通窍活血汤加减联合甘露醇治疗椎动脉型颈椎病的临床疗效观察

Clinical observation of modified Tongqiao Huoxue Decoction combined with mannitol in the treatment of vertebral-artery-type cervical spondylosis

目的探讨通窍活血汤加减联合甘露醇治疗椎动脉型颈椎病的临床疗效。方法50例椎动脉型颈椎病患者,选择随机数字表法分成对照组及观察组,各25例。对照组接受甘露醇注射液联合氟桂利嗪胶囊治疗,观察组在对照组基础上加用通窍活血汤加减治疗。比较两组治疗效果、治疗前后症状和体征积分与椎动脉血流指标[左侧椎动脉平均血流速(LVA-Vm)、右侧椎动脉平均血流速(RVA-Vm)、左侧椎动脉血流阻力指数(LVA-RI)、右侧椎动脉血流阻力指数(RVA-RI)]水平,安全性。结果观察组治疗总有效率96.00%高于对照组的76.00%(P<0.05)。两组治疗后症状和体征积分均高于同组治疗前,且观察组治疗后症状和体征积分(21.06±2.12)分高于对照组的(13.47±1.95)分(P<0.05)。两组治疗后LVA-Vm、RVA-Vm水平均高于同组治疗前,LVA-RI、RVA-RI水平均低于同组治疗前,且观察组治疗后LVA-Vm(31.20±3.32)cm/s、RVA-Vm(32.06±2.97)cm/s均高于对照组的(27.65±2.87)、(28.11±2.44)cm/s,LVA-RI(0.54±0.06)、RVA-RI(0.46±0.10)均低于对照组的(0.62±0.07)、(0.64±0.09)(P<0.05)。两组治疗期间均未出现三大常规异常或肝肾功能异常情况,也无其他不良反应,安全性良好。结论通窍活血汤加减联合甘露醇治疗椎动脉型颈椎病疗效显著,能够有效改善患者的椎动脉血流状况,且安全性良好。

Objective To explore the clinical efficacy of modified Tongqiao Huoxue Decoction combined with mannitol in the treatment of vertebral-artery-type cervical spondylosis.Methods 50 patients with vertebral-artery-type cervical spondylosis were randomly divided into a control group and an observation group,with 25 cases in each group.The control group was treated with mannitol injection and flunarizine capsule,and the observation group was treated with modified Tongqiao Huoxue Decoction on the basis of the control group.Both groups were compared in terms of treatment effect,the scores of symptoms and signs,and the level of vertebral artery blood flow indexes[mean blood flow velocity in the left vertebral artery(LVA-Vm),mean blood flow velocity in the right vertebral artery(RVA-Vm),resistance index in the left vertebral artery(LVA-RI),resistance index in the right vertebral artery(LVA-RI)]before and after treatment,and safety.Results The total effective rate of treatment in the observation group was 96.00%,which was higher than 76.00%in the control group(P<0.05).After treatment,the scores of symptoms and signs in both groups were higher than those before treatment;and the score of symptoms and signs of(21.06±2.12)points in the observation group was higher than(13.47±1.95)points in the control group(P<0.05).After treatment,the levels of LVA-Vm and LVA-VM in both groups were higher than those before treatment,and the levels of LVA-RI and LVA-RI were lower than those before treatment;LVA-Vm of(31.20±3.32)cm/s and LVA-VM of(32.06±2.97)cm/s in the observation group were higher than(27.65±2.87)and(28.11±2.44)cm/s in the control group;LVA-RI of(0.54±0.06)and LVA-RI of(0.46±0.10)in the observation group were lower than(0.62±0.07)and(0.64±0.09)in the control group(P<0.05).There were no three major routine abnormalities or abnormal liver and kidney function in the two groups during treatment,and no other adverse reactions,indicating good safety.Conclusion Modified Tongqiao Huoxue Decoction combined with mannitol is effective in the treatment of vertebral-artery-type cervical spondylosis,which can effectively improve the blood flow status of the vertebral artery in patients with high safety.