建瓴汤对改善后循环缺血性眩晕患者椎动脉血流的临床观察

Clinical research of jianling decoction on the improvement vertebral artery blood flow in the patients with posterior circulatory ischemic vertigo

目的评估建瓴汤对"肝阳上亢型"后循环缺血性眩晕患者椎动脉血流的影响。方法采用随机数字法将134例"肝阳上亢型"后循环缺血性眩晕的患者分为对照组67例与治疗组67例。对照组采用标准化基础治疗,治疗组在标准化治疗基础上加用建瓴汤治疗,2周为1个疗程,连续服用2个疗程。分别记录干预前患者的年龄、病程、既往史积分、伴发病积分;4周后的椎动脉血流值(Q值)、安全指标(血、尿常规、肝肾功能、心电图);及入组后8周时的不良事件和不良反应。比较干预前后两组椎动脉血流值,并分析入组时椎动脉血流与年龄、病程、既往史积分、伴发病积分的相关性。结果治疗组在干预后左侧椎动脉血流量(LQ)、右侧椎动脉血流量(RQ)、椎动脉总血流量值(Q值)均较入组时升高,差异有统计学意义(P<0.01);而对照组干预前后,差异无统计学意义(P>0.05)。治疗组在干预后左侧血管内径(LD)、右侧血管内径(RD)较入组时增大,差异有统计学意义(P<0.01);而对照组干预前后,差异无统计学意义(P>0.05)。干预后与对照组相比,治疗组RQ、Q值均升高,差异有统计学意义(P<0.01);干预后两组左侧速度时间积分(LVTI)、右侧速度时间积分(RVTI)、总速度时间积分(VTI)均较入组时略有升高,但差异无统计学意义(P>0.05)。干预后与对照组相比,治疗组LD、RD增大,差异有统计学意义(P<0.05,P<0.01);入组时Q值与既往史积分、伴发病积分、病程均呈负相关,与年龄呈正相关,但差异无统计学意义(P>0.05)。结论建瓴汤能够有效且安全的改善"肝阳上亢型"后循环缺血性眩晕患者椎动脉血流;椎动脉血流与发病影响因素无明显相关性。

Objective To evaluate the effects of jianling decoction on vertebral artery blood flow in the patients of posterior circulatory ischemic vertigo differentiated as hyperactivity of liver yang. Methods A total of 134 cases of posterior circulatory ischemic vertigo differentiated as hyperactivity of liver yang were divided into a control group（ 67 cases） and a treatment group（ 67 cases） according to random number table. In the control group,the normalized basic treatment was given. In the treatment group,based the treatment as the control group,jianling decoction was added. The duration of treatment was 2 weeks as one session. 2 sessions were required. Separately,the age,duration of sickness,medical history and the score of the accompanied diseases were recorded before intervention. 4 weeks later,the vertebral artery blood flow（ Q value） and the safety indexes（ blood and urine routines,liver and kidney functions,ECG） as well as adverse events and adverse reactions in 8 weeks after recruited were recorded. Q value was compared before and after intervention in the two groups. The correlation of the blood flow was analyzed with age,duration of sickness,medical history and the accompanied diseases when recruited. Results In the treatment group,after intervention,LQ,RQ and Q values were all increased as compared the values when recruited,indicating the significant differences（ P〈0. 01）. The differences were not significant before and after intervention in the control group（ P〈0. 05）. After intervention,LD and RD were all increased in the treatment group as compared with the values when recruited,indicating the significant differences（ P〈0. 01）. The differences were not significant before and after intervention in the control group（ P〈0. 05）. After intervention,compared with the control group,RQ and Q values were all increased in the treatment group,indicating the significant differences（ P〈0. 01）. After intervention,LVTI,RVTI and VTI were increased slightly as compared with those when recruited in the two groups,without significant differences（ P〈0. 05）. After intervention,compared with the control group,LD and RD were increased in the treatment group,indicating the significant differences（ P〈0. 05,P〈0. 01）.When recruited,Q value was correlated negatively with medical history,the score of accompanied diseases and the duration of sickness. It was positively with age,but without significant differences（ P〈0. 05）. Conclusion Jianling decoction effectively and safely improves the vertebral artery blood flow in the patients of posterior circulatory ischemic vertigo differentiated as hyperactivity of liver yang. The vertebral artery blood flow is not obviously related to the causative factors.