醒脑开窍汤加减治疗后循环缺血性眩晕的疗效及对脑血流量的影响  

Efficacy of modified Xingnao Kaiqiao Decoction in treating posterior circulation ischemic vertigo and its effect on cerebral blood flow

作　　者：晋红宾 候玉辉 高向伟 李晶晶 王来群 JIN Hong-bin;HOU Yu-hui;GAO Xiang-wei;LI Jing-jing;WANG Lai-qun(Department of Neurology,the People's Hospital of Qixian,Qixian 456750,Henan,CHINA;Department of Medical Affairs,the People's Hospital of Qixian,Qixian 456750,Henan,CHINA;Department of Rehabilitation,the People's Hospital of Qixian,Qixian 456750,Henan,CHINA)

机构地区：[1]淇县人民医院神经内科,河南淇县456750 [2]淇县人民医院医务科,河南淇县456750 [3]淇县人民医院康复科,河南淇县456750

出　　处：《海南医学》2025年第5期643-647,共5页Hainan Medical Journal

基　　金：河南省医学教育研究项目(编号:WJLX2024127)。

摘　　要：目的研究醒脑开窍汤加减治疗后循环缺血性眩晕(PCIV)的疗效及对脑血流量影响。方法选取2022年1月至2023年12月淇县人民医院收治的92例PCIV患者进行研究,按随机数表法分为观察组和对照组,每组46例。对照组患者采用常规治疗,观察组患者在对照组治疗的基础上联合醒脑开窍汤加减治疗,两组均持续治疗两周。治疗两周后,比较两组患者的临床疗效,以及治疗前后的中医证候积分、眩晕残障量表(DHI)和眩晕评估评分量表(DARS)评分、脑血流量[血管搏动指数(PI)、舒张末期血流速度(Vd)、收缩期峰值血流速度(Vs)];比较两组患者治疗期间的不良反应发生情况;随访6个月后,比较两组患者的复发情况。结果治疗两周后,观察组患者的总有效率为95.65%,明显高于对照组的80.43%,差异有统计学意义(P<0.05)。治疗前,两组患者的中医证候积分比较差异无统计学意义(P>0.05);治疗两周后,两组患者的中医证候主证及次症积分均下降,且观察组患者的中医证候主证及次症积分分别为(4.20±0.50)分、(1.02±0.20)分,明显低于对照组的(6.69±0.84)分、(1.78±0.26)分,差异均有统计学意义(P<0.05)。治疗前,两组患者的DHI评分和DARS评分比较差异均无统计学意义(P>0.05);治疗两周后,两组患者的DHI评分和DARS评分均下降,且观察组患者的DHI评分和DARS评分分别为(19.20±2.71)分、(8.32±1.10)分,明显低于对照组的(27.33±3.59)分、(12.19±1.77)分,差异均有统计学意义(P<0.05)。治疗前,两组患者的脑血流量比较差异无统计学意义(P>0.05);治疗两周后,两组患者PI值均下降,Vd、Vs值均增加,且观察组患者的PI值为0.76±0.10,明显低于对照组的0.82±0.12,Vd、Vs值分别为(28.75±3.42)cm/s、(57.93±6.11)cm/s,明显高于对照组的(23.73±3.29)cm/s、(53.26±5.74)cm/s,差异均有统计学意义(P<0.05)。治疗期间两组患者的不良反应总发生率比较差异无统计学意义(P>0.05)。Objective To investigate the efficacy of modified Xingnao Kaiqiao Decoction in the treatment of posterior circulation ischemic vertigo(PCIV)and its impact on cerebral blood flow.Methods A total of 92 PCIV patients admitted to the People's Hospital of Qixian from January 2022 to December 2023 were selected for the study.They were randomly divided into an observation group and a control group using a random number table method,with 46 patients in each group.Patients in the control group received conventional treatment,while those in the observation group received conventional treatment combined with modified Xingnao Kaiqiao Decoction.Both groups of patients were treat ed for two weeks.After treatment,the clinical efficacy of the two groups was compared,along with changes in traditional Chinese medicine(TCM)syndrome scores,Dizziness Handicap Inventory(DHI)scores,Dizziness Assessment Rating Scale(DARS)scores,and cerebral blood flow parameters(pulsatility index[PI],end-diastolic velocity[Vd],and peak systolic velocity[Vs])before and after treatment.The incidence of adverse reactions during treatment was also compared between the two groups.After a six-month follow-up,the recurrence rates of the two groups were compared.Results After treatment,the total effective rate in the observation group was 95.65%,significantly higher than 80.43%in the control group(P<0.05).Before treatment,there was no statistically significant difference in the TCM syndrome scores between the two groups(P>0.05);After treatment,the scores of the main and secondary TCM syndromes in both groups of patients decreased,and the scores of the main and secondary TCM syndromes in the observation group were(4.20±0.50)points and(1.02±0.20)points,respectively,which were significantly lower than(6.69±0.84)points and(1.78±0.26)points in the control group,with statistically significant differences(P<0.05).Before treatment,the difference in DHI and DARS scores between the two groups of patients was not statistically significant(P>0.05);after treatment,the D

关 键 词：后循环缺血 眩晕 醒脑开窍汤 疗效 脑血流量 

分 类 号：R742[医药卫生—神经病学与精神病学]