摘要
目的评价针刺联合通痹益脑汤治疗后循环缺血性孤立性眩晕的疗效。方法选择2019年2月-2022年2月眉山市人民医院中医康复科78例老年后循环缺血性孤立性眩晕患者作为观察对象, 采用开放随机、平行对照的试验方法将患者分为2组, 每组39例。对照组给予西医常规疗法+口服盐酸氟桂利嗪胶囊治疗, 观察组在对照组基础上给予针刺+通痹益脑汤治疗。2组均治疗2个月。分别于治疗前后进行中医证候评分, 采用简易智力状态检查量表(MMSE)评价患者智力水平, 采用经颅多普勒超声仪探测基底动脉、左椎动脉、右椎动脉血流速度, 采用血液流变仪检测血浆黏度、全血低切黏度、全血高切黏度, 记录治疗期间的不良反应, 评价临床疗效。结果观察组总有效率为94.87%(37/39)、对照组为76.92%(30/39), 2组比较差异有统计学意义(χ^(2)=5.19, P=0.023)。治疗后, 观察组眩晕头晕[(1.05±0.12)分比(2.14±0.74)分, t=9.080]、胸闷恶心[(0.97±0.10)分比(2.06±0.61)分, t=11.01]、唇甲紫绀[(1.07±0.88)分比(2.55±0.70)分, t=8.22]、肌肤甲错[(0.85±0.22)分比(2.02±0.84)分, t=8.42]积分及总分[(3.94±1.32)分比(8.77±2.89)分, t=9.49]低于对照组(P<0.01);MMSE[(26.39±2.20)分比(24.20±2.37)分, t=4.01]评分高于对照组(P<0.01)。治疗后, 观察组基底动脉[(37.55±3.61)cm/s比(33.50±2.96)cm/s, t=5.42]、左椎动脉[(34.27±4.87)cm/s比(30.58±3.74)cm/s, t=3.75]、右椎动脉[(38.74±5.21)cm/s比(35.17±4.54)cm/s, t=3.23]血流速度高于对照组(P<0.01);血浆黏度[(1.32±0.19)mPa·s比(1.45±0.21)mPa·s, t=20.28]、全血低切黏度[(8.71±0.35)mPa·s比(8.97±0.38)mPa·s, t=3.14]、全血高切黏度[(5.41±0.39)mPa·s比(5.92±0.43)mPa·s, t=5.49]低于对照组(P<0.01)。治疗期间, 观察组不良反应发生率为28.2%(11/39)、对照组为20.5%(8/39), 2组比较差异无统计学意义(χ^(2)=0.63, P=0.429)。结论针灸联合通痹益脑汤可有效维持老年后循环缺血性孤立性眩晕患者血流动力学及脑血流量, 提高临床疗效, 且安全性较好。
Objective To evaluate the effects of acupuncture combined with Tongbi Yinao Decoction in the treatment of isolated vertigo due to posterior circulation ischemia.Methods A total of 78 elderly patients with isolated vertigo due to posterior circulation ischemia who were admitted to the Traditional Chinese Medicine Rehabilitation Department of Meishan People's Hospital from February 2019 to February 2022 were selected as the study subjects.They were divided into two groups by open randomized parallel control trail method,with 39 cases in each group.The control group was given conventional Western medicine treatment and oral administration of flunarizine hydrochloride capsules.On this basis,the observation group was treated with acupuncture combined with Tongbi Yinao Decoction.Both groups received 2 months of treatment.TCM syndrome scores before and after treatment were recorded.The Mini Mental State Examination(MMSE)was used to evaluate the patients'intelligence level.Transcranial Doppler ultrasound was used to detect blood flow velocity of the basilar artery,left vertebral artery and right vertebral artery.The blood rheometer was used to detect plasma viscosity,whole blood low shear viscosity and whole blood high shear viscosity.Adverse reactions that occurred during treatment were recorded,and clinical efficacy was evaluated.Results The total effective rates in the observation group and the control group were 94.87%(37/39)and 76.92%(30/39),with statistical significance(χ^(2)=5.19,P=0.023).After treatment,the observation group in terms of vertigo and dizziness(1.05±0.12 vs.2.14±0.74,t=9.08),chest distress and nausea(0.97±0.10 vs.2.06±0.61,t=11.01),cyanosis of lip and nail(1.07±0.88 vs.2.55±0.70,t=8.22),scaly dry skin(0.85±0.22 vs.2.02±0.84,t=8.42)and the total score(3.94±1.32 vs.8.77±2.89,t=9.49)were lower than those in the control group(P<0.01).The MMSE score(26.39±2.20 vs.24.20±2.37,t=4.01)was higher than that of the control group(P<0.01).After treatment,blood flow velocity of the basilar artery[(37.55±3.61)cm/s vs.(33.50±2.96)cm/s,t=5.42],left vertebral artery[(34.27±4.87)cm/s vs.(30.58±3.74)cm/s,t=3.75]and right vertebral artery[(38.74±5.21)cm/s vs.(35.17±4.54)cm/s,t=3.23]in the observation group were higher than those in the control group(P<0.01);The plasma viscosity[(1.32±0.19)mPa•s vs.(1.45±0.21)mPa•s,t=20.28],whole blood low shear viscosity[(8.71±0.35)mPa•s vs.(8.97±0.38)mPa•s,t=3.14]and whole blood high shear viscosity[(5.41±0.39)mPa•s vs.(5.92±0.43)mPa•s,t=5.49]were lower than those in the control group(P<0.01).During treatment,the incidence rates of adverse reactions in the observation group and the control group were 28.2%(11/39)and 20.5%(8/39),without statistical significance(χ^(2)=0.63,P=0.429).Conclusion Acupuncture combined with Tongbi Yinao Decoction can effectively maintain hemodynamics and cerebral blood flow of patients with isolated vertigo due to posterior circulation ischemia,and improve clinical efficacy,with good safety.
作者
胡峻瑞
刘燕平
梁韡斌
Junrui Hu;Yanping Liu;Weibin Liang(Traditional Chinese Medicine Rehabilitation Department,Meishan People's Hospital,Meishan 620010,China;Neurosurgery Department,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530000,China)
出处
《国际中医中药杂志》
2024年第7期854-859,共6页
International Journal of Traditional Chinese Medicine
基金
广西自然科学基金(2019JJA140592)。
关键词
针刺疗法(中医)
通痹益脑汤
后循环缺血
孤立性眩晕
老年人
脑血流
血流动力学
Acupuncture therapy(TCM)
Tongbi Yinao Decoction
Posterior circulation ischemia
Isolated vertigo
Aged
Cerebral blood flow
Hemodynamics
