天竹定眩汤辅助治疗后循环缺血性眩晕患者的疗效及对其血管舒缩因子水平和脑神经递质的影响

Efficacy of Tianzhu Dingxuan Decoction as an Adjuvant Therapy in Patients with Posterior Circulation Ischemic Vertigo and its Impact on V asomotor Factors and Neurotransmitters

目的探讨天竹定眩汤辅助治疗后循环缺血性眩晕患者的临床疗效及对其血管舒缩因子水平和脑神经递质的影响。方法选取2019年6月-2022年6月期间郑州人民医院收治的后循环缺血性眩晕患者120例,采用随机数字表法分为对照组和研究组,每组各60例。对照组采用西医常规治疗,研究组在对照组基础上加用天竹定眩汤辅助治疗。治疗2周后,观察比较两组患者临床疗效、安全性,治疗前后中医证候积分、眩晕障碍量表(DHI)评分,血管舒缩因子[降钙素基因相关肽(Calcitonin gene related peptide,CGRP)、内皮素-1(Endothelin-1,ET-1)]、脑神经递质[5-羟吲哚乙酸(5-hydroxyindole acetic acid,5-HIAA)、神经生长因子(Nerve growth factor,NGF)、γ-氨基丁酸(γ-aminobutyric acid,GABA)]水平。结果治疗后研究组总有效率91.67%(55/60)明显高于对照组76.67%(46/60),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分及DHI评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组中医证候积分及DHI评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CGRP水平均较治疗前升高,ET-1水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组血清CGRP水平明显高于对照组,ET-1水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清5-HIAA、NGF、GABA水平均较治疗前升高,差异有统计学意义(P<0.05);且研究组血清5-HIAA、NGF、GABA水平均明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论天竹定眩汤辅助治疗后循环缺血眩晕的疗效显著,能进一步减轻眩晕症状,调节血管舒缩因子及脑神经递质水平,且具有良好的安全性。

Objective To study the clinical efficacy of Tianzhu Dingxuan decoction as an adjuvant therapy for patients with posterior circulation ischemic vertigo and its impact on vasomotor factors and neurotransmitters.Methods From June 2019 to June 2022,120 patients with posterior circulation ischemic vertigo admitted to the People′s Hospital of Henan University of Chinese Medicine were selected.They were divided into a control group and a study group using the random number table method,with 60 patients in each group.The control group received conventional Western medical treatment,while the study group received Tianzhu Dingxuan decoction in addition to the conventional treatment.After 2 weeks of treatment,the clinical efficacy and safety of the two groups were observed and compared,along with the changes in traditional Chinese medicine(TCM)syndrome scores,dizziness handicap inventory(DHI)scores,levels of vasomotor factors[calcitonin gene-related peptide(CGRP),and endothelin-1(ET-1)],and neurotransmitters[5-hydroxyindole acetic acid(5-HIAA),nerve growth factor(NGF),andγ-aminobutyric acid(GABA)]before and after treatment.Results After treatment,the total effective rate was significantly higher in the study group(91.67%,55/60)compared to the control group(76.67%,46/60),with a statistically significant difference(P<0.05).Both groups showed significant reductions in TCM syndrome and DHI scores compared to before treatment,with a statistically significant difference(P<0.05);the study group showed lower TCM syndrome and DHI scores than the control group,with a statistically significant difference(P<0.05).Serum CGRP levels increased and ET-1 levels decreased significantly in both groups compared to before treatment,with a statistically significant difference(P<0.05);the study group showed higher CGRP and lower ET-1 levels than the control group,with a statistically significant difference(P<0.05).Serum levels of 5-HIAA,NGF,and GABA increased significantly in both groups compared to before treatment,with a statistically significant difference(P<0.05);the study group showed higher 5-HIAA,NGF,and GABA levels than the control group,with a statistically significant difference(P<0.05).The incidence of adverse reactions did not differ significantly between the two groups during the treatment period,without a statistically significant difference(P>0.05).Conclusion Tianzhu Dingxuan decoction,as an adjuvant therapy,is effective in treating posterior circulation ischemic vertigo.It significantly alleviates vertigo symptoms,regulates levels of vasomotor factors and neurotransmitters,and is safe for use.