椎-基底动脉供血不足性眩晕经颅多普勒超声分型与中医证型在治疗中的价值

Values of transcranial Doppler ultrasound classification and TCM syndromes in the treatment of patients with vertebrobasilar insufficiency vertigo

目的探讨椎-基底动脉供血不足性眩晕经颅多普勒超声(TCD)分型与中医证型在治疗中的价值。方法将150例处于发作期的椎-基底动脉供血不足性眩晕患者根据TCD检查的血流速度分为流速缓慢组、流速增快组、流速正常组,同时行中医证型分类,并且分为常规治疗组、结合TCD治疗组、结合TCD和中医证型治疗组。结果150例患者中,肝阳上亢证30例,气血亏虚证73例,肾精不足证16例,痰湿中阻证14例,瘀血阻窍证17例。椎-基底动脉供血不足性眩晕以肝阳上亢证和气血亏虚证为主。中医证型在流速缓慢组、流速增快组、流速正常组中分布有显著差异(P<0.001)。常规治疗组、结合TCD治疗组、结合TCD和中医证型治疗组的疗效有显著差异(P=0.001)。结论结合TCD分型与中医证型对椎-基底动脉供血不足性眩晕进行治疗能提高疗效。

Objective To explore the values of transcranial Doppler (TCD) ultrasound classification and Traditional Chinese Medicine (TCM) syndromes in the treatment of patients with vertebrobasilar insufficiency vertigo. Methods Totally 150 patients with vertebrobasilar insufficiency vertigo at attack stage were divided into slow flow group, fast flow group and normal flow group according to the blood flow velocity by TCD examination. At the same time, TCM syndromes were classified and patients were divided into conventional treatment group, combined with TCD treatment group, TCD treatment combined with TCM syndrome treatment group. Results Among 150 patients, there were 30 cases with type of hyperactivity of liver yang, 73 cases with type of deficiency of qi and blood, 16 cases with deficiency of kidney essence, 14 cases with type of obstruction of phlegm and dampness, and 17 cases with obstruction of orifices by blood stasis. Vertebrobasilar insufficiency vertigo was mainly characterized by hyperactivity of liver-yang and deficiency of qi and blood. There were significant differences in the distribution of TCM syndromes among the slow flow group, the fast flow group and the normal flow group ( P <0.001). There were significant differences in the efficacy between conventional treatment group, combined with TCD treatment group, TCD treatment combined with TCM syndrome treatment group ( P =0.001). Conclusion Combination of TCD classification and TCM syndromes can improve the curative effect for patients with vertebrobasilar insufficiency vertigo.