行气活血化痰方治疗痰瘀阻络型后循环缺血性眩晕的临床研究

Clinical Study on Posterior Circulation Ischemic Vertigo with Phlegm and Blood Stasis Obstructing Collaterals Treated by Xingqi Huoxue Huatan Recipe

【目的】观察行气活血化痰方治疗痰瘀阻络型后循环缺血性眩晕的临床疗效。【方法】将90例痰瘀阻络型后循环缺血性眩晕患者随机分为对照组和观察组,每组各45例。对照组采用西医常规治疗(包括控制血压、降血脂、降血糖、抗血小板聚集等),观察组在对照组西医常规治疗基础上加用行气活血化痰方治疗,疗程14 d。观察2组患者治疗前后TCD监测椎动脉和基底动脉平均血流速度(Vm)变化情况,评价2组疗效及安全性。【结果】(1)治疗14 d后,观察组总有效率为95.56%,对照组为77.78%,观察组的临床疗效明显优于对照组,差异有统计学意义(P <0.05)。(2)治疗后,观察组患者椎动脉和基底动脉Vm较治疗前均有显著提高(P <0.05),对照组患者仅椎动脉Vm较治疗前有显著提高(P <0.05);组间比较,观察组的椎动脉和基底动脉Vm均明显高于对照组(P <0.05)。(3)治疗过程中,2组患者均未出现明显不良反应,治疗前后复查血、尿常规及肝、肾功能均未见明显异常。【结论】行气活血化痰方对痰瘀阻络型后循环缺血性眩晕具有较好疗效,能有效缓解患者头晕症状,改善椎动脉和基底动脉的平均血流速度。

Objective To observe the clinical efficacy of Xingqi Huoxue Huatan Recipe(a herbal compound with the actions of activating Qi and blood and resolving phlegm)for the treatment of posterior circulation ischemic vertigo with the syndrome of phlegm and blood stasis obstructing collaterals.Methods Ninety cases of posterior circulation ischemic vertigo patients with phlegm and blood stasis obstructing collaterals were randomly divided into observation group(n=45)and control group(n=45).The control group was treated with routine western medicine for controlling blood pressure,lowering blood lipid and blood glucose,and counteracting platelet aggregation.On the basis of the treatment for the control group,the observation group was additionally treated with Xingqi Huoxue Huatan Recipe orally.The treatment lasted for 14 days.Before and after treatment,the mean blood flow velocity(Vm)of vertebral artery and basilar artery were monitored with transcranial Doppler ultrasound(TCD).After treatment,the clinical efficacy and safety were compared between the two groups.Results(1)After treatment for 14 days,the total effective rate was 95.56%in the observation group and 77.78%in the control group,the clinical efficacy of the observation group being superior to that of the control group(P<0.05).(2)After treatment,Vm of vertebral artery and basilar artery in the observation group and Vm of vertebral artery in the control group were increased(P<0.05 compared with those before treatment),and the increase of Vm of vertebral artery and basilar artery in the observation group was superior to that in the control group(P<0.05).(3)During treatment,no obvious adverse reaction was found in the two groups,no abnormalities were found in the routine examination of blood and urine as well as the hepatic and renal function,either.Conclusion Xingqi Huoxue Huatan Recipe has certain effect on posterior circulation ischemic vertigo with the syndrome of phlegm and blood stasis obstructing collaterals by relieving the vertigo symptom and improving the Vm of vertebral artery and basilar artery.