化痰清眩汤联合前列地尔治疗血管源性眩晕的疗效及其对脑血流灌注和血管内皮功能的影响研究  

Effect of Huatan Qingxuan Decoction Combined with Alprostadil in the Treatment of Vascular Vertigo and Its Impact on Cerebral Blood Perfusion and Vascular Endothelial Function

作　　者：吴悦 季宏 陈华山 马胜民 WU Yue;JI Hong;CHEN Huashan;MA Shengmin(Department of Otolaryngology,Shanghai Traditional Chinese Medicine Hospital of Fengxian District,Shanghai 201499,China)

机构地区：[1]上海市奉贤区中医医院耳鼻喉科,201499

出　　处：《实用心脑肺血管病杂志》2020年第8期110-115,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景血管源性眩晕发病率近年呈上升趋势,占眩晕的50%以上。血管源性眩晕的西药治疗以对症治疗为主,但长期用药会引起不良反应。目的探讨化痰清眩汤联合前列地尔治疗血管源性眩晕的疗效及其对脑血流灌注和血管内皮功能的影响。方法选择2016—2019年在上海市奉贤区中医医院就诊的血管源性眩晕患者102例为研究对象。按照随机数字表法将患者分为观察组和对照组,各51例。对照组予以前列地尔治疗,观察组在对照组的基础上予以化痰清眩汤治疗,均治疗4周。观察并比较两组疗效和治疗前后中医证候积分、眩晕评定量表的评分系统(DARS)评分、眩晕障碍量表(DHI)评分、血液流变学指标(包括全血高切黏度、全血低切黏度、血浆黏度、血细胞比容)、脑血流灌注指标[包括左侧椎动脉(LVA)血流速度、右侧椎动脉(RVA)血流速度、基底动脉(BA)血流速度、BA阻力指数]、血管内皮功能指标[包括内皮素1(ET-1)、降钙素基因相关肽(CGRP)、羧甲基赖氨酸(CML)、氧化修饰的低密度脂蛋白(ox-LDL)]及治疗期间不良反应发生率。结果观察组总有效率[96.1%(49/51)]高于对照组[80.4%(41/51)](P<0.05)。治疗后,观察组中医证候积分、DARS评分、DHI评分低于对照组(P<0.05)。对照组、观察组治疗后中医证候积分、DARS评分、DHI评分分别低于本组治疗前(P<0.05)。治疗后,观察组全血高切黏度、全血低切黏度、血浆黏度、血细胞比容低于对照组(P<0.05)。对照组、观察组治疗后全血高切黏度、全血低切黏度、血浆黏度、血细胞比容分别低于本组治疗前(P<0.05)。治疗后,观察组LVA血流速度、RVA血流速度、BA血流速度快于对照组,BA阻力指数低于对照组(P<0.05)。对照组、观察组治疗后LVA血流速度、RVA血流速度、BA血流速度分别快于本组治疗前,BA阻力指数分别低于本组治疗前(P<0.05)。治疗后,观察组ET-1、CML、oxLBackground The incidence of vascular vertigo is increasing in recent years,accounting for more than 50%of vertigo.The western medicine treatment is mainly symptomatic treatment of vasogenic vertigo,but long-term medication will cause adverse reactions.Objective To explore the effect of Huatan Qingxuan Decoction combined with alprostadil in the treatment of vascular vertigo and its impact on cerebral blood perfusion and vascular endothelial function.Methods 102 patients with vascular vertigo who were treated in the Shanghai Traditional Chinese Medicine Hospital of Fengxian District from 2016 to 2019 were selected as the research subjects.The patients were divided into observation group and control group according to the random number table method,with 51 cases in each group.The control group was treated with alprostadil,and the observation group was treated with Huatan Qingxuan Decoction on the basis of the control group,both groups were treated for 4 weeks.The efficacy,TCM symptom score,DARS score,DHI score,hemorheology indicators(including whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and hematocrit),cerebral blood perfusion indicators(including LVA blood flow velocity,RVA blood flow velocity,BA blood flow speed,BA RI)and vascular endothelial function indicators(including ET-1,CGRP,CML,ox-LDL)before and after treatment,and the incidence of adverse reactions were observed and compared between the two groups.Results The total effective rate in observation group[96.1%(49/51)]was higher compared with the control group[80.4%(41/51)](P<0.05).After treatment,the TCM symptom score,DARS score,and DHI score in observation group were lower than those in control group(P<0.05).The TCM symptom score,DARS score and DHI score after treatment in control group and observation group were lower than those before treatment,respectively(P<0.05).After treatment,the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,and hematocrit in observation group were lower than th

关 键 词：眩晕 血管源性眩晕 化痰清眩汤 前列地尔 治疗结果 血流灌注 脑 血管内皮功能 

分 类 号：R255.3[医药卫生—中医内科学]