天麻素注射液治疗脑外伤性眩晕临床研究

Clinical study of Gastrodine Injection in Treatment of Dizziness due to Traumatic Brain Injury

目的：观察天麻素注射液治疗脑外伤性眩晕的临床疗效及对血液流变学的影响。方法：将90例脑外伤性眩晕患者按随机数字表分为对照组和治疗组,每组45例。对照组采用盐酸倍他司汀注射液,每天30 mg,静脉注射;治疗组在对照组治疗基础上给予天麻素注射液治疗,每次200 mg,每天2次,肌肉注射;4 d为1个疗程,休息2 d后行下1个疗程治疗,共治疗2个疗程。治疗后比较两组患者的临床疗效,眩晕程度采用欧洲眩晕评价量表评价,在治疗前、治疗后14 d和治疗后30 d分别测评;检测治疗前后血液流变学检测指标;采用经颅多普勒检测左椎动脉、右椎动脉和基底动脉的收缩期和舒服期的平均血流速度。结果：治疗组有效率为93.33%,对照组有效率为77.78%,治疗组优于对照组,差异有统计学意义（χ~2=4.406,P〈0.05）;治疗组治疗后14 d、治疗后30 d欧洲眩晕评价量表评分均显著低于同期对照组,差异有统计学意义（P〈0.01）;治疗后两组患者全血黏度（全血高切、全血低切）、血浆黏度、纤维蛋白原、血小板聚集率等血液流变学指标均较治疗前下降,差异有统计学意义（P〈0.01）;治疗后治疗组血液流变学各指标的改善均优于对照组,差异有统计学意义（P〈0.01）;治疗后观察组左椎动脉、右椎动脉和基底动脉均显著下降,并低于治疗后对照组,差异有统计学意义（P〈0.01）。结论：天麻注射液联合倍他司汀治疗颅脑外伤后眩晕,能改善临床症状,改善血液微循环,降低颅底动脉血流速度,临床疗效较好,且不良反应较少。

Objective： To observe the clinical efficacy of Gastrodine Injection in treatment of dizziness traumatic brain injury and the Hemorheology effect. Methods： 90 patients patients were randomly divided into control group and treatment group,with 45 cases in each group. The control group was intravenous injected with Betahistine Hydrochloride with 30 mg daily,while the treatment group received intravenous injection of Gastrodine with 200 mg each time,twice a day based on that of the control group. The treatment lasted for 4 days. After 2 day＇s rest,another 4 days of treatment followed. After treatment,the clinical efficacies of the two groups were compared. The dizziness degree was examined with European vertigo dizziness rating scale. The evaluations before treatment,14 d and 30 d after treatment were made respectively. The hemorheology indexes were detected before and after the treatment. Results： The effective rate of the treatment group was 93. 33% and that of the control group was 77. 78%,with the difference being statistically significant（ χ~2= 4. 406,P 〈0. 05）. 14 d and 30 d after treatment,the European vertigo Evaluation scale scores were significantly lower of the treatment group than those in the control group（ P 〈0. 01）. The hemorheology indexes of the treatment group were better than those of the control group,with the difference being statistically significant（ P 〈0. 01）. Conclusion： Gastrodine injection combined with Betahistine Hydrochloride in treatment of dizziness due to traumatic brain injury can achieve better clinical efficacy by improving the clinical symptoms,improving blood circulation and reducing arterial blood flow velocity of the skull base,with fewer adverse reactions.