辨证治疗后循环缺血性眩晕疗效观察

Efficacy Observation on Syndrome Differentiation and Treatment of Vertigo Caused by Posterior Circulatory Ischemia

目的：观察辨证论治后循环缺血性眩晕的临床疗效。方法：选取本院收治的后循环缺血性眩晕患者100例,按随机数字表法分为两组,每组50例,中药组给予辨证论治,西药组给予常规西医治疗,均连续治疗3周。观察两组患者治疗前后椎动脉和基底动脉的平均流速、血液流变学指标、临床疗效及不良反应。结果：中药组的疗效优于西药组（Z=-2.028,P=0.034）;治疗后中药组椎-基底动脉流速、胆固醇、三酰甘油、血液流变学（全血黏度高切、全血黏度低切、血浆黏度、凝血因子Ⅰ）、疗效评分（眩晕评估评分量表评分、眩晕障碍调查表评分）等指标改善均优于西药组（P〈0.01）;中药组的不良反应发生率低于西药组（χ2=4.000,P=0.046）。结论：辨证论治后循环缺血性眩晕,能改善脑部后循环血流速度和血液流变学指标,疗效优于西药治疗,且不良反应较少。

Objective：To observe the clinical effect of vertigo caused by posterior circulatory ischemia treated with syndrome differentiation. Methods：Total 100 patients with vertigo caused by posterior circulatory ischemia were divided into two groups by random number table. TCM group（50 cases） was treated with syndrome differentiation while the western medicine group（50 cases） was treated by routine western medicine.All patients were treated for 3 weeks to observe the average velocity of vertebral and basilar arteries,hemorheology,clinical efficacy and adverse reactions before and after treatment. Results：The curative effect of TCM group was better than that of western medicine group（Z=-2.028,P= 0.034）. The velocity of vertebrobasilar artery blood flow, cholesterol, triglycerides, blood rheology（blood viscosity at high shear, whole blood viscosity at low shear,plasma viscosity,fibrinogen）,efficacy score（dizziness assessment rating scale,dizziness handicap inventory） in TCM group were better than those in western medicine group after treatment（P〈 0.01）. The incidence of adverse reactions in TCM group was lower than that in western medicine group（χ~2= 4.000,P= 0.046）. Conclusion：TCM syndrome differentiation and treatment of ischemic vertigo could improve the blood flow velocity of cerebral circulation and blood rheology index with better curative effect and less adverse reactions than the western medicine group.