和中理气汤辅助治疗痰湿中阻证椎-基底动脉供血不足患者的效果

Efficacy Evaluation of Hezhong Liqi Decoction in Adjuvant Treatment of Patients with Vertebral-Basilar Insufficiency of Phlegm-Dampness

目的 观察和中理气汤辅助治疗痰湿中阻证椎-基底动脉供血不足(VBI)患者的临床效果。方法 选取民权县中医院2019年10月至2020年12月收治的94例痰湿中阻证VBI患者作为研究对象,按照治疗药物分为西医组(47例)和中西医联合组(47例)。西医组患者接受常规西医治疗,中西医联合组患者在西医组用药基础上,接受和中理气汤进行治疗。比较两组治疗总有效率、治疗前与治疗14 d后中医证候积分(呕吐痰涎、头痛如裹、视物旋转)、血流动力学(右椎动脉、基底动脉、左椎动脉血流速度)。结果 中西医联合组治疗总有效率(93.62%)高于西医组(78.72%)(P<0.05);与治疗前比较,两组患者治疗14 d后的呕吐痰涎、头痛如裹、视物旋转积分均下降(P<0.05);治疗14 d后,中西医联合组患者的呕吐痰涎、头痛如裹、视物旋转积分较西医组均降低(P<0.05)。与治疗前比较,两组患者治疗14 d后的右椎动脉、基底动脉、左椎动脉血流速度均升高,RI降低(P<0.05);治疗14 d后,中西医联合组患者的右椎动脉、基底动脉、左椎动脉血流速度、RI较西医组改善明显(P<0.05);与治疗前比较,两组患者治疗14 d后的血浆黏度、纤维蛋白原、全血高切黏度和低切黏度均降低(P<0.05);治疗14 d后,中西医联合组血浆黏度、纤维蛋白原、全血高切黏度和低切黏度低于西医组(P<0.05)。结论 在常规西医治疗基础上,加用和中理气汤治疗痰湿中阻证VBI,可有效改善患者的血流动力学和血液流变学,有效缓解患者的临床症状。

Objective To observe the curative effect of Hezhong Liqi Decoction in adjuvant treatment of patients with vertebrobasilar insufficiency(VBI) of phlegm-dampness middle blockage.Methods A total of 94 VBI patients with phlegm-dampness middle resistance syndrome admitted to Minquan County Hospital of Traditional Chinese Medicine from October 2019 to December 2020 were selected as the research objects,and they were divided into western medicine group(47 cases) and Chinese-western combination group(47 cases) according to different therapeutic drugs.Patients in the western medicine group were treated with conventional western medicine.Patients in the Chinese-western combination group were given Hezhongliqi decoction based on the western medicine group.The total effective rate of treatment,TCM syndrome scores(vomiting phlegm and salivation,headache like wrapping,vision rotation),hemodynamics(right vertebral artery,basilar artery,left vertebral artery blood flow) before and after 14 days of treatment were compared between the two groups.Results The total effective rate of treatment in the Chinese-western combination group was(93.62%) higher than that of the western medicine group(78.72%)(P<0.05).Compared with before treatment,vomiting,phlegm and salivation,headache,and visual rotation scores in both groups after 14 days of treatment were decreased(P<0.05).After 14 days of treatment,vomiting,phlegm and salivation,headache,and visual rotation scores in the Chinese-western combination group were lower than those in the western medicine group(P<0.05).Compared with before treatment,the blood flow velocities of the right vertebral artery,basilar artery and left vertebral artery in the two groups after 14 days of treatment were increased,and the RI was decreased(P<0.05).After 14 days of treatment,compared with the western medicine group,the blood flow velocities of the right vertebral artery,basilar artery and left vertebral artery in Chinese-western combination group were increased,and the RI was decreased(P<0.05).Compared with before treatment,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity in the two groups after 14 days of treatment were decreased(P<0.05).After 14 days of treatment,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity in Chinese-western combination group were lower than those in the western medicine group(P<0.05).Conclusion On the basis of conventional western medicine treatment,Hezhong Liqi Decoction in the treatment of VBI patients with phlegm-dampness and middle-resistance syndrome can improve effectively the hemodynamics and hemorheology,and alleviate effectively the clinical symptoms of patients.