芪地理归汤联合甲磺酸倍他司汀对后循环缺血性眩晕患者中医证候积分及脑血流动力学的影响

Effect of Qigegui decoction combined with betahistine mesylate on TCM syndrome score and cerebral hemodynamics in patients with posterior circulation ischemic vertigo

目的:探讨芪地理归汤、甲磺酸倍他司汀联合治疗后循环缺血性眩晕(PCIV)的临床疗效及其应用价值。方法:选取2021年9月至2023年9月于郑州市金水区总医院诊治的114例PCIV患者为研究对象,依据治疗方案不同分为单一组、联合组,每组各57例。单一组给予甲磺酸倍他司汀治疗,联合组给予芪地理归汤联合甲磺酸倍他司汀治疗,连续治疗8周。治疗8周后比较两组疗效。统计对比两组治疗前后中医证候积分、综合症状积分、眩晕障碍筛查量表(DHI-S)评分、脑血流动力学[平均血流速度(Vm)、血管搏动指数(PI)]、脑损伤指标[神经元特异性烯醇化酶(NSE)、S100钙结合蛋白B(S100B)、胶质纤维酸性蛋白因子(GFAP)]、血管内皮功能[一氧化氮(NO)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)]。比较两组不良反应与治疗后3个月内复发率。结果:联合组总有效率为92.98%,比单一组78.95%高(P<0.05);联合组治疗后中医证候积分、综合症状积分、DHI-S评分低于单一组(P<0.05);联合组治疗后Vm高于单一组,PI低于单一组(P<0.05);联合组治疗后血清NSE、S100B、GFAP水平低于单一组(P<0.05);联合组治疗后血清NO、CGRP水平高于单一组,血清ET-1水平低于单一组(P<0.05);联合组复发率5.26%低于单一组19.30%(P<0.05),两组不良反应无明显差异(P>0.05)。结论:芪地理归汤、甲磺酸倍他司汀联合治疗PCIV的疗效确切,可改善临床症状,促进脑组织血液循环,减轻脑组织损伤,保护血管内皮功能,降低复发率,且具有一定安全性。

Objective:To investigate the clinical efficacy and application value of Qigegui decoction combined with betahistine mesylate in the treatment of posterior circulation ischemic vertigo(PCIV).Methods:A total of 114 cases of PCIV patients treated in Zhengzhou Jinshui District General Hospital from September 2021 to September 2023 were retrospectively selected as the research objects,and they were divided into single group and combined group according to different treatment schemes,with 57 cases in each group.The single group was treated with betahistine mesylate,and the combined group was treated with Qigegui decoction combined with betahistine mesylate for 8 weeks.The curative effects of the two groups were compared after 8 weeks of treatment.The TCM syndrome score,comprehensive symptom score,screening version of the Dizziness Handicap Inventory(DHI-S)score,cerebral hemodynamics[mean blood flow velocity(Vm),vascular pulsatility index(PI)],brain injury indicators[neuron specific enolase(NSE),S100 calcium binding protein B(S100B),glial fibrillary acidic protein factor(GFAP)],vascular endothelial function[nitric oxide(NO),endothelin-1(ET-1),calcitonin gene-related peptide(CGRP)]were statistically compared between the two groups before and after treatment.The adverse reactions and recurrence rate within 3 months after treatment were compared between the two groups.Results:The total effective rate of the combined group was 92.98%,which was higher than 78.95%of the single group(P<0.05);after treatment,the TCM syndrome score,comprehensive symptom score and DHI-S score of the combined group were lower than those of the single group(P<0.05);after treatment,Vm in the combined group was higher than that in the single group,and PI was lower than that in the single group(P<0.05);after treatment,the serum levels of NSE,S100B,GFAP in the combined group were lower than those in the single group(P<0.05);after treatment,the serum levels of NO and CGRP in the combined group were higher than those in the single group,and the serum level of ET-1 was lower than that in the single group(P<0.05);the recurrence rate of the combined group was 5.26%,which was lower than 19.30%of the single group(P<0.05);there was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Qigegui decoction combined with betahistine mesylate in the treatment of PCIV has exact curative effect,can improve clinical symptoms,promote blood circulation of brain tissue,reduce brain tissue damage,protect vascular endothelial function,reduce the recurrence rate,and has certain safety.