半夏白术天麻汤加减结合穴位手法推拿治疗颈性眩晕的临床研究

Clinical Study on Treatment of Patients with Cervical Vertigo with Banxia Baizhu Tianma Decoction Combined with Acupoint Manipulation Massage

目的:研究半夏白术天麻汤加减联合穴位手法推拿治疗颈性眩晕(CV)患者的临床疗效。方法:将100例CV患者按随机烽字表法分为对照组和观察组,对照组给予穴位手法推拿治疗,观察组在对照组基础上行半夏白术天麻汤加减治疗,比较2组治疗后的总有效率、临床症状评分、脑血流灌注状态指标、血液相关指标及不良反应发生率。结果:治疗后观察组的总有效率高于对照组,观察组治疗后的各临床症状评分高于对照组,观察组治疗后的局部血容量(rCBV)、局部血流量(rCBF)高于对照组,而平均通过时间(rMTT)及达峰时间(TTP)均低于对照组。观察组治疗后的内皮素-1(ET-1)、D-二聚体(DDi)水平低于对照组,而人降钙素基因相关肽(CGRP)水平高于对照组。2组不良反应发生率比较差异无统计学意义。结论:半夏白术天麻汤加减联合穴位手法推拿治疗可明显降低血液中DDi、ET-1水平,提高CGRP水平,从而改善CV患者的临床症状和脑血流灌注状态。

Objective:To study the clinical effect of Banxia Baizhu Tianma decoction combined with acupoint manipulation massage on patients with cervical vertigo(CV).Methods:100 cases of patients with CV were randomly divided into observation group and control group.The control group was given the treatment of acupoint manipulation massage,and the observation group were treated with modified Banxia Baizhu Tianma decoction on the basis of the control group.The total effective rate,clinical symptoms score,cerebral perfusion status,and related blood indexes were all compared between the two groups.The incidence of adverse reactions during treatment were compared between the two groups.Results:After treatment,the total effective rate in the observation group was significantly higher than that in the control group.The scores of vertigo,shoulder and neck pain and headache after treatment in observation groups were significantly higher than in control group.The regional blood volume(rCBV),regional blood flow(rCBF)levels in the observation group after treatment were significantly higher than the control group,while the mean transit time(rMTT)and peak time(TTP)levels in the observation group was lower than the control group.The endothelin-1(ET-1)and D-dimer(DDi)levels in the observation group was lower than those of the control group.But the level of human calcitonin gene-related peptide(CGRP)in the observation group was higher than that of the control group.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Banxia Baizhu Tianma decoction combined with acupoint manipulation massage can lower the level of DDi and ET-1 in the blood and raise the level of CGRP,thus improve the clinical symptoms and cerebral blood perfusion status.