苓桂术甘汤合桂附地黄丸加减治疗脑动脉供血不足性眩晕临床研究  

Clinical Study on Modified Linggui Zhugan Decoction Combined with Guifu Dihuang Pills for Vertigo Due to Insufficiency of Cerebral Arterial Blood Supply

作　　者：张成明 詹根龙 徐庆 郑雯 陈博[2] ZHANG Chengming;ZHAN Genlong;XU Qing;ZHENG Wen;CHEN Bo(Zhejiang Quhua Hospital,Quzhou Zhejiang 324000,China;Tongde Hospital of Zhejiang Province,Hangzhou Zhejiang 310012,China)

机构地区：[1]浙江衢化医院,浙江衢州324000 [2]浙江省立同德医院,浙江杭州310012

出　　处：《新中医》2023年第16期10-15,共6页New Chinese Medicine

摘　　要：目的:观察苓桂术甘汤合桂附地黄丸加减治疗脑动脉供血不足性眩晕脾肾阳虚证的临床疗效。方法:选取102例脑动脉供血不足性眩晕脾肾阳虚证患者,按随机数字表法分为观察组和对照组各51例。对照组给予盐酸氟桂利嗪胶囊治疗,观察组在对照组基础上加用苓桂术甘汤合桂附地黄丸加减治疗,2组均治疗4周。比较2组临床疗效,中医证候积分,欧洲眩晕评分量表(EEV)、眩晕障碍量表(DHI)评分,脑血流指标,血清血栓素B2 (TXB2)、白细胞介素-6 (IL-6)水平。结果:治疗后,观察组临床疗效总有效率92.16%,高于对照组76.47%(P<0.05)。2组主症、次症积分及中医证候总分均较治疗前降低(P<0.05),观察组主症、次症积分及中医证候总分均低于对照组(P<0.05)。2组EEV、DHI评分均较治疗前降低(P<0.05),观察组EEV、DHI评分均低于对照组(P<0.05)。2组双侧椎动脉和基底动脉收缩期血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)均较治疗前升高(P<0.05),脑平均血流量均较治疗前增加(P<0.05);观察组双侧椎动脉和基底动脉Vs、Vd、Vm均高于对照组(P<0.05),脑平均血流量大于对照组(P<0.05)。2组血清TXB2、IL-6水平均较治疗前降低(P<0.05),观察组血清TXB2、IL-6水平均低于对照组(P<0.05)。结论:苓桂术甘汤合桂附地黄丸加减治疗脑动脉供血不足性眩晕脾肾阳虚证,可有效缓解患者的眩晕,改善其脑血流指标,降低血清TXB2、IL-6水平。Objective:To observe the clinical effect of modified Linggui Zhugan Decoction combined with Guifu Dihuang Pills on vertigo with spleen-kidney yang deficiency syndrome due to insufficiency of cerebral arterial blood supply.Methods:A total of 102 patients with vertigo with spleen-kidney yang deficiency syndrome due to insufficiency of cerebral arterial blood supply were selected and divided into the observation group and the control group according to the random number table method,with 51 cases in each group.The control group was given Flunarizine Hydrochloride Capsules for treatment,and the observation group was additionally treated with modified Linggui Zhugan Decoction combined with Guifu Dihuang Pills based on the treatment of the control group.Both groups were treated for 4 weeks.The clinical effects,traditional Chinese medicine(TCM)syndrome scores,scores of European Evaluation of Vertigo(EEV)and Dizziness Handicap Inventory(DHI),indexes of cerebral blood flow,and levels of serum thromboxane B2(TXB2)and interleukin-6(IL-6)were compared between the two groups.Results:After treatment,the total clinical effective rate was 92.16%in the observation group,higher than that of 76.47%in the control group(P<0.05).The scores of primary and secondary symptoms as well as the total scores of TCM syndrome in both groups were decreased when compared with those before treatment(P<0.05),and the above three scores in the observation group were lower than those in the control group(P<0.05).The scores of EEV and DHI in the two groups were decreased when compared with those before treatment(P<0.05),and the above two scores in the observation group were lower than those in the control group(P<0.05).The systolic velocity(Vs),diastolic velocity(Vd),and mean velocity(Vm)of bilateral vertebral and basilar arteries in both groups were increased when compared with those before treatment(P<0.05),and the average cerebral blood flow was increased when compared with that before treatment(P<0.05);the Vs,Vd,and Vm of bilateral vertebral and ba

关 键 词：脑动脉供血不足性眩晕 脾肾阳虚证 苓桂术甘汤 桂附地黄丸 中医证候 脑血流指标 血栓素B2 白细胞介素-6 

分 类 号：R255.3[医药卫生—中医内科学]