丁苯酞结合通神复脑丸治疗循环缺血性眩晕患者的疗效及对血清PAF、TXB2表达的影响

Effects of n-butylphthalide combined with Tongshenfunao pill on posterior circulation ischemic vertigo

目的探究丁苯酿结合通神复脑丸对循环缺血性眩晕(posterior circulation ischemic vertigo,PCIV)患者的血清血小板聚集因子(platelet agglutinating factor,PAF)、血检素B2(Thromboxane B2,TXB2)表达的影响,分析丁苯酞结合通神复脑丸治疗的临床疗效。方法选取2016年8月-2019年8月于邯郸明仁医院神经内科诊断为PCIV患者186例,根据随机数字表法分为对照组(n=93)和治疗组(n=93),对照组患者给予丁苯酞治疗,治疗组患者则给予丁苯酞结合通神复脑丸治疗,观察两组患者的临床疗效、眩晕评定量表的评分系统(DARS)评分、眩晕障碍量表的筛查表(DHI)评分、基底动脉及双侧椎动脉血流速度、血清PAF、TXB2水平,并进行药物的安全性评价。结果经治疗,与对照组患者相比较,治疗组患者的临床治疗总有效率显著性升高(P<0.05),血清PAF、TXB2水平及DARS、DHI评分均显著性降低(P<0.05),而基底动脉及双侧椎动脉的血流速度呈显著性升高(P<0.05)。两组患者均未发生严重的不良反应事件,不良反应发生率无统计学意义。(x^(2)=0.148,P=0.700).结论丁苯酞结合通神复脑丸治疗可显著改善PCIV患者的临床症状,加快脑血管的血流速度,降低血清PAF、TXB2水平,DARS、DHI评分减低,临床疗效显著,且临床用药安全性高.

Objective To investigate the effects of n-butylphthalide(NBP)combined with Tongshenfunao pill on the clinical manifestation and the levels of platelet and expression of platelet agglutinating factor(PAF)and thromboxane B2(TXB2)of the patients with posterior circulation ischemic vertigo(PCIV).Methods 186 patients with PCIV were randomLy divided into 2 equal groups:control group treated with oral administration of aspirin enteric-coated tablet and injection of NBP for 14 days,and observation group treated with Tongshenfunao pill in addition to the above drugs.The curative effects and adverse reactions were observed.Dizziness Assessment Rating Scale(DARS)and Dizziness Handicap Inventory(DHI)were used to evaluate the clinical manifestations.Transcranial Doppler(TCD)was used to monitor the blood flow rate in the basilar and vertebral arteries.Peripheral venous blood samples were collected 14 days later to undergo examination of the levels of PAF and TXB2 by ELISA.Results The effective rate of the observation group was 97.85%,significantly higher than that of the control group(88.17%,P<0.05).The DARS and DHI scores after treatment were significantly lower than those before treatment in both groups(all P<0.05).The DARS and DHI scores after treatment of the observation group were both significantly lower than those of the control group(both P<0.05).The blood flow rate of the basilar and vertebral arteries after treatment were all significantly higher than those before treatment in both groups(all P<0.05).The blood flow rates of the basilar and vertebral arteries after treatment of the observation group were all significantly higher than those of the control group(all P<0.05).The serum levels of PA and TXB2 after treatment were all significantly lower than those before treatment in both groups(all P<0.05).The serum levels of PA and TXB2 after treatment of the observation group were both significantly lower than those of the control group(both P<0.05).No severe adverse reaction occurred in both groups and ihere was no significant difference in adverse reactions between these 2 groups(x^(2)=O.148,P=0.700).Conclusion N-hutylphthalide combined with Tongshenfunao pill significantly improves the clinical manifestations of PCTV patients,increases the blood flow rate in cerebral vessels,decreases the serum PAF and TXB2,and lower the DARS and DHI scores.