in treatment group （90.00%） was significantly better than those in control group （76.00%）（P〈0.05）. （2） Traditional Chinese medicine symptoms： the total efficiency was 94% and 80% in treatment group and control group, respectively. The improvement oftraditional Chinese medicine symptoms in treatment groupwas significantly better than those in control group. （3） Hemorheology： the hemodynamic indexes decreased in treatment group was significant better thancontrol group （P〈0.05）. （4） Transcranial Doppler ultrasonography： theaverage blood flow velocity improved in treatment group compared with control group （P〈0.05）. Conclusion：Yiqi huoxue and eliminating phlegm and freeing channels recipe was a convenient, safe and effective therapy in the treatment of vertebrobasilar insufficiency （VBI） dizziness, which was worth popularizing in clinic.