加味祛风定晕汤联合针刺对风阳上扰型前庭神经炎患者眩晕、前庭损伤的改善作用及对平衡功能、脑血流速度和ET-1、25OHD_(3)的影响  

Improvement of Modified Qufeng Dingyun Decoction Combined with Acupuncture on Vertigo and Vestibular Injury and Its Effects on Balance Function,Cerebral Blood Flow Velocity and ET-1,25OHD_(3) Levels in Patients with Vestibular Neuritis of Fengyang Shangrao Syndrome

作　　者：宋温婷 唐静 刘丽杰 SONG Wenting;TANG Jing;LIU Lijie(Dept.of Cardiology,Shijiazhuang Central Hospital,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中心医院心病二科,石家庄050000

出　　处：《中国医院用药评价与分析》2023年第11期1321-1325,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省中医药管理局科研计划项目(No.2022466)。

摘　　要：目的:观察加味祛风定晕汤联合针刺对风阳上扰型前庭神经炎患者眩晕、前庭损伤的改善作用及对平衡功能、脑血流速度和内皮素1(ET-1)、25羟维生素D3(25OHD_(3))的影响。方法:选择2020年1月至2022年5月该院前庭神经炎患者100例,根据随机数字表法分组,50例患者为单一治疗组,给予加味祛风定晕汤治疗;50例患者为联合治疗组,给予加味祛风定晕汤联合针刺治疗。治疗前后检测两组患者ET-1、肿瘤坏死因子α(TNF-α)、血管性血友病因子(vWF)、C反应蛋白(CRP)、超氧化物歧化酶(SOD)和25OHD_(3)水平,检查患者右椎动脉(RVA)、左椎动脉(LVA)和基底动脉(BA)血流速度,采用视频头脉冲试验(vHIT)检测vHIT增益异常半规管平均增益,并进行日常活动前庭功能障碍等级(VADL)、眩晕评估评分量表(DARS)、Berg平衡量表(BBS)和眩晕障碍量表(DHI)评价,比较两组患者的临床疗效。结果:治疗后,联合治疗组患者的CRP、TNF-α水平较单一治疗组明显降低,SOD、25OHD_(3)水平较单一治疗组明显升高,ET-1、vWF水平较单一治疗组明显降低,RVA、LVA和BA血流速度较单一治疗组更快,vHIT增益异常半规管平均增益较单一治疗组明显升高,差异均有统计学意义(P<0.05)。治疗后,联合治疗组患者的VADL评分较单一治疗组明显降低,DARS、DHI评分较单一治疗组降低,BBS评分较单一治疗组升高,差异均有统计学意义(P<0.05)。联合治疗组患者的总有效率为98.00%(49/50),高于单一治疗组的84.00%(42/50),差异有统计学意义(P<0.05)。结论:加味祛风定晕汤治疗风阳上扰型前庭神经炎,可降低患者CRP、TNF-α水平,提高SOD、25OHD_(3)水平,抑制机体炎症,减少氧化应激及血管内皮损伤,改善脑血流速度,提升前庭功能,缓解眩晕症状,提高临床疗效、平衡能力及生活质量;加味祛风定晕汤联合针刺治疗可增强上述疗效,缓解临床症状。OBJECTIVE:To observe the improvement of modified Qufeng Dingyun decoction combined with acupuncture on vertigo and vestibular injury and its effects on balance function,cerebral blood flow velocity and endothelin 1(ET-1),25-hydroxyvitamin D 3(25OHD_(3))levels in patients with vestibular neuritis of Fengyang Shangrao syndrome.METHODS:A total of 100 patients with vestibular neuritis admitted into this hospital from Jan.2020 to May 2022 were selected,according to the random number table method,50 patients received modified Qufeng Dingyun decoction were set as monotherapy group;another 50 patients received modified Qufeng Dingyun decoction combined with acupuncture were set as combined treatment group.Before and after treatment,the ET-1,tumor necrosis factorα(TNF-α),von Willebrand factor(vWF),C reactive protein(CRP),superoxide dismutase(SOD)and 25OHD_(3) levels of both groups were measured,the blood flow velocities of right vertebral artery(RVA),left vertebral artery(LVA)and basilar artery(BA)were detected,the average semicircular canal gain of abnormal vHIT gain was conducted by using video head impulse test(vHIT),the vestibular dysfunction in daily activities(VADL),dizziness assessment rating scale(DARS),Berg balance scale(BBS)and vertigo handicap inventory(DHI)were performed,so that the clinical efficacy was compared between two groups.RESULTS:After treatment,the CRP and TNF-αlevels were significantly lower,the SOD and 25OHD_(3) levels were significantly higher,the ET-1 and vWF levels were significantly lower,the blood flow velocities of RVA,LVA and BA were significantly faster,and the average semicircular canal gain of abnormal vHIT gain was significantly higher in the combined treatment group than those in the monotherapy group,with statistically significant differences(P<0.05).After treatment,the VADL score was significantly lower,the DARS and DHI scores were significantly lower,and the BBS score was significantly higher in the combined treatment group than those in the monotherapy group,with statistically s

关 键 词：加味祛风定晕汤 针刺 前庭神经炎 炎症 氧化应激 血管内皮损伤 前庭功能 

分 类 号：R932[医药卫生—生药学]