加味温胆汤联合盐酸地芬尼多治疗后循环缺血性眩晕临床观察

Clinical observation on the Wendan decoction plus diphenidol hydrochloride in treating postcyclic ischemic vertigo

目的:观察加味温胆汤联合盐酸地芬尼多对后循环缺血性眩晕的临床疗效。方法:以北京中医药大学附属护国寺中医医院内科门诊2020年7月―2022年1月临床辨证分型为肝肾阴虚、湿热内蕴的76例患者作为观察对象,运用计算机统计软件包SPSS 17.0随机将76例患者分为两组,治疗组42例,对照组34例,治疗组予加味温胆汤联合盐酸地芬尼多口服,对照组单纯应用西药,两组患者均以21天为一个疗程,连续治疗2个疗程。同时视具体情况行降血脂、降血糖、降压等基础治疗,限制使用其他对血管舒缩功能有影响的药物。治疗2个疗程后对治疗组与对照组发作眩晕的频次、持续时间、程度、伴随症状等方面进行临床评价,两组病例均应用经颅多普勒超声检测后循环血流速度。同时,观察安全性指标,包括血常规、尿常规、便常规、心电图、肝肾功能等,通过收集以上观察资料对两组病例的治疗效果及治疗的安全性进行评估。结果:治疗组在临床证候改善、疗效及后循环血流的速度变化等方面优于对照组,两组比较差异有统计学意义(P<0.05)。结论:温胆汤治疗眩晕在中医古籍中就有记载,其具有调补兼施之效。临床应用加味温胆汤联合盐酸地芬尼多可以使后循环缺血性眩晕的临床疗效得到明显提高,同时可以通过经颅多普勒超声检测得到验证。

Objective:To observe the clinical effect of the Wendan decoction(温胆汤)plus diphenidol hydrochloride in treating postcyclic ischemic vertigo.Methods:A total of 76 patients with clinical classification of Yin deficiency(阴虚)of liver and kidney and dampness-heat in the Outpatient Department of Huguosi Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Chinese Medicine from July 2020 to January 2022 were taken as the observation subjects.The 76 patients were randomly divided into two groups by computer statistical software package SPSS17.0,including 42 patients in the treatment group and 34 patients in the control group.The treatment group was given the Wendan decoction plus diphenidol hydrochloride orally,while the control group was simply given Western medicine.Both groups were treated for 2 consecutive courses,with 21 days as a course of treatment.At the same time,basic treatment such as lowering blood lipid,lowering blood glucose and lowering blood pressure should be performed according to the specific situation,and the use of other drugs affecting vasomotor function should be restricted.After 2 courses of treatment,the frequency,duration,degree and accompanying symptoms of vertigo were clinically evaluated in the treatment group and the control group,and the circulating blood velocity was detected by craniocerebral Doppler ultrasound(TCD)in both groups.At the same time,safety indicators were observed,including blood routine,urine routine,stool routine,electrocardiogram,liver and kidney function,etc.By collecting the above observation data,the therapeutic effect and safety in the two groups of patients were evaluated.Results:The treatment group was superior to the control group in the amelioration of clinical syndromes,efficacy and velocity changes of posterior circulation blood flow,and there were significant differences between the two groups(P<0.05).Conclusion:The treatment of vertigo with the Wendan decoction is recorded in ancient books of traditional Chinese medicine,which has the effect of both regulating and replenishing.Clinical application of the Wendan decoction plus difenidol hydrochloride can significantly improve the clinical efficacy of postcyclic ischemic vertigo,and can be verified by TCD detection.