益气聪明汤加减联合盐酸氟桂利嗪治疗后循环缺血性眩晕疗效观察

Clinical observation on modified Yiqi Congming Decoction combined with flunarizine hydrochloride in treatment of post-stroke ischemic vertigo

目的观察益气聪明汤加减联合盐酸氟桂利嗪治疗后循环缺血性眩晕(PCIV)临床疗效。方法将我院94例PCIV患者随机分为对照组与观察组各47例。对照组服用盐酸氟桂利嗪治疗,观察组在对照组的治疗基础上联用益气聪明汤加减。比较两组总有效率,眩晕分级,眩晕残障评定量表(DHI)评分,左椎动脉平均血流速度(LVAVm)、右椎动脉平均血流速度(RVAVm)、基底动脉血流速度(BAVm),血浆黏度(PV)、红细胞聚集指数(RBCAI)、纤维蛋白原(FIB),同型半胱氨酸(Hcy)、超氧化物歧化酶(SOD)、超敏C反应蛋白(hs-CRP)、一氧化氮(NO)水平以及复发率。结果治疗后,观察组总有效率高于对照组(P<0.05);两组眩晕分级轻于治疗前,观察组眩晕分级轻于对照组(P<0.05);两组DHI评分低于治疗前,观察组DHI评分低于对照组(P<0.05);两组LVAVm、RVAVm、BAVm高于治疗前,LVARI、RVARI、BAVRI低于治疗前;观察组LVAVm、RVAVm、BAVm高于对照组,LVARI、RVARI、BAVRI低于对照组(P<0.05);两组PV、RBCAI、FIB低于治疗前,观察组PV、RBCAI、FIB低于对照组(P<0.05);两组Hcy、hs-CRP水平低于治疗前,SOD、NO水平高于治疗前;观察组Hcy、hs-CRP水平低于对照组,SOD、NO水平高于对照组(P<0.05);观察组复发率低于对照组(P<0.05)。结论益气聪明汤加减联合盐酸氟桂利嗪治疗PCIV疗效较好,能够加快椎基底动脉血流,降低椎基底动脉搏动指数,减轻眩晕症状,改善血流动力学指标,调节Hcy、SOD、hs-CRP、NO水平,减少复发情况。

Objective To observe the therapeutic effect of modified Yiqi Congming Decoction combined with flunarizine hydrochloride in treatment of posterior circulation ischemic vertigo(PCIV).Methods Ninety-four PCIV patients were randomly divided into control group and observation group,with 47 cases in each group.Control group was treated with flunarizine hydrochloride,while observation group was treated with modified Yiqi Congming Decoction on the basis of control group.Compared the total effective rates of two groups,including Dizziness Disability Assessment Scale(DHI)score,left vertebral artery mean blood flow velocity(LVAVm),right vertebral artery mean blood flow velocity(RVAVm),basilar artery blood flow velocity(BAVm),dizziness grading,plasma viscosity(PV),red blood cell aggregation index(RBCAI),fibrinogen(FIB),homocysteine(Hcy),superoxide dismutase(SOD),high-sensitivity C-reactive protein(hs-CRP),nitric oxide(NO)levels and the recurrence rates.Results After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);the dizziness grades of both groups were milder than before treatment,and were milder in observation group than control group(P<0.05);the DHI scores of both groups were lower than before treatment,and was lower in observation group than control group(P<0.05);LVAVm,RVAVm,and BAVm in both groups were higher than before treatment,while LVARI,RVARI,and BAVRI were lower,the above indicators were superior in observation group to those in control group(P<0.05);PV,RBCAI and FIB in both groups were lower than before treatment,and were lower in observation group than control group(P<0.05);Hcy and hs-CRP levels in both groups were lower than before treatment,while SOD and NO levels were higher,the above indicators were superior in observation group to those in control group(P<0.05);the recurrence rate of observation group was lower than that of control group(P<0.05).Conclusion Modified Yiqi Congming Decoction combined with flunarizine hydrochloride has a good therapeutic effect on PCIV,which can accelerate the blood flow of the vertebral basilar artery,reduce the pulsatility index of the vertebral basilar artery,alleviate dizziness symptoms,improve hemodynamic indicators,regulate Hcy,SOD,hs CRP,and NO levels,and reduce recurrence.