摘要
目的观察尼麦角林（乐喜林）治疗后循环缺血眩晕（PCIV）的临床疗效。方法共入选87例PCIV患者，随机分为尼麦角林治疗组45例和对照组42例，观察治疗前、治疗后第7天及第8周眩晕评估评分量表（dizziness assessment rating scale，DARs）评分、眩晕障碍调查表（dizziness handicap inventory，DHI）总评分以及经颅多普勒超声（TCD）、脑干诱发电位（BAEP）的变化。结果治疗前尼麦角林组和对照组DARS评分分别为（24．9±7．3）分、（22．5±9．7）分，DHI总评分分别为（55．8±19．7）分、（57．5±19．3）分；治疗后第7天尼麦角林组和对照组DARS评分分别为（15．6±2．1）分、（14．3±4．4）分，DHI总评分分别为（38．3±11．4）分、（39．5±14．7）分；第8周DARS评分分别为（8．9±3．9）分、（9．9±4．7）分，DHI总评分分别为（26．3±12．8）分、（35．8±13．1）分；尼麦角林组和对照组治疗后第7天有效率分别为71．1％（32／45）、61．9%（26／42），治疗后第8周分别为93．3％（42／45）、78．6％（33／42）。治疗后第7天、第8周两组DARS评分和DHI总评分均较治疗前明显降低（均P〈0．05），两组治疗后第7天DARS评分和DHI总评分以及有效率比较差异均无统计学意义（均P〉0．05），第8周时尼麦角林组DHI总评分较对照组显著下降（t=2．17，P〈0．05）、有效率明显增高（y。=3．98，P〈0．05）；且尼麦角林治疗后8周椎基底动脉血流流速以及听觉通路的传导均显著改善，以脑干上段最明显。结论尼麦角林片治疗PCIV具有快速、高效的作用，并通过改善亚临床的脑干缺血达到持久的症状缓解效果。
Objective To investigate the effects of nicergoline on the treatment of posterior circulation ischemia vertigo （PCIV）. Methods A total of 87 patients with PCIV were randomly treated either with nicergoline （45 cases） or betahistine （42 cases）. Dizziness assessment rating scale （DARS） and dizziness handicap inventory （DHI） were used to evaluate the changes of manifestations before treatment, after 7 days and 8 weeks treatment with nicergoline, meanwhile transcranial Doppler ultrasound （TCD） and brainstem auditory evoked potential （BAEP） were observed to assess the effects. Results After 7 days of treatment, the scores of DARS and DHI were decreased significantly in nicergoline group （DARS： 15.6±2.1 ; DHI： 38.3±11.4 ） and control group （DARS： 14.3±4.4; DHI： 39.5±14.7） compared with the scores before treatment （DARS： 24.9±7.3, 22.5 ±9.7 ; DHI： 55.8 ± 19.7, 57.5 ± 19.3） （all P〈 0. 05 ）, and the treatment efficiency was 71.1% （32/45）, 61.9% （26/42）. After 8 weeks of treatment, the scores of DARS and DHI were also decreased significantly in nicergoline group （DARS： 8.9± 3.9; DHh 26.3 ± 12.8） and control group （DARS： 9.9~4.7; DHI： 35.84-13.1） compared with the scores before treatment （all P〈 0. 05）, and the treatment efficiency was 93.30/＇00 （42/45）, 78.6% （33/42） . There was significantly differences in the scores of DHI and treatment efficiency between the two groups at 8 weeks （t = 2.169,P% 0. 05, and）X2=3.98,P〈0. 05 ）, but no differences at 7 days （both P〈0. 05）. In consistent with the remission of the clinical symptoms, nicergoline group significantly recovered from both low blood diffusion in the verbal-basal artery system and extended peak latency（PL） and interpeak latency（IPL） in the auditory pathway examined by TCD and BAEP individually at 8 weeks, especially in the upper part of the brainstem （P〈0.05）. Conclusions Nicergoline is very effective in the treatment of PCIV and could
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第3期291-295,共5页
Chinese Journal of Geriatrics
关键词
二氢麦角毒
眩晕
Dihydroergotoxine
Vertigo
