瓜蒌薤白白酒汤结合刺络放血治疗痰瘀互结证椎动脉型颈椎病疗效观察

Curative Effect of Using Gualou Xiebai Baijiu Decoction Combined with Blood-letting Puncture in the Treatment of Cervical Spondylosis of Vertebral Artery Type with Phlegm-Blood Stasis Syndrome

目的:观察瓜蒌薤白白酒汤结合刺络放血治疗痰瘀互结证椎动脉型颈椎病(CSA)的疗效。方法:随机数表法将2017年3月~2018年7月的86例痰瘀互结证CSA门诊病例分为观察组和对照组,每组各43例。对照组采用刺络放血治疗,观察组采用瓜蒌薤白白酒汤结合刺络放血治疗,均治疗3个月。比较两组患者的疗效、治疗前后眩晕和疼痛缓解程度、椎动脉血流参数变化、血清一氧化氮(NO)、内皮素(ET)水平以及不良反应情况。结果:观察组总有效率为93.02%,明显高于对照组的76.74%(P<0.05)。观察组患者治疗后眩晕症状评分和血清ET水平均明显低于对照组,McGill疼痛询问量表(MPQ)评分、左右两侧椎动脉收缩流速(Vs)、舒张流速(Vd)、平均峰流速(Vm)和血清NO水平均明显高于对照组(P<0.05)。两组患者均无明显不良反应。结论:痰瘀互结证CSA患者采用瓜蒌薤白白酒汤结合刺络放血治疗,相比单用刺络放血治疗效果更佳,可有效减轻患者眩晕和疼痛,改善椎动脉血流,安全性好。

Objective:To investigate the curative effect of using Gualou Xiebai Baijiu Decoction combined with blood-letting puncture in the treatment of cervical spondylosis of vertebral artery type(CSA) with phlegm-blood stasis syndrome.Methods:86 clinic cases with CSA and phlegm-blood stasis syndrome treated in the hospital from March 2017 to July 2018 were divided into observation group and controlled group by the random number table method with 43 cases in each group.The controlled group was treated with blood-letting puncture while the observation group was treated with Gualou Xiebai Baijiu Decoction combined with blood-letting puncture.All subjects were treated for 3 months.The curative effect,relief of vertigo and pain,changes in vertebral artery blood flow parameters before and after treatment,levels of serum nitric oxide(NO),endothelin(ET) and adverse reactions were compared between the two groups.Results:The total response rate of the observation group was significantly higher than that of the controlled group(93.02% vs 76.74%)(P < 0.05).The vertigo symptom scores and serum ET level in the observation group after treatment were significantly lower than those in the controlled group.The McGill Pain Questionnaire(MPQ) scores,systolic velocity(Vs),diastolic velocity(Vd) and mean peak velocity(Vm) of left and right vertebral arteries and serum NO level were significantly higher than the controlled group(P < 0.05).There were no obvious adverse reactions in either group.Conclusion:Compared with blood-letting puncture alone,the curative effect of Gualou Xiebai Baijiu Decoction combined with blood-letting puncture is better in the treatment of patients with CSA and phlegm-blood stasis syndrome.It can effectively relieve dizziness and pain and improve vertebral artery blood flow,with safety.