CDFI、TCD及BAEP评价行气通脉方治疗痰瘀阻络型后循环缺血性眩晕的疗效

Evaluation of Clinical Efficacy of Xingqi Tongmai Recipe for Posterior Circulation Ischemic Vertigo of Phlegm and Stasis Blocking Collaterals Type by Methods of Color Doppler Flow Imaging,Transcranial Doppler Ultrasound and Brainstem Auditory Evoked Potent

【目的】采用彩色超声多普勒(CDFI)、经颅多普勒超声(TCD)、脑干听觉诱发电位(BAEP)等方法观察行气通脉方治疗痰瘀阻络型后循环缺血性眩晕(PCIV)患者的疗效。【方法】将72例患者随机分为治疗组和对照组,每组各36例。2组患者均给予控制血压血糖、降脂稳斑、抗血小板聚集等常规西医治疗,在此基础上,治疗组给予行气通脉方治疗,对照组给予甲磺酸倍他司汀治疗,疗程为14 d。观察2组患者治疗前后CDFI、TCD、BAEP等检查参数的变化情况,比较分析两种治法的临床疗效。【结果】(1)CDFI结果显示:治疗后,治疗组可显著增加左右椎动脉最大血流速度(Vmax)值,减少左右椎动脉阻力指数(RI)值(P<0.05),但在改善左右椎动脉内径(R)值方面差异无统计学意义(P>0.05);对照组可显著增加左右椎动脉Vmax值(P<0.05),但在改善左右椎动脉R值和RI值方面差异无统计学意义(P>0.05);组间比较,治疗组在改善Vmax值和RI值方面明显优于对照组(P<0.05),而在改善R值方面2组差异无统计学意义(P>0.05)。(2)TCD结果显示:治疗后,治疗组和对照组均可显著增加左右椎动脉和基底动脉平均血流速度(Vm)值,且治疗组在改善左右椎动脉和基底动脉Vm值方面明显优于对照组(P<0.05)。治疗组可显著减少基底动脉博动指数(PI)值,但对左右椎动脉PI值无明显改善作用(P>0.05),而对照组对左右椎动脉和基底动脉搏动指数(PI)值均无明显改善作用(P>0.05);组间比较,治疗组在改善基底动脉PI值方面明显优于对照组,差异有统计学意义(P<0.05)。(3)BAEP结果显示:治疗后,治疗组在改善BAEP方面效果显著(P<0.05),而对照组在改善BAEP方面无显著效果(P>0.05);组间比较,治疗组在改善BAEP方面疗效优于对照组,差异有统计学意义(P<0.05)。【结论】经CDFI、TCD、BAEP评估,可以认为行气通脉方治疗痰瘀阻络型后循环缺血性眩晕临床疗效确切,其疗效优于甲磺酸倍他司汀。

Objective To investigate the therapeutic effect of Xingqi Tongmai Recipe for the treatment of the patients with posterior circulation ischemic vertigo of phlegm and stasis blocking collaterals type by the methods of color Doppler flow imaging(CDFI),transcranial Doppler ultrasound(TCD)and brainstem auditory evoked potential(BAEP).Methods A total of 72 qualified patients were randomly divided into treatment group and control group,with 36 cases in each group.The two groups were given conventional western medicine treatment for controlling the blood pressure and blood glucose level,lowering blood lipid level,stabilizing plaque,and counteracting platelet aggregation.Additionally,the treatment group was treated with Xingqi Tongmai Recipe orally and the control group was treated with Betahistine Mesylate Tablets orally.The course of treatment for both groups lasted 14 days.Before and after treatment,the parameters of CDFI,TCD and BAEP in the two groups were compared.And after treatment,the clinical efficacy of the two groups was evaluated.Results(1)CDFI results showed that the treatment group could significantly increase the maximum flow velocity(Vmax)value of the left and right vertebral artery,and reduce the resistance index(RI)value of the left and right vertebral artery after treatment,the differences being statistically significant(P<0.05).However,the difference in improving the radius(R)value of the left and right vertebral artery in the treatment group was insignificant(P>0.05).The control group could significantly increase the Vmax value of the left and right vertebral artery and the differences were statistically significant(P<0.05).However,the difference in improving the R value and RI value of the left and right vertebral artery in the control group was insignificant(P>0.05).After treatment,the curative effect of the treatment group on improving Vmax value and RI value was superior to that of the control group(P<0.05),but the difference in improving the R value between the two groups was insignificant(P>0.05).(2)TCD results showed that both of the treatment group and the control group could significantly increase the mean flow velocity(Vm)value of the left and right vertebral artery as well as the basilar artery after treatment,and the effect of the treatment group on improving the Vm was stronger than that of the control group,the differences being statistically significant(P<0.05).The treatment group could significantly reduce the pulse index(PI)value of the basilar artery(P<0.05),but showed no significant effect on reducing the PI value of the left and right vertebral artery(P>0.05).The control group had no significant effect on reducing the PI value of the left and right vertebral artery or the basilar artery after treatment(P>0.05).The effect of the treatment group on improving the PI value of the basilar artery was superior to that of the control group,and the difference was statistically significant(P<0.05).(3)BAEP results showed that the treatment group had significant effect on improving BAEP after treatment(P<0.05),while the control group had no significant effect on improving BAEP(P>0.05).The effect of the treatment group on improving BAEP after treatment was superior to that of the control group,and the difference was statistically significant(P<0.05).Conclusion The evaluation with the methods of CDFI,TCD and BAEP proved that the clinical effect of Xingqi Tongmai Recipe is stronger than Betahistine Mesylate Tablets for the treatment of the patients with posterior circulation ischemic vertigo of phlegm and stasis blocking collaterals type.