葛根姜黄汤联合复方天麻蜜环糖肽片治疗颈源性眩晕的临床观察

Clinical Observation on Treatment of Cervical Vertigo with Gegen Jianghuang Decoction and Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets

【目的】探讨葛根姜黄汤联合复方天麻蜜环糖肽片治疗颈源性眩晕的临床疗效。【方法】将86例颈源性眩晕患者随机分为观察组和对照组,每组各43例。对照组给予复方天麻蜜环糖肽片口服治疗,观察组给予葛根姜黄汤联合复方天麻蜜环糖肽片治疗,疗程为4周。观察2组患者治疗前后眩晕评分、双侧椎—基底动脉最大血流速度、血液流变学指标、C-反应蛋白(CRP)、血浆内皮素(ET-1)水平的变化情况,比较2组治疗后眩晕缓解天数和生活质量评分情况,评价2组临床疗效和安全性,并随访半年以观察2组的复发情况。【结果】(1)治疗4周后,观察组的总有效率为95.35%(41/43),对照组为74.42%(32/43),观察组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的眩晕评分均较治疗前明显降低(P<0.05),且观察组的降低作用明显优于对照组(P<0.01)。(3)治疗后,2组患者的血浆比黏度、全血高切黏度、CRP、ET-1水平均较治疗前明显下降(P<0.05),且观察组的下降作用均明显优于对照组(P<0.05)。(4)治疗后,2组患者双侧椎—基底动脉最大血流速度均较治疗前明显改善(P<0.05),且观察组的改善作用均明显优于对照组(P<0.05)。(5)治疗后,观察组患者的眩晕缓解天数明显短于对照组,生活质量评分明显高于对照组,差异均有统计学意义(P<0.01)。(6)随访半年,观察组的复发率为9.30%(4/43),明显低于对照组的23.26%(10/43),差异有统计学意义(P<0.05)。(7)治疗期间,2组患者均无明显不良反应情况发生。【结论】葛根姜黄汤联合复方天麻蜜环糖肽片治疗颈源性眩晕临床疗效显著,可以有效降低血黏度,改善血管内皮功能,降低机体炎症水平,缓解患者临床症状,提高患者生活质量和减少复发率。

Objective To investigate the clinical effect of Gegen Jianghuang Decoction combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets in the treatment of cervical vertigo.Methods Eighty-six patients with cervical vertigo were randomly divided into observation group and control group,43 cases in each group.The control group was treated with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets orally,and the observation group was treated with Gegen Jianghuang Decoction combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets orally.The course of treatment lasted 4 weeks.Before and after 4 weeks of treatment,the vertigo scores,the maximum blood flow velocity of the bilateral vertebrobasilar artery,hemorheology indexes,C-reactive protein(CRP),and plasma endothelin 1(ET-1)level in the two groups were observed.After treatment,the days for vertigo relief and the scores of quality of life in the two groups were compared,the clinical efficacy and safety were evaluated,and the recurrence rate was monitored during the follow-up for half a year.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 95.35%(41/43),and the that of the control group was 74.42%(32/43),the clinical efficacy of the observation group being superior to that of the control group(P<0.05).(2)After treatment,the vertigo scores in the two groups were significantly decreased in comparison with those before treatment(P<0.05),and the effect on decreasing the vertigo scores in the observation group was superior to that of the control group(P<0.01).(3)After treatment,plasma specific viscosity,whole blood high shear viscosity,the levels of CRP and ET-1 in the two groups were lower than those before treatment(P<0.05),and the degree of decrease in the observation group was superior to that in the control group(P<0.05).(4)After treatment,the maximum blood flow velocity of the bilateral vertebrobasilar artery in the two groups was improved in comparison with that before treatment(P<0.05),and the improvement in the observation group was superior to that in the control group(P<0.05).(5)After treatment,the days for vertigo relief were reduced and the scores of quality of life were increased in the observation group as compared with those in the control group,and the differences were statistically significant(P<0.01).(6)The results of follow-up for half a year showed that the recurrence rate in the observation group was 9.30%(4/43),much lower than that in the control group(23.26%,10/43),and the difference was statistically significant(P<0.05).(7)During the treatment,no obvious adverse reaction occurred in the two groups.Conclusion Gegen Jianghuang Decoction combined with Compound Armillaria Mellea Polysaccharide and Polypeptide Tablets exerts certain clinical efficacy for the treatment of cervical vertigo,which can effectively reduce the blood viscosity,improve vascular endothelium,decrease the inflammatory factor level,relieve the clinical symptoms of the patients,improve the quality of life and reduce the recurrence rate.