调督益脑针刺法对肝阳上亢型后循环缺血性眩晕患者眩晕症状、血液流变学指标及经颅多普勒超声指标的影响

Effects of Tiaodu Yinao acupuncture method for vertigo symptoms,hemorheology index and transcranial doppler index in patients with posterior circulation ischemic vertigo of hyperactivity of liver-yang

目的观察调督益脑针刺法对肝阳上亢型后循环缺血性眩晕患者眩晕症状、血液流变学指标及经颅多普勒超声(TCD)指标的影响。方法将92例肝阳上亢型后循环缺血性眩晕患者按照随机数字表法分为2组,对照组46例予常规西药治疗,治疗组46例在对照组治疗基础上予调督益脑针刺法治疗。2组均治疗20 d。比较2组治疗前后眩晕障碍评定量表(DHI)评分、眩晕评估评分量表(DARS)评分、血液流变学指标及经颅多普勒超声(TCD)指标[左颈总动脉(LVA)、右颈总动脉(RVA)、基底动脉(BA)的平均峰流速(Vm)]的改善情况,并评估2组临床疗效及安全性。结果治疗组总有效率93.5%(43/46),对照组总有效率76.1%(35/46),治疗组疗效优于对照组(P<0.05)。2组治疗后DHI、DARS评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后全血黏度(高切)、全血黏度(中切)、全血黏度(低切)、血浆黏度及红细胞聚集指数均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后LVA、RVA、BA的Vm均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组在治疗期间均未出现明显不良反应。结论调督益脑针刺法能够调节肝阳上亢型后循环缺血性眩晕患者脑血流动力学指标,降低血液黏稠度,改善微循环,有助于缓解患者眩晕症状,安全可靠。

Objective To observe the effects of Tiaodu Yinao acupuncture method for vertigo symptoms,hemorheology index and Transcranial Doppler(TCD)index in patients with posterior circulation ischemic vertigo(PCIV)of hyperactivity of liver-yang.Methods Totally 92 patients with PCIV(hyperactivity of liver-yang)were randomly assigned into the treatment group(n=46)and the control group(n=46);apart from conventional Western medicine,and the treatment group was additionally treated with Tiaodu Yinao acupuncture method.Treated for 20 days,aiming to compare the dizziness handicap inventory(DHI)scores,the dizziness assessment rating scale(DARS),hemorheology indexes and TCD indexes(mean peak flow velocity[Vm]of left vertebral artery[LVA],right vertebral arteries[RVA],basilar artery[BA]);the curative effect and drug safety were assessed.Results The overall effective rate in the treatment group was better than that in the control group(93.5%[43/46]vs 76.1%[35/46],[P<0.05],respectively).After treatment,DHI and DARS scores in groups were decreased(P<0.05),which were lower in the treatment group than in the control group(P<0.05);whole blood viscosity(WBV)(middle-shear,middle-shear and low-shear),plasma viscosity(PLV),red cell aggregation(RCA)in groups were decreased(P<0.05),reduction in the treatment group was more prevalent(P<0.05);Vm of LVA,RVA,BA in groups was increased(P<0.05),the treatment group was more common(P<0.05).No obvious adverse reaction was found in groups.Cconclusion For patients with PCIV(hyperactivity of liver-yang),Tiaodu Yinao acupuncture method can regulate cerebral hemodynamic index,reduce blood viscosity,improve microcirculation,relieve vertigo symptoms,with safety and reliability.