半夏白术天麻汤加减治疗椎-基底动脉供血不足性眩晕60例临床研究  

A Clinical Observation on Modified Banxia Baizhu Tianma Decoction for 60 Cases of Vertebrobasilar Insufficiency-Associated Vertigo

作　　者：孔亮 狄美琪 李超生 顾俊泉 王挺刚 桂树华 

机构地区：[1]无锡市中西医结合医院神经内科

出　　处：《中医杂志》2013年第4期315-317,共3页Journal of Traditional Chinese Medicine

摘　　要：目的观察半夏白术天麻汤加减治疗椎-基底动脉供血不足(VBI)性眩晕的临床疗效并探讨其作用机制。方法 120例VBI患者随机分为治疗组(60例)和对照组(60例)。对照组给予倍他司汀片和胞磷胆碱钠注射液等西医常规治疗,治疗组在对照组治疗基础上加服半夏白术天麻汤加减,两组患者均以14天为1个疗程,连续治疗两个疗程后观察疗效。治疗前后两组患者应用经颅多普勒(TCD)分别检测椎动脉(VA)、基底动脉(BA)的收缩峰血流速度(Vp)、舒张末期血流速度(Vd)、平均血流速度(Vm)并检测血液流变学的变化。结果治疗组、对照组的总有效率分别为90.0%、73.3%,两组比较差异有统计学意义(P<0.05);治疗后两组患者Vp、Vd和Vm较治疗前均有显著提高(P<0.01);两组治疗后比较,治疗组的Vd、Vm均高于对照组(P<0.01),但治疗后两组Vp比较差异无统计学意义(P>0.05)。治疗组治疗后较治疗前血液流变学各指标均有明显改善(P<0.01),对照组治疗前后无明显变化(P>0.05);两组治疗后比较,血液流变学各指标改善治疗组明显优于对照组(P<0.01)。结论半夏白术天麻汤对VBI性眩晕具有良好的治疗效果,其作用机制可能与改善患者的血液流变学、提高Vd和Vm有关。Objective To observe the therapeutic effect and mechanism of modified Banxia Baizhu Tianma Decoction EPinel- lia, White Atractylodes and Gastrodia Decoction, decoction of Banxia （Rhizoma Pinelliae）, Baizhu （Rhizoma Atractylodis Macrocephalae） and Tianma （Rhizoma Gastrodiae）＇] for vertebrobasilar insufficiency （VBI）-associated vertigo. Methods To- tally 120 cases of VBI were randomized into the treatment group and control group, with 60 in each. Both groups were given betahistine and citieoline sodium on the basis of routine treatment. The treatment group was added with modified Banxia Baizhu Tianma Decoction. One treatment course lasted for 14 days. The therapeutic effect was observed after 2 treatment courses. The peak-systolic velocity （Vp）, end-diastolic velocity （Vd） and mean velocity （Vm） of vertebral artery （VA） and basilar ar- tery （BA） were examined with transcranial doppler （TCD） before and after treatment. The change of hemorheology was detec- ted. Results The total effective rate of the treatment group and control group was 90.00~ and 73.3~//oo respectively, with a significant difference between groups （P^0.05）. The Vp, Vd and Vm were significantly increased in both groups after treat- ment （P%0.01）. The Vd and Vm in the treatment group were significantly higher than those in the control group after treat- ment （P^0.01）. There was no significant difference between groups in the Vp after treatment （P^0.05）. The hemorheologi- cal indexes were significantly improved in the treatment group after treatment （P%0.01）. There was no significant difference in hemorheological indexes between before and after treatment in the control group （P^0. 05）. Comparing with the control group, the hemorheological indexes were significantly improved in the treatment group after treatment （P〈 0. 01 ）. Conclusion Banxia Baizhu Tianma Decoction is effective for VBI-associated vertigo. The mechanism may be related to improving hemorheology and increasing Vd

关 键 词：半夏白术天麻汤 椎基底动脉供血不足 眩晕 经颅多普勒 血液流变学 

分 类 号：R285.6[医药卫生—中药学]