加味补阳还五汤联合盐酸倍他司汀治疗椎-基底动脉缺血性眩晕的疗效及对血液流变学指标的影响

Effect of modified Buyang Huanwu decoction combined with betahistine hydrochloride in the treatment of vertebral-basilar artery ischemic vertigo and its influence on hemorheological index

目的 观察加味补阳还五汤联合盐酸倍他司汀治疗椎-基底动脉缺血性眩晕的疗效及对血液流变学指标的影响.方法 将80例椎-基底动脉缺血性眩晕患者按随机数字表分为观察组和对照组,每组40例,对照组单独口服盐酸倍他司汀,12 mg/次,每天3次,观察组在对照组的基础上再口服加味补阳还五汤,每天1剂,4周为1个疗程,治疗前、治疗4周后进行眩晕评估量表（DARS）及眩晕障碍调查表（DHI）评分,采用经颅多普勒超声检查椎-基底动脉血液流速,比较两组临床疗效差异.结果 与治疗前比较,观察组和对照组治疗后DARS和DHI评分均明显下降（t=14.716和5.258,20.662和14.609,均P＜0.01）,观察组治疗后DARS和DHI评分明显低于对照组（t=3.644、7.116,均P＜0.05）.观察组和对照组左侧椎动脉、右侧椎动脉、基底动脉血液平均流速均明显提高（t=11.216和7.447,10.103和7.204,11.303和6.642,均P＜0.01）;组间比较,观察组治疗后左侧椎动脉、右侧椎动脉、基底动脉血液平均流速明显高于对照组（t=4.405、4.761、5.824,均P＜0.01）.观察组的临床总有效率为95.00%（38/40）,明显高于对照组的77.50%（31/40）,差异有统计学意义（Z=-2.000,P＜0.05）.结论 加味补阳还五汤联合盐酸倍他司汀治疗椎-基底动脉缺血性眩晕的疗效确切,能够改善颅脑血液供给,从而缓解眩晕症状,值得推广应用.

Objective To observe the therapeutic effect of modified Buyang Huanwu decoction combined with betahistine hydrochloride in the treatment of vertebral-basilar artery ischemic vertigo and its influence on hemorheological index.Methods 80 patients with vertebral-basilar artery ischemic vertigo were randomly divided into observation group and control group,40 cases in each group.The control group was given betahistine hydrochloride 12 mg,three times a day.The observation group was given modified Buyang Huanwu decoction on the basis of the control group, 4 weeks for a course.The DARS and DHI were measured before and after 4 weeks of treatment.The blood flow velocity was detected by transcranial Doppler ultrasonography, the difference of clinical curative effect between the two groups was compared.Results After treatment, the DARS and DHI scores of the observation group and control group were significantly decreased（t=14.716 and 5.258,20.662 and 14.609,all P〈0.01）.The DARS and DHI scores in the observation group were significantly lower than those in the control group （t=3.644,7.116,all P〈0.05）.After treatment,the average blood flow velocity of the vertebral artery, right vertebral artery and basilar artery in the observation group and the control group were significantly increased（t=11.216 and 7.447,10.103 and 7.204,11.303 and 6.642,all P〈0.01）.The average blood flow velocity of the vertebral artery, right vertebral artery and basilar artery in the observation group were significantly higher than those of the control group （t=4.405,4.761,5.824,all P〈0.01）.The total effective rate of the observation group was 95.00% （38/40）,which was significantly higher than that of the control group （77.50%,31/40）, the difference was statistically significant （Z=-2.000,P〈0.05）.Conclusion Modified Buyang Huanwu decoction combined with betahistine hydrochloride is effective in the treatment of vertebro-basilar ischemic vertigo.It can improve the blood supply to the brain and relieve the symptoms of vertigo, which is worthy of popularization and application.