早期针刺治疗对后循环缺血性眩晕痰浊上蒙证患者的疗效观察  

Effect of Early Acupuncture on Phlegm Syndrome of Vertigo Resulting from Posterior Circulation Ischemia

作　　者：李鑫[1] 张智龙[2] 许可[1] LI Xin;ZHANG Zhilong;XU Ke(Beichen Hospital of Traditional Chinese Medicine Affiliated to Tianjin University of Traditional Chinese Medicine,Tianjin 300400,China;Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine,Tianjin 300120,China)

机构地区：[1]天津市北辰区中医医院,天津300400 [2]天津市中医药研究院附属医院,天津300120

出　　处：《辽宁中医杂志》2023年第2期166-169,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局“十二五”重点专科培育项目;全国基层名老中医师承项目2015;天津市北辰区科委计划项目(2016-SHGY-16)。

摘　　要：目的 观察早期针刺治疗后循环缺血性眩晕痰浊上蒙证的临床疗效,探讨其可能机制。方法 选择后循环缺血性眩晕痰浊上蒙证患者60例,按随机数字表法随机分为针药组及西药组,每组各30例。西药组给予西比灵胶囊口服,每晚睡前服用1次,每次5 mg,针药组在西药组基础上采用调气化痰定眩法针刺,穴取中脘、丰隆、支沟、四神聪等,留针30 min, 1次/d,两组均持续治疗8周。观察两组患者治疗前后眩晕评估评分量表(dizziness assessment rating scale, DARS)评分,眩晕障碍评定量表(Dizziness Handicap Inventory, DHI)评分,检测大脑椎动脉(vertebral artery, VA)、基底动脉(basilar artery, BA)血流速度变化及中医证候积分,并判定临床疗效。结果 针药组总有效率为96.67%(29/30),西药组为73.33%(22/30),观察组优于对照组(P<0.01)。两组治疗后DARS评分、DHI评分、中医证候积分均较治疗前明显改善(P<0.01),且针药组优于西药组(P<0.01)。针药组治疗后双侧VA、BA血流速度较治疗前增快(P<0.01),且快于西药组(P<0.01)。结论 早期针刺治疗能改善后循环缺血性眩晕痰浊上蒙证患者的生活质量、临床表现,其机制可能与改善VA、BA血流速度、增加血流、提高脑灌注有关。Objective To observe the clinical efficacy of early acupuncture for phlegm syndrome of vertigo resulting from posterior circulation ischemia, and explore its possible mechanism.Methods A total of 60 patients with vertigo resulting from posterior circulation ischemia were randomized into an acupuncture combined with medication group(30 cases)and a western medication group(30 cases).In the western medication group, flunarizine capsules were given orally, one time before sleeping, 5 mg for each time.On the basis of the treatment in the western medication group, Acupuncture treatment for regulating Qi and resolving phlegm and relieving vertigo was applied at Zhongwan(CV12),Fenglong(ST40)and Zhigou(TE6),Sishencong(EX-HN1)in the acupuncture combined with medication group, 30 min for each time, once a day.The treatment was given 8 weeks in both groups.Before and after treatment, the scores of dizziness assessment rating scale(DARS),Dizziness Handicap Inventory(DHI),blood flow velocity of vertebral artery(VA)and basilar artery(BA)were detected, and the clinical efficacy was evaluated in the two groups.Results The total effective rate was 96.67%(29/30)in the acupuncture combined with medication group, which was superior to 73.33%(22/30)in the western medication group(P<0.01).Compared with those before treatment, the total scores of DARS,DHI scores and TCM syndrome scores after treatment were improved in the two groups(P<0.01),and the scores in the acupuncture combined with medication group were superior to those in the western medication group(P<0.01).After treatment, the blood flow velocity of bilateral VA and BA were increased in the acupuncture combined with medication group(P<0.01),which was faster than that of the western medication group(P<0.01).Conclusion Early acupuncture could improve the quality of life and clinical manifestations in patients with phlegm syndrome of vertigo resulting from posterior circulation ischemia, its mechanism may be related to improving the blood flow velocity of VA and BA,promoting bloo

关 键 词：后循环缺血性眩晕 痰浊上蒙证 针刺疗法 

分 类 号：R255.3[医药卫生—中医内科学]