丁苯酞联合氟桂利嗪与前庭康复训练治疗前庭性偏头痛疗效观察

Efficacy of Butylphthalide Combined with Flunarizine and Vestibular Rehabilitation Training in the Treatment of Vestibular Migraine

目的 探讨丁苯酞联合氟桂利嗪与前庭康复训练治疗前庭性偏头痛(VM)的临床疗效,以及对患者脑血流动力学指标和血清神经递质水平的影响。方法 选取中国人民解放军海军青岛特勤疗养中心2020年6月至2022年12月收治的VM患者110例,按随机数字表法分为观察组和对照组,各55例。两组患者均予前庭康复训练和盐酸氟桂利嗪胶囊口服治疗,观察组患者在此基础上加用丁苯酞软胶囊。两组患者均连续治疗1个月,随访3个月。结果 观察组总有效率为85.45%,显著高于对照组的65.45%(P <0.05)。治疗后,观察组患者随访期间每月眩晕发作频率、每月眩晕持续时间及眩晕残障评定量表、视觉模拟量表评分均显著降低(P <0.05),且均显著低于对照组(P <0.05);观察组患者的椎动脉、基底动脉平均血流速度均显著升高(P <0.05),且均显著高于对照组(P <0.05);观察组患者的血清降钙素基因相关肽水平显著降低(P <0.05),血清5-羟色胺、去甲肾上腺素水平均显著升高(P <0.05),且均显著优于对照组(P <0.05)。治疗期间,观察组和对照组不良反应发生率相当(9.09%比16.36%,P> 0.05)。结论 丁苯酞联合氟桂利嗪与前庭康复训练治疗VM的临床疗效良好,能有效提高患者的脑组织血流量,调节血清神经递质水平,且安全性良好。

Objective To investigate the efficacy of butyphthalide combined with flunarizine and vestibular rehabilitation training in the treatment of vestibular migraine,and its effects on cerebral hemodynamics and serum neurotransmitter levels.MethodsA total of 110 patients with vestibular migraine admitted to the Qingdao Special Service Recuperation Center of the PLA Navy from June2020 to December 2022 were selected and divided into the observation group and the control group according to the random number table method,with 55 cases in each group.The patients in the two groups were treated with vestibular rehabilitation training and Flunarizine Hydrochloride Capsules,on this basis,the patients in the observation group were treated with Butylphthalide Soft Capsules.Both groups were treated for one month and followed up for three months.Results The total effective rate in the observation group was 85.45%,which was significantly higher than 65.45% in the control group(P<0.05).After treatment,the vertigo attack frequency and duration of vertigo per month,the Vertigo Disability Assessment Scale and Visual Analog Scale score during the follow-up period,in the observation group were significantly lower than those before treatment(P<0.05),and those in the observation group were significantly lower than those in the control group(P<0.05),the average blood flow velocity of vertebral artery and basilar artery in the observation group was significantly higher than that before treatment(P<0.05),and that in the observation group was higher than that in the control group(P<0.05);the level of serum calcitonin gene-related peptide in the observation group was significantly lower than that before treatment(P<0.05),while the levels serum of 5-hydroxytryptamine and norepinephrine in the observation group were significantly higher than those before treatment(P<0.05),and those in the observation group were significantly better than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was comparable to that in the control group(9.09% vs.16.36%,P>0.05).Conclusion Butylphthalide combined with flunarizine and vestibular rehabilitation training is effective and safe in the treatment of vestibular migraine,which can effectively increase brain tissue blood flow,and regulate serum neurotransmitter levels.