通督调任针刺法联合益气聪明汤加味治疗气血亏虚型眩晕疗效观察

Efficacy of Tongdu Tiaoren acupuncture combined with modified Yiqi Congming Decoction in the treatment of dizziness due to Qi and blood deficiency

目的 观察通督调任针刺法联合益气聪明汤加味对气血亏虚型眩晕患者的治疗效果。方法 选取2021年2月至2024年2月河南省职工医院收治的90例气血亏虚型眩晕患者作为研究对象,按随机数表法分为观察组和对照组,每组45例。对照组患者给予常规西药治疗,观察组患者在常规西药治疗的基础上加用通督调任针刺法及益气聪明汤加味。治疗周期为4周。比较两组患者的治疗效果,以及治疗前后的平衡能力和眩晕程度[Berg平衡表(BBS)、眩晕评估评分量表(DARS)]、中医症状积分[眩晕、头部沉重感、恶心呕吐评分]、脑血流速度[椎基底动脉(BA)、左椎动脉(LVA)、右椎动脉(RVA)血流速度]和生活质量[眩晕残障程度评定量表(DHI)]。结果 观察组患者的治疗总有效率为97.78%,明显高于对照组的75.56%,差异有统计学意义(P<0.05);治疗后,观察组患者的BBS评分为(46.21±4.05)分,明显高于对照组的(44.98±4.21)分,DARS评分为(2.79±0.67)分,明显低于对照组的(3.68±1.09)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的眩晕、头部沉重感、恶心呕吐症状积分分别为(2.07±0.76)分、(2.06±0.74)分、(2.04±0.69)分,明显低于对照组的(2.93±0.77)分、(2.99±0.71)分、(2.88±0.78)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的BA和RVA血流速度分别为(32.03±3.44) cm/s、(29.93±3.22) cm/s,明显快于对照组的(29.74±3.37) cm/s、(27.80±3.23) cm/s,差异均有统计学意义(P<0.05);治疗2周、4周后,观察组患者的情感、功能、躯体的评分明显低于对照组,差异均有统计学意义(P<0.05)。结论 通督调任针刺法联合益气聪明汤加味治疗气血亏虚型眩晕效果优于单纯西药治疗,其能显著改善患者的眩晕症状和中医症状积分,提高生活质量。

Objective To observe the therapeutic effect of Tongdu Tiaoren acupuncture combined with modified Yiqi Congming Decoction in the treatment of dizziness due to Qi and blood deficiency.Methods A total of 90 patients with dizziness due to Qi and blood deficiency admitted to Henan General Hospital from February 2021 to February 2024 were selected and randomly divided into an observation group and a control group,with 45 patients in each group.Patients in the control group received conventional Western medicine treatment,while those in the observation group received Tongdu Tiaoren acupuncture and modified Yiqi Congming Decoction in addition to conventional Western medicine.The treatment lasted for 4 weeks.The clinical efficacy,balance ability and dizziness scores(Berg Balance Scale[BBS],Dizziness Assessment Rating Scale[DARS]),Traditional Chinese Medicine(TCM)symptom scores(dizziness,heavy head sensation,nausea and vomiting scores),cerebral blood flow velocity(basilar artery[BA],left vertebral artery[LVA],right vertebral artery[RVA]),and quality of life(Dizziness Handicap Inventory[DHI])were compared between the two groups before and after treatment.Results The overall effective rate of treatment in the observation group was 97.78%,significantly higher than 75.56%in the control group(P<0.05).After treatment,the BBS score of the observation group was(46.21±4.05)points,which was significantly higher than(44.98±4.21)points of the control group;the DARS score of the observation group was(2.79±0.67)points,which was significantly lower than(3.68±1.09)points of the control group (P<0.05). After treatment, the scores for dizziness, heavy head sensation, and nausea and vomiting in the observation group were (2.07±0.76) points, (2.06±0.74) points, and (2.04±0.69) points, respectively, which were signifi-cantly lower than (2.93±0.77) points, (2.99±0.71) points, (2.88±0.78) points in the control group (P<0.05). The blood flow velocities of BA and RVA in the observation group after treatment were (32.03±3.44) cm/s and (29.93±3.22) cm/s, respectively, which were significantly higher than (29.74 ±3.37) cm/s and (27.80± 3.23) cm/s in the control group (P< 0.05). At 2 weeks and 4 weeks after treatment, the emotional, functional, and physical scores of the observation group were significantly lower than those of the control group (P<0.05). Conclusion Tongdu Tiaoren acupuncture combined with modified Yiqi Congming Decoction is more effective than conventional Western medicine alone for the treatment of dizziness due to Qi and blood deficiency. It can significantly improve dizziness symptoms, reduce TCM symptom scores, and enhance quality of life.