葛根汤联合定眩汤及地芬尼多片治疗颈性眩晕疗效及对患者血流动力学、血液流变学的影响

Efficacy of Gegen decoction combined with Dingxuan decoction and difenidol tablets on patients with cervical vertigo and its influence on hemodynamics and hemorheology

目的:探讨葛根汤联合定眩汤及地芬尼多片对颈性眩晕患者的疗效及对血流动力学、血液流变学的影响。方法:116例颈性眩晕患者为研究对象,按随机数字表法分为观察组(58例,给予葛根汤联合定眩汤及地芬尼多片治疗)和对照组(58例,给予地芬尼多片治疗)。观察治疗后两组临床疗效,对比治疗前后两组中医证候积分、眩晕程度、血流动力学[基底动脉(BA)、右侧椎动脉(RVA)及左侧椎动脉(LVA)]、血液流变学(全血高切黏度、血浆黏度及全血低切黏度)及降钙素基因相关肽(CGRP)、血浆内皮素(ET)。结果:治疗后,观察组临床疗效高于对照组(P<0.05)。两组颈部活动受限或疼痛,涉及肩背部,向外上肢放射,身重而痛,四肢拘挛,手指麻木,肌肉萎缩评分治疗后均较治疗前降低,与对照组相比,研究组颈部活动障碍或疼痛,累及肩膀胸疼痛,向外上肢放射,身重而痛,四肢拘挛,手指麻木,肌肉萎缩评分均更低(P<0.05)。治疗后,两组全血高切黏度、血浆黏度及全血低切黏度水平均较治疗前降低,与对照组相比,观察组全血高切黏度、血浆黏度及全血低切黏度水平更低(均P<0.05)。治疗后,两组BA、RVA、LVA水平均较治疗前升高,与对照组相比,观察组BA、RVA、LVA水平均升高(P<0.05)。两组ET水平治疗后较治疗前降低、CGRP水平及眩晕程度评分均较治疗前升高,与对照组相比,观察组ET水平更低,CGRP水平及眩晕程度评分更高(均P<0.05)。结论:葛根汤联合定眩汤及地芬尼多片能够有效改善颈性眩晕患者临床症状,改善血流动力学及血液流变学。

Objective:This study aims to investigate the effects of Gegen decoction combined with Dingxuan decoction and difenidol tablets on patients with cervical vertigo and the effects on hemodynamics and hemorheology.Methods:A total of 116 patients with cervical vertigo were taken as the research objects.They were divided into the observation group(58 cases,given Gegen decoction combined with Dingxuan decoction and difenidol tablets)according to the random number table method,and the control group(58 cases were given difenidol tablets treatment).Observe the clinical efficacy of the two groups after treatment,compare the scores of TCM syndromes,the degree of dizziness,hemodynamics[basal artery(BA),right vertebral artery(RVA)and left vertebral artery(LVA)],blood rheology(high shear viscosity of whole blood,plasma viscosity and low shear viscosity of whole blood),calcitonin gene-related peptide(CGRP),plasma endothelin(ET).Results:After treatment,the clinical efficacy of the study group was higher than that of the control group(96.55%vs.82.76%,P<0.05).After treatment,the two groups of neck activities restriction or pain,involving shoulders and chest,radiation to the upper limbs,body weight and pain,limbs constriction,finger numbness,and muscle atrophy scores were all lower than before treatment.Compared with the control group,the study group had neck mobility disorder or pain,involving the shoulders chest pain,radiating outward upper limbs,weight and pain,limbs contraction,numbness of fingers,lower muscle atrophy score(P<0.05).After treatment,the two groups of whole blood high-shear viscosity,plasma viscosity and whole blood low-shear viscosity levels were compared with the treatment compared with the control group,the study group had lower levels of whole blood high-shear viscosity,plasma viscosity and whole blood low-shear viscosity(all P<0.05).After treatment,the levels of BA,RVA and LVA in the two groups were higher than before treatment.Compared with the control group,the levels of BA,RVA and LVA in the study group were increase(P<0.05).After treatment,the ET levels of the two groups were lower than before treatment,and the CGRP levels and dizziness scores were higher than those before treatment,which were compared with the control group.Compared with the study group,the ET level was lower,the CGRP level and dizziness score were higher(all P<0.05).Conclusion:Gegen decoction combined with Dingxuan decoction and difenidol tablets can effectively improve the clinical symptoms of patients with cervical vertigo,improve hemodynamics and hemorheology.