眩晕宁片联合氟桂利嗪治疗前庭性偏头痛的疗效及对血液流变学、脑血流和血清神经递质水平的影响  

Effect of Xuanyunning Tablets combined with flunarizine in the treatment of vestibular migraine and its effects on hemorheology,cerebral blood flow and serum neurotransmitter levels

作　　者：薛铮 张瀛颖 卢磊 张浩[3] XUE Zheng;ZHANG Yingying;LU Lei;ZHANG Hao(Department of Traditional Chinese Medicine,Nanyang First People’s Hospital,Nanyang 473000,China;Department of Cardiology,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,China;Department of Traditional Chinese Medicine,He’nan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]南阳市第一人民医院中医科,南阳473000 [2]南阳市中医院心血管内科,南阳473000 [3]河南省人民医院中医科,郑州450000

出　　处：《西北药学杂志》2025年第2期119-125,共7页Northwest Pharmaceutical Journal

基　　金：河南省医学科技攻关计划项目(编号:182102310034)。

摘　　要：目的探讨眩晕宁片联合氟桂利嗪治疗前庭性偏头痛(vestibular migraine,VM)的临床疗效及对患者血液流变学、脑血流和血清神经递质水平的影响。方法选取122例VM患者,按照随机数字表法分为对照组和观察组。对照组单用氟桂利嗪治疗,观察组在此基础上联合眩晕宁片治疗。3个月疗程结束后观察2组疗效。比较治疗前后2组眩晕发作情况、眩晕障碍量表(dizziness handicap inventory,DHI)总分、血液流变学指标[全血高切黏度(high blood viscosity,HBV)和低切黏度(low blood viscosity,LBV),红细胞变形指数及聚集指数(erythrocyte deformation index,EDI和erythrocyte aggregation index,EAI)]、脑血流参数[大脑中动脉(middle cerebral artery,MCA)、前动脉(anterior cerebral artery,ACA)、后动脉(posterior cerebral artery,PCA)、椎动脉(vertebral artery,VA)的平均血流速度],以及血清5-羟色胺(5-hydroxytryptamine,5-HT)、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、一氧化氮(nitric oxide,NO)水平。统计2组不良反应情况。结果与对照组[49.18%(30/61)]比较,观察组的明显改善率[75.41%(46/61)]显著提高(P<0.05)。治疗后,2组眩晕视觉模拟量表(visual analog scale,VAS)评分、发作频率和DHI总分均显著降低(P<0.05),眩晕发作持续时间均显著缩短(P<0.05),且观察组改善更显著(P<0.05)。治疗后,2组的血液流变学指标HBV、LBV、EDI、EAI和颅内动脉MCA、ACA、PCA、VA的平均血流速度以及血清CGRP、NO水平均显著降低(P<0.05),血清5-HT水平均显著上升(P<0.05),且观察组变化更显著(P<0.05)。观察组不良反应发生率[6.56%(4/61)]与对照组[4.92%(3/61)]比较,差异无统计学意义(P>0.05)。结论眩晕宁片联合氟桂利嗪治疗VM的疗效确切,能安全有效地稳定患者的病情,提高生活质量,纠正血液流变学异常,改善脑血流,调控血清相关神经递质表达。Objective To investigate the clinical efficacy of Xuanyunning Tablets combined with flunarizine in the treatment of vestibular migraine(VM),and the effects on hemorheology,cerebral blood flow and serum neurotransmitter levels.Methods A total of 122 VM patients were selected and divided into control group and observation group according to random number table method.The control group was treated with flunarizine alone,on this basis,the observation group was treated with Xuanyunning Tablets.After 3 months of treatment,the curative effect of the 2 groups was observed.In terms of dizziness onset,dizziness handicap inventory(DHI)total score,hemorheology index[high blood viscosity(HBV),and low tangential viscosity(LBV)],erythrocyte deformation index(EDI)and erythrocyte aggregation index(EAI),cerebral blood flow parameters[middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA),average blood flow velocity of vertebral artery(VA)],and serum 5-hydroxytryptamine(5-HT),calcitonin gene-related peptide(CGRP),nitric oxide(NO)levels were compared between the 2 groups before and after treatment.The adverse reactions of the 2 groups were analyzed.Results Compared with the control group[49.18%(30/61)],the improvement rate of the observation group[75.41%(46/61)]was significantly increased(P<0.05).After treatment,the visual analog scale(VAS)score,the attack frequency and total DHI score of the 2 groups were significantly decreased(P<0.05),and the duration of vertigo attack was significantly shortened(P<0.05),and the improvement was more significant in the observation group(P<0.05)than in the control group.After treatment,the hemorheology indexes HBV,LBV,EDI,EAI,intracranial artery MCA,ACA,PCA,VA average blood flow velocity and serum CGRP and NO levels were significantly decreased in the 2 groups(P<0.05),and the serum 5-HT levels were significantly increased in the 2 groups(P<0.05),especially in the observation group(P<0.05).There was no significant difference in the adverse reaction rate between the

关 键 词：前庭性偏头痛 眩晕宁片 氟桂利嗪 血液流变学 脑血流 神经递质 

分 类 号：R971[医药卫生—药品]