通督活血汤对椎动脉型颈椎病患者的临床疗效

Clinical effects of Tongdu Huoxue Decoction on patients with cervical spondylosis of vertebral artery type

目的考察通督活血汤对椎动脉型颈椎病患者的临床疗效。方法85例患者随机分为对照组(44例)和观察组(41例),对照组给予盐酸倍他司汀片,观察组在对照组基础上加用通督活血汤,疗程14 d。检测临床疗效、血流动力学指标(椎动脉阻力指数、椎动脉收缩期血流速度、椎动脉舒张期血流速度)、中医证候评分、疾病相关血清指标(NSE、NPY、NF-κB)、颈椎活动度指标(屈伸活动范围、颈椎弧度、椎体水平位移)、血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度)、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组椎动脉阻力指数、疾病相关血清指标、中医证候评分、椎体水平位移、血液流变学指标降低(P<0.05),椎动脉收缩期血流速度、椎动脉舒张期血流速度、屈伸活动范围、颈椎弧度升高(P<0.05),以观察组更明显(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论通督活血汤可安全有效地改善椎动脉型颈椎病患者中医证候评分和颈椎活动度,其机制可能为调节血液流变学、血流动力学、疾病相关血清指标。

AIM To investigate the clinical effects of Tongdu Huoxue Decoction on patients with cervical spondylosis of vertebral artery type.METHODS Eighty-five patients were randomly assigned into control group(44 cases)for 14-day administration of Betahistine Hydrochloride Tablets,and observation group(41 cases)for 14-day administration of both Tongdu Huoxue Decoction and Tongdu Huoxue Decoction.The changes in clinical effects,hemorheological indices(vertebral artery resistance index,vertebral artery systolic blood flow velocity,vertebral artery diastolic blood flow velocity),TCM syndrome scores,disease-related serum indices(NSE,NPY,NF-κB),cervical motion indices(flexion and extension range of motion,cervical curvature,horizontal vertebral displacement),hemodynamic indices(whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity)and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05).After the treatment,the two groups displayed decreased vertebral artery resistance index,disease-related serum indices,TCM syndrome scores,horizontal vertebral displacement,hemodynamic indices(P<0.05),and increased vertebral artery systolic blood flow velocity,vertebral artery diastolic blood flow velocity,flexion and extension range of motion,cervical curvature(P<0.05),especially for the observation group(P<0.05).No significant difference in incidence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with cervical spondylosis of vertebral artery type,Tongdu Huoxue Decoction can safely and effectively improve TCM syndrome scores and cervical motion,whose mechanisms may contribute to the regulation of hemorheology,hemodynamics and disease-related serum indices.