加味补阳还五汤联合氟桂利嗪治疗椎-基底动脉缺血性眩晕的疗效及对血液流变学、血流动力学指标的影响

Efficacy of modified Buyang Huanwu Decoction in the treatment of vertebrobasilar ischemic vertigo and its influence on hemorheology and hemodynamic indexes

目的 探讨加味补阳还五汤联合氟桂利嗪治疗椎-基底动脉缺血性眩晕的疗效及对血液流变学、血流动力学指标的影响。方法 84例椎-基底动脉缺血性眩晕患者,按随机数字表法分为对照组和观察组,每组42例。对照组患者单纯口服盐酸氟桂利嗪治疗,观察组患者在对照组的基础上再口服加味补阳还五汤治疗。比较两组患者临床疗效、不良反应发生情况以及治疗前后血流动力学指标[左侧椎动脉(LVA)、右侧椎动脉(RVA)、基底动脉(BA)血流速度]、血液流变学指标(全血粘度、血浆粘度、红细胞聚集指数)水平。结果 治疗后,两组患者LVA、RVA、BA血流速度快于治疗前,且观察组患者LVA血流速度(39.45±3.61)cm/s、RVA血流速度(42.23±4.04)cm/s、BA血流速度(49.03±5.13)cm/s均快于对照组的(30.84±3.22)、(34.22±3.75)、(40.86±4.74)cm/s,差异均具有统计学意义(P<0.05)。治疗后,两组患者全血粘度、血浆粘度、红细胞聚集指数均低于治疗前,且观察组患者全血粘度(3.13±0.66)mPa·s、血浆粘度(1.53±0.20)mPa·s、红细胞聚集指数(3.10±0.32)均低于对照组的(4.02±0.60)mPa·s、(1.95±0.22)mPa·s、(3.46±0.36),差异均具有统计学意义(P<0.05)。观察组治疗总有效率95.24%高于对照组的69.05%,差异具有统计学意义(P<0.05)。两组患者治疗过程中均未见明显不良反应。结论 加味补阳还五汤联合氟桂利嗪治疗椎-基底动脉缺血性眩晕疗效确切,能有效改善血液流变学、血流动力学指标,提高临床治疗效果,且安全性良好。

Objective To discuss the efficacy of modified Buyang Huanwu Decoction in the treatment of vertebrobasilar ischemic vertigo and its influence on hemorheology and hemodynamic indexes.Methods A total of 84 patients with vertebrobasilar ischemic vertigo were divided into control group and observation group according to the random numerical table,with 42 cases in each group.The control group was given flunarizine hydrochloride alone,and the observation group was given modified Buyang Huanwu Decoction on the basis of the control group.Both groups were compared in terms of clinical efficacy,occurrence of adverse reactions,hemodynamic indexes[left vertebral artery(LVA),right vertebral artery(RVA),blood velocity of basilar artery(BA)],hemorheology indexes(whole blood viscosity,plasma viscosity,erythrocyte aggregation index)before and after treatment.Results After treatment,the blood flow velocity of LVA,RVA and BA in the two groups was faster than those before treatment in this group;the above indicators were(39.45±3.61),(42.23±4.04)and(49.03±5.13)cm/s in the observation group,which were faster than those of(30.84±3.22),(34.22±3.75)and(40.86±4.74)cm/s in the control group;all the differences were statistically significant(P<0.05).After treatment,whole blood viscosity,plasma viscosity and erythrocyte aggregation index in the two groups were lower than those before treatment in this group;whole blood viscosity of(3.13±0.66)mPa·s,plasma viscosity of(1.53±0.20)mPa·s and erythrocyte aggregation index of(3.10±0.32)in the observation group were lower than those of(4.02±0.60)mPa·s,(1.95±0.22)mPa·s,(3.46±0.36)in the control group;all the differences were statistically significant(P<0.05).The total effective rate of 95.24%in the observation group was higher than that of 69.05%in the control group,and the difference was statistically significant(P<0.05).No obvious adverse reactions were observed in the two groups during treatment.Conclusion Modified Buyang Huanwu Decoction combined with flunarizine is effective in the treatment of vertebrobasilar ischemic vertigo,and can effectively improve hemorheology and hemodynamic indexes, improve clinical efficacy with high safety.