针刺联合加味半夏白术汤改善良性阵发性眩晕的机制研究  

Effects and Mechanism of Acupuncture Combined with Modified Banxia Baizhu Tianma Decoction on Benign Paroxysmal Positional Vertigo Based on The Level of Monoamine Neurotransmitters

作　　者：吴淑君 王宝爱 符文雄 WU Shu-jun;WANG Bao-ai;FU Wen-xiong(Haikou Traditional Chinese Medicine Hospital,Haikou 570216,China)

机构地区：[1]海口市中医医院,海口

出　　处：《中国中医基础医学杂志》2021年第4期634-637,共4页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：海南省自然科学基金青年基金项目(818QN324)-半夏白术天麻汤联合G-Force眩晕综合诊疗系统治疗良性阵发性位置性眩晕的临床研究。

摘　　要：目的:观察针刺联合加味半夏白术天麻汤对良性阵发性位置性眩晕(BPPV)患者单胺类神经递质水平的影响,探讨其可能的作用机制。方法:收集2017年6月至2019年3月我院眩晕疾病科门诊及住院部收治的BPPV患者68例,随机分为观察组和对照组各34例,对照组以加味半夏白术天麻汤治疗,观察组以针刺联合加味半夏白术天麻汤,疗程2周。评价2组患者治疗前后眩晕障碍量表(dizziness handicap inventory,DHI)、视觉模拟评分(visuo-analogic scale,VAS)、眩晕病临床证候积分表,并比较2组疗效;检测患者血清5-羟色胺(5-Hydroxytryptophan,5-HT)、多巴胺(dopamine,DA)、去甲肾上腺素(noradrenalin,NE)及其代谢物高香草酸(high vanilic acid,HVA)、3-甲氧基-4-羟基苯乙醇(3-methoxyl-4-hydroxyphenylethanol,MHPG)、5-羟吲哚醋酸(5-hydroxyindole acetic acid,5-HIAA)和3,4-双羟苯乙酸(3,4-dihydroxyphenylacetic acid,DOPAC)。结果:观察组DHI躯体评分(physical score,P)、功能评分(functional score,F)、情绪评分(emotional score,E)、总评分均显著优于对照组,VAS显示观察组主观头晕分值和头晕程度方面疗效显著优于对照组,眩晕临床证候积分显示观察组患者中医临床证候疗效显著优于对照组,观察组总有效率为91.2%,显著优于对照组73.5%。与对照组比较观察组血清NE、DA、5-HT水平显著升高,血清代谢物MHPG、DOPAC、5-HIAA水平显著升高,HVA水平显著降低。结论:针刺联合加味半夏白术天麻汤治疗良性阵发性位置性眩晕临床效果良好,能显著改善患者头晕症状,其作用机制可能是通过调节BPPV患者单胺类神经递质水平来实现的。Objective:To investigate the effects of acupuncture combined with modified Banxia Baizhu Tianma decoction on the level of monoamine neurotransmitters in patients with benign paroxysmal positional vertigo.Methods:Between June 2017 to March 2019,68 patients with benign paroxysmal positional vertigo admitted to our hospital were collected,they were randomly divided into observation group and the control group(n=34),The control group were treated with modified Banxia Baizhu Tianma decoction,while the observation group were treated with acupuncture combined with modified Banxia Baizhu Tianma decoction for 2 weeks.The DHI,VAS and the Dizziness Clinical Symptom Score(DCSC)were evaluated.The curative effects of TCM syndromes were compared between the two groups;and the serum 5-HT,DA,NE and their corresponding metabolites,including HVA,MHPG,5-HIAA and DOPAC were detected.Results:In the observation group,the P,F,E and total score of the DHI were significantly better than those in the control group.The VAS showed that the subjective dizziness score and dizziness were significantly better than those in the control group.The DCSC showed that curative effect of TCM clinical syndrome were significantly better than those in the control group.The total effective rate was 91.2%in the observation group and 73.5%in the control group.Compared with the control group,serum 5-HT,NE,DA levels significantly increased in the observation group,serum metabolites MHPG,DOPAC and 5-HIAA levels significantly increased,and HVA levels significantly decreased in the observation group.Conclusion:Acupuncture combined with modified Banxia Baizhu Tianma decoction have a good clinical effect in the treatment of benign paroxysmal positional vertigo,it can significantly improve the symptoms of dizziness in patients,the mechanism may be achieved by regulating the level of monoamine neurotransmitters.

关 键 词：针刺 加味半夏白术天麻汤 单胺类神经递质 良性阵发性位置性眩晕 

分 类 号：R245.31[医药卫生—针灸推拿学]