养血通脉汤联合洛美利嗪治疗椎-基底动脉供血不足眩晕患者的临床研究

Clinical study of Yangxue Tongmai decoction with lomerizine in the treatment of vertigo patients with vertebrobasilar insufficiency

目的研究养血通脉汤联合洛美利嗪对椎-基底动脉供血不足眩晕(VBIV)患者的临床效果,重点探讨该疗法对患者中医证候积分及颅内血流动力学的影响。方法选取2017年8月~2019年3月收治的70例VBIV患者,采用随机数字表分为对照组(n=35)和研究组(n=35)。对照组采用洛美利嗪治疗,研究组采用养血通脉汤联合洛美利嗪治疗,两组均持续治疗2周。对比两组治疗效果、不良反应发生情况,并比较两组治疗前、治疗结束后中医证候积分、颅内血流动力学[左侧椎动脉(VA)、右侧VA及基底动脉(BA)收缩期峰值血流速度]。结果研究组治疗总有效率(97.14%)高于对照组(77.14%),差异有统计学意义(P<0.05);两组治疗结束后头晕、目眩、视物旋转分值均低于治疗前,且研究组低于对照组(P<0.001);两组治疗结束后左侧VA、右侧VA及BA收缩期峰值血流速度均高于治疗前,且研究组高于对照组(P<0.01);研究组不良反应总发生率(8.57%)与对照组(5.71%)比较无统计学意义(P>0.05)。结论采用养血通脉汤联合洛美利嗪治疗VBIV患者,能显著减轻患者临床症状,改善颅内血流动力学,增强治疗效果,且具有一定安全性。

Objective To study the effect of Yangxue Tongmai decoction plus lomerizine on TCM syndrome scores and intracranial hemodynamics in patients with vertebrobasilar insufficiency vertigo(VBIV).Methods A total of 70 patients with VBIV(from August 2017 to March 2019)admitted to our hospital were randomized into two groups(35 cases each).The control group was treated with lomerizine,and the study group was treated with Yangxue Tongmai decoction combined with lomerizine.Both groups received the treatment for two weeks.The TCM syndrome score and intracranial hemodynamics[left pushing pulse(VA),right VA,and peak systolic blood flow velocity of basilar artery(BA)]before and after treatment were compared for the evaluation of the therapeutic effect and adverse reactions between the two groups.Results The total effective rate of treatment in the study group(97.14%)was statistically higher than that in the control group(77.14%)(P<0.05);the scores of dizziness,vertigo and rotation of visual objects in the two groups decreased after treatment,and those in the study group were statistically lower than those in the control group(P<0.001);the peak systolic blood flow velocity of VA on the left,VA on the right and BA in the two groups were higher than that before the treatment,and those in the study group was statistically higher than that in the control group(P<0.01);no significant difference was observed in the total incidence of adverse reactions between the study group(8.57%)and the control group(5.71%)(P>0.05).Conclusion Yangxue Tongmai decoction with lomerizine can markedly reduce clinical symptoms in patients with VBIV,improve intracranial hemodynamics,enhance the treatment effect and be safe.