地菊平肝汤治疗脉络瘀阻证眩晕临床观察

Clinical Observation of Using Diju Pinggan Decoction in Treatment of Vessel Obstruction Syndrome Vertigo

目的:观察地菊平肝汤治疗脉络瘀阻证眩晕的效果。方法:选取2017年6月~2019年1月本院诊治的眩晕患者168例,采用信封法随机将其分为84例对照组和84例观察组,分别给予常规临床治疗和常规治疗+地菊平肝汤治疗。比较两组疗效差异;使用眩晕残障量表(DHI)评价两组患者治疗前后眩晕程度;对比治疗前后两组患者中医证候积分及血液流变学参数差异;使用多普勒超声检查仪探查两组治疗前后脑部血流情况,并评价药物安全性。结果:两组疗效对比:观察组总有效率92.86%,高于对照组82.14%(P<0.05);两组治疗后DHI评分、中医证候积分及血液流变学参数[红细胞压积、全血黏度]均有所降低,且观察组治疗后积分及血流变参数值均低于对照组(P<0.05);两组治疗后脑部血流情况[椎动脉流速(Vm)、椎动脉血管搏动指数(PI)]均有所改善,且观察组治疗后Vm高于对照组,PI低于对照组(P<0.05);两组药物不良反应发生率对比未见明显差异(P>0.05)。结论:地菊平肝汤在治疗脉络瘀阻证眩晕的疗效确切,可显著改善患者眩晕症状及大脑血流情况,且药物安全性较高,具有较高临床应用价值。

Objective:To observe the curative effect of Diju Pinggan Decoction on vessel obstruction syndrome vertigo.Methods:168 vertigo patients who were treated in the hospital from June 2017 to January 2019 were enrolled.They were randomly divided into controlled group and observation group by envelope method,84 cases in each group.The two groups were given routine clinical treatment or routine treatment combined with Diju Pinggan Decoction,respectively.The differences in the curative effect were compared between the two groups.The vertigo degree before and after treatment in both groups was evaluated by Dizziness Handicap Inventory(DHI).The differences in TCM syndrome scores and hemorheology parameters before and after treatment were compared between the two groups.Doppler ultrasound inspection tester was performed to probe brain blood flow in both groups before and after treatment.The drug safety was evaluated.Results:The total response rate of the observation group was higher than that of the controlled group(92.86%vs 82.14%)(P<0.05).After treatment,DHI score,TCM syndromes scores and hemorheology parameters[hematocrit,whole blood viscosity]in both groups were decreased.After treatment,scores and hemorheology parameters in the observation group were lower than those in the controlled group(P<0.05).After treatment,brain blood flow[vertebral artery velocity(Vm),vertebral artery pulsatility index(PI)]in both groups was improved.After treatment,Vm in the observation group was higher than that in the controlled group,while PI was lower than that in the controlled group(P<0.05).There was no significant difference in incidence of adverse drug reactions between the two groups(P>0.05).Conclusion:The curative effect of Diju Pinggan Decoction is significant on vessel obstruction syndrome vertigo,which can significantly improve vertigo symptoms and brain blood flow in patients.The drug safety is high,with high clinical application value.