天麻钩藤饮加减联合醒脑开窍针刺法治疗后循环缺血性眩晕的疗效及对sCD40L、ET-1、NSE水平的影响

Effect of Tianma Gouteng Decoction Combined with Xingnao Kaiqiao Acupuncture on the Levels of sCD40L,ET-1and NSE in Patients with Circulatory Ischemic Vertigo after Treatment

目的:观察天麻钩藤饮加减联合醒脑开窍针刺法治疗后循环缺血性眩晕的疗效及对可溶性CD40配体(sCD40L)、内皮素-1(ET-1)、神经元特异性烯醇化酶(NSE)水平的影响。方法:选取2019年2月~2021年4月本溪市中医院收治的后循环缺血性眩晕患者106例,随机数字法分为对照组(n=53)和观察组(n=53)。对照组给予盐酸氟桂利嗪治疗,观察组在对照组基础上给予天麻钩藤饮加减联合醒脑开窍针刺法治疗。比较两组疗效和不良反应,记录两组sCD40L、ET-1、NSE及彩色多普勒(TCD)检查结果差异。结果:观察组治疗总有效率为92.45%,高于对照组的77.36%,差异有统计学意义(P<0.05);治疗后,两组sCD40L、ET-1、NSE较治疗前降低(P<0.05);与对照组比较,观察组治疗后的sCD40L、ET-1、NSE明显更低(P<0.05);治疗后,两组左右椎动脉(LVA和RVA)、基底动脉(BA)的平均血流速度(Vm)均较治疗前升高,LVA、RVA、BA的血管搏动指数(PI)均较治疗前降低(P<0.05);与对照组比较,观察组治疗后的LVA、RVA、BA的Vm明显更高,LVA、RVA、BA的PI明显更低(P<0.05);两组在轻微腹泻、嗜睡、皮疹、恶心等不良反应方面比较,差异无统计学意义(P>0.05)。结论:天麻钩藤饮加减联合醒脑开窍针刺法治疗后循环缺血性眩晕可提高脑组织血液供应,降低sCD40L、ET-1、NSE的表达,且安全性较好。

Objective:To observe the effects of Tianma Gouteng Decoction combined with Xingnao Kaiqiao acupuncture treatment on soluble CD40ligand(sCD40L),endothelin-1(ET-1),and neuron-specific enolase levels.Methods:A total of 106patients with posterior circulation ischemic vertigo admitted to the Benxi Hospital of Traditional Chinese Medicine from February 2019to April 2021were selected and divided into a control group(n=53)and an observation group(n=53)by random number method.The control group was treated with flunarizine hydrochloride,and the observation group was treated with Tianma Gouteng Decoction Combined with xingnaokaiqiao acupuncture on the basis of the control group.The efficacy and adverse reactions of the two groups were compared,and the differences in sCD40L,ET-1,NSE and color Doppler(TCD)examination results were recorded.Results:The total effective rate of the observation group was 92.45%,higher than 77.36%of the control group(P<0.05).After treatment,sCD40L,ET-1and NSE in the two groups were lower than before treatment(P<0.05).Compared with the control group,the observation group had significantly lower sCD40L,ET-1,and NSE after treatment(P<0.05).After treatment,the average blood flow velocity(Vm)of the left and right vertebral arteries(LVA and RVA)and basilar artery(BA)in the two groups were higher than before treatment,and the vascular pulsatility index(PI)of LVA,RVA and BA were higher than before treatment.Decrease(P<0.05).Compared with the control group,the Vm of LVA,RVA and BA of the observation group after treatment was significantly higher,and the PI of LVA,RVA and BA was significantly lower(P<0.05).There was no significant difference between the two groups in the side effects of mild diarrhea,lethargy,rash,nausea,etc.(P>0.05).Conclusion:Tianma Gouteng Decoction combined with Xingnao Kaiqiao acupuncture treatment can improve the blood supply of brain tissue,reduce the expression of sCD40L,ET-1,and NSE,and has high safety.