丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕临床研究  

Clinical Study on Danshen Chuanxiongqin Combined with Alprostadil for Posterior Circulation Ischemic Vertigo

作　　者：王希瑞[1] 周正谦 WANG Xirui;ZHOU Zhengqian

机构地区：[1]南阳市第一人民医院中医门诊,河南南阳473000 [2]南阳市中心医院神经内科,河南南阳473003

出　　处：《新中医》2021年第5期70-75,共6页New Chinese Medicine

基　　金：2018年度河南省医学科技攻关计划项目(2018051126)。

摘　　要：目的:观察丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕的效果及对患者血液动力学和血液流变学的影响。方法:选取110例后循环缺血性眩晕患者,按随机数字表法分为对照组和研究组各55例。对照组给予神经内科常规药物治疗,研究组在对照组基础上给予丹参川芎嗪联合前列地尔治疗。比较2组临床疗效,检测血液动力学指标[基底动脉(BA)、左椎动脉(LVA)、右椎动脉(RVA)血流速度及阻力系数(RI)]、血液流变学指标[血浆黏度(PV)、红细胞压积(PCV)、全血低切黏度、全血高切黏度]、凝血功能指标[纤维蛋白原(FIB)、凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)]、血清指标[内皮素-1 (ET-1)、降钙素基因相关肽(CGRP)及ET-1/CGRP比值],采用眩晕障碍量表筛查表(DHI-S)及眩晕量表(DARS)评价2组的眩晕症状。结果:研究组恶心呕吐、眩晕头痛、共济失调、平衡障碍等临床症状消除时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,2组BA、LVA、RVA血流速度较治疗前明显升高,RI较治疗前明显降低,且研究组各指标更优于对照组,差异均有统计学意义(P<0.05)。治疗后,2组PV、PCV、全血低切黏度、全血高切黏度均较治疗前降低,且研究组PV、PCV、全血低切黏度、全血高切黏度均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组PT及APTT水平较治疗前升高,FIB较治疗前降低,且研究组各项指标均优于对照组,差异均有统计学意义(P<0.05)。治疗后,2组ET-1及ET-1/CGRP较治疗前明显降低,CGRP较治疗前明显升高,且研究组各项指标明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,2组DHI-S及DARS评分均较治疗前明显降低,且研究组DHI-S及DARS评分低于对照组,差异均有统计学意义(P<0.05)。结论:丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕可促进患者临床症状迅速转归,改善血液动力学、血液流变学Objective:To observe the curative effect of Danshen Chuanxiongqin combined with alprostadil for posterior circulation ischemic vertigo and its effect on hemodynamics and hemorheology. Methods: A total of 110 cases of patients with posterior circulation ischemic vertigo were selected and divided into the control group and the study group according to the random number table method, 55 cases in each group. The control group was given routine medicine treatment of neurology, and the study group was additionally given Danshen Chuanxiongqin combined with alprostadil based on the treatment of the control group. The clinical effect was compared between the two groups. The differences in the hemodynamics indexes [blood flow velocity of basilar artery(BA),left vertebral artery(LVA),right vertebral artery(RVA),and resistance index(RI)],the hemodynamics indexes [plasma viscosity(PV),packet cell volume(PCV),whole blood viscosity at low shear and high shear], indexes of blood coagulation function [fibrinogen(FIB), prothrombin time(PT), and activated partial thromboplastin time(APTT), and the serum indexes [endothelin-1(ET-1), calcitonin gene-related peptide(CGRP),and the ratio of ET-1 to CGRP] were detected. Dizziness Handicap Inventory-Screening(DHI-S) and Dizziness Assessment Rating Scale(DARS) were applied to evaluating the vertigo symptoms in the two groups. Results: The elimination time of nausea and vomiting,vertigo and headache,ataxia,and disequilibrium in the study group was earlier than that in the control group,differences being significant(P<0.05). After treatment,blood flow velocity of BA,LVA,and RVA in the two groups were significantly increased when compared with those before treatment,and RI was significantly decreased;each index above in the study group was better than that in the control group,differences being significant(P<0.05). After treatment,PV,PCV,and whole blood viscosity at low shear and high shear in the two groups were decreased when compared with those before treatment, and the four indexes above

关 键 词：后循环缺血性眩晕 丹参川芎嗪 前列地尔 血液动力学 血液流变学 凝血功能 眩晕障碍量表筛查表 

分 类 号：R441.2[医药卫生—诊断学]