活血通络汤治疗椎基底动脉供血不足眩晕的疗效

Curative Effect of Huoxue Tongluo Decoction(活血通络汤)on Vertebrobasilar Insufficiency Vertigo

目的观察活血通络汤在椎基底动脉供血不足眩晕(VBIV)的临床疗效及对血流速度、血液流变学参数的影响。方法选取淮南新华医院2020年5月—2022年2月接收的100例VBIV患者,根据随机对照原则将入组患者分为观察组与对照组,每组50例。其中对照组患者给予常规西药治疗(阿司匹林+盐酸氟桂利嗪+盐酸川芎嗪),观察组在对照组基础上给予活血通络汤,两组疗程均为1个月。记录两组治疗前后血流速度及血液流变学参数的变化,并对其临床疗效及安全性进行客观性评价。结果治疗后两组基底动脉(BA)、左椎动脉(LVA)及右椎动脉(RVA)平均血流速度均明显提高(P<0.05),且观察组BA、LVA及RVA平均血流速度均高于对照组(P<0.05);治疗前两组全血黏度高切、全血黏度低切、血浆黏稠度及纤维蛋白原等血液流变学参数相比,无明显统计学意义(P>0.05),治疗后均显著降低(P<0.05),且观察组血液流变学参数指标均低于对照组(P<0.05);观察组总有效率明显高于对照组(P<0.05),不良反应发生率低于对照组,但差异无明显统计学意义(P>0.05)。结论活血通络汤联合西药治疗VBIV患者较常规西药而言,其疗效更显著,不仅能加快椎基底动脉血流速度,还能降低血浆黏稠度,改善血液流变学指标,具有较高的临床应用价值。

Objective To observe the clinical effect of Huoxue Tongluo Decoction(活血通络汤)in the treatment of vertebrobasilar insufficiency vertigo(VBIV)and the influence on blood flow velocity and hemorheological parameters.Methods A total of 100 patients with VBIV admitted to Huainan Xinhua Hospital from May 2020 to February 2022 were selected,and randomly divided into observation group and control group with 50 cases in each group.All patients were treated with conventional western medicines(aspirin combined with flunarizine hydrochloride and ligustrazine hydrochloride).On this basis,the patients in the observation group were treated with Huoxue Tongluo Decoction.Both groups underwent 1 month of treatment.The changes of blood flow velocity and hemorheological parameters in the two groups were recorded.The clinical effect and safety were evaluated.Results After treatment,the mean flow velocities of basilar artery(BA),left vertebral artery(LVA)and right vertebral artery(RVA)were significantly increased in the two groups(P<0.05),which were higher in the observation group than those in the control group(P<0.05).There was no statistically significant difference between the two groups in whole blood high-shear viscosity,whole blood low-shear viscosity,plasma viscosity or fibrinogen before treatment(P<0.05).These hemorheological parameters were significantly decreased after treatment(P<0.05),and lower in the observation group than those in the control group(P<0.05).The total effective rate in the observation group was significantly higher than that in the control group(P<0.05),and the incidence of adverse reactions was lower than that in the control group(P>0.05).Conclusion Compared with conventional western medicine,Huoxue Tongluo Decoction combined with western medicine is more effective in the treatment of VBIV.It can not only increase the blood flow of vertebrobasilar artery but also reduce the plasma viscosity and improve the hemorheological parameters.