恒清汤对椎-基底动脉供血不足性眩晕作用的临床观察及其机制研究

Clinical Efficacy of Hengqing Decoction for Vertebrobasilar Insufficiency-Associated Vertigo Patients and Its Mechanism

目的:研究恒清汤对椎-基底动脉供血不足性(VBI)眩晕的临床疗效及其作用。方法:收集VBI眩晕的门诊及住院患者,将其随机分为治疗组(69)及对照组(67)。在基础治疗的基础下,治疗组采用恒清汤治疗,对照组采用盐酸氟桂利嗪胶囊(西比灵)治疗,疗程4周,共2个疗程。治疗前后,进行眩晕症状评分、欧洲眩晕量表及国际DHI眩晕障碍量表评分,经颅多普勒检测(TCD)及生化检查,计算动脉硬化指数(ASI)。结果:治疗组总有效率85.51%,对照组总有效率73.13%,两组比较有统计学差异(P<0.05);两组治疗后,与对照组比较,治疗组的眩晕症状积分明显降低(P<0.01),治疗前后差值明显降低(P<0.01),EEV分值及DHI分值均明显降低(P均<0.05),两侧VA和BA的Vp、Vm均升高(P<0.05或P<0.01),两侧VA和BA的PI和RI均下降(P<0.05或P<0.01),治疗组的TC下降(P<0.05),HDL-C升高(P<0.05),ASI明显下降(P<0.01),全血高切、全血低切、血浆黏度、RBC聚集指标、纤维蛋白原均下降(P<0.05,或P<0.01)。结论:恒清汤对VBI眩晕患者有显著的疗效,其机制可能是通过提高VA和BA血流速度,降低总胆固醇、升高高密度脂蛋白,降低ASI,改善血流变指标来实现的。

Objective：To study the clinical efficacy and mechanism of Hengqing Decoction for vertebrobasilar insufficiency （VBI） - associated vertigo. Methods ： Cases of VB1 - associated vertigo were randomized into treatment group and control group, with 69 cases in treatment group and 67 cases in control group. Both groups were giver＇s routine treatment. The treatment group added Hengqing Decoction. One treatment course lasted for 28 days. The therapeutic effect was observed after two treatment courses. Count vertigo symptom score, European dizziness scale score and international DHI vertigo disorder scale score. The peak- systolic velocity （Yp） , end- diastolic velocity （Vd） and mean velocity （Vm） of vertebral artery （VA） and basilar artery （BA） were detected with transcranial doppler （TCD） before and after treat- ment. Change of blood lipid and hemorhcology was also detected. Results ： The total effective rate of the treatment group and control group was 85.51% and 73.13% respectively, with a significant difference between the two groups （P 〈 0.05 ）. After treatment, compared with the control group, vertigo symptom score of the treatment group decreased （ P 〈 0. 01 ）. The difference value before and after treatment of the treatment group decreased （ P 〈 0. 01 ）. EEV score and DHI score of the treatment group decreased（P 〈0. 05）, Vp and Vm in VA and BA of the treatment group increased （P 〈 0. 05 or P 〈 0. 01 ）, quantity of TC of the treatment group increased （ P 〈 0.05 ）, ASI decreased of the treatment group （ P 〈 0. 05 ） . Conclusion ： Hengqing Decoction is effective for VB1 - associated vertigo. The underlying mechanism may be associated with improving VBI - associated vertigo symptoms in patients, improving VBI transcranial Doppler blood flow velocity, pulsatility index and resistance index, increasing VBI with high - density lipoprotein levels, Lowering total cholesterol, improving their atherogenic index and hemorhcology index.