摘要
目的观察镇肝熄风汤联合耳尖放血治疗肝阳上亢型后循环缺血性眩晕(PCIV)的临床疗效。方法将174例肝阳上亢型PCIV患者按照随机数字表法分为3组,对照组58例予甲磺酸倍他司汀片治疗,中药组58例在对照组治疗基础上联合镇肝熄风汤治疗,针药组58例在中药组治疗基础上联合耳尖放血治疗。3组均治疗4周。比较3组治疗前后中医证候评分、血流动力学指标[各组椎动脉、基底动脉、大脑后动脉的血流平均速度(Vm)、动脉搏动指数(PI)],并统计3组临床疗效。结果针药组总有效率100%(58/58),中药组总有效率98.28%(57/58),对照组总有效率94.83%(55/58),针药组临床疗效优于对照组(P<0.05)。3组治疗后椎动脉、基底动脉、大脑后动脉的Vm均较本组治疗前升高(P<0.05),且针药组治疗后均高于对照组、中药组(P<0.05);3组治疗后各动脉PI均降低(P<0.05),且针药组治疗后均低于对照组、中药组(P<0.05)。3组治疗后中医证候评分均较本组治疗前降低(P<0.05),且针药组治疗后均低于中药组、对照组(P<0.05)。结论镇肝熄风汤联合耳尖放血治疗肝阳上亢型PCIV具有良好的疗效。
Objective To explore the clinical effect of Zhengan Xifeng Decoction combined with ear apex bloodletting for posterior circulation ischemic vertigo(PCIV)of liver yang hyperactivity type.Methods A total of 174 PCIV patients(liver yang hyperactivity type)were randomzied 1∶1∶1 to receive betahistine mesilate tablets(the control group)or betahistine mesilate tablets plus Zhengan Xifeng Decoction(the herbal medicine group)or betahistine mesilate tablets plus Zhengan Xifeng Decoction plus ear apex bloodletting(the acupuncture-medicine group).Treated for 4 weeks,the aim was to compare liver-yang hyperactivity syndrome score,hemodynamic indexes(average blood flow velocity[VM]and pulsatility index[PI]of vertebral artery[VA],basilar artery[BA]and posterior cerebral arteries[PCA]).The curative effect was assessed.Results After treatment,the total effective rate in the acupuncture-medicine group was better than that of the herbal medicine group and the control group(100%[58/58]vs 98.28%[57/58]vs 94.83%[55/58],P<0.05).The levels of VM of VA,BA and PCA in the three groups were significantly increased(P<0.05),which increased notably in the acupuncture-medicine group compared with the herbal medicine group and the control group(P<0.05).The levels of PI of VA,BA and PCA in the three groups were significantly decreased(P<0.05),which was significantly lower in the acupuncture-medicine group than in the herbal medicine group and the control group(P<0.05).The liver-yang hyperactivity syndrome score in the three groups was significantly decreased(P<0.05),which was significantly lower in the acupuncture-medicine group than in the herbal medicine group and the control group(P<0.05).Conclusion For PCIV patients(liver yang hyperactivity type),Zhengan Xifeng Decoction combined with ear apex bloodletting has good curative effect,which is capable of improving the quality of life and presenting the superiority of combined treatment,it is worthy of clinical promotion.
作者
石蓬莱
徐霖
SHI Penglai;XU Lin(Department of Encephalology,YanTai Penglai Traditional Chinese Medicine Hospital,Yantai,Shandong 265600)
出处
《河北中医》
2024年第5期762-765,771,共5页
Hebei Journal of Traditional Chinese Medicine
基金
山东省中医药科技计划项目(编号:2020Q090)。
关键词
后循环缺血性眩晕
肝阳上亢
镇肝熄风汤
耳尖放血
Posterior circulation ischemic vertigo
Liver yang hyperactivity
Zhengan Xifeng Decoction
Ear apex bloodletting
