摘要
目的:探讨针刺颅底五穴联合化痰通络汤对痰瘀阻络型急性后循环梗死性眩晕(PCIV)的临床疗效。方法:选取2022年10月—2023年10月在深圳市宝安区中医院诊断为后循环梗死性眩晕(脑梗死急性期)、中医辨证为痰瘀阻络证的病人114例作为研究对象,按照随机数字表法分为观察组(54例)和对照组(60例),对照组给予口服化痰通络汤治疗,观察组在对照组基础上针刺颅底五穴治疗,两组均予神经内科基础治疗及对症支持治疗,疗程14 d。比较两组治疗前后的中医证候积分、眩晕障碍量表(DHI)积分、脑血流动力学指标、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、临床疗效。结果:与治疗前比较,两组治疗后中医证候积分、DHI积分、LDL-C、Hcy均显著下降(P<0.05);双侧椎动脉(VA)、基底动脉(BA)平均血流速度均显著升高(P<0.05)。与对照组比较,观察组治疗后中医证候积分显著降低(P<0.05),临床治疗总有效率升高(P<0.05)。与对照组比较,观察组治疗后VA、BA平均血流速度显著升高(P<0.05);DHI积分、LDL-C、Hcy显著下降(P<0.05)。结论:针刺颅底五穴联合化痰通络汤治疗痰瘀阻络型急性后循环梗死性眩晕的临床应用效果显著,可提高病人日常生活能力及生活质量,改善脑血流状态,调节脂代谢,保护脑血管。
Objective:To explore the clinical effect of five acupoints of the skull base combined with Huatan Tongluo decoction on acute posterior circulation infarct vertigo(PCIV)of phlegm and blood stasis blocking collaterals.Methods:A total of 114 patients with PCIV(acute stage of cerebral infarction)of phlegm and blood stasis blocking collaterals were selected and divided into observation group(54 cases)and control group(60 cases).The control group was treated with oral Huatan Tongluo decoction,the observation group was treated with acupuncture"five acupoints of skull base"treatment on the basis of the control group.Both groups received basic neurological treatment and symptomatic supportive treatment for 14 d.Traditional Chinese medicine(TCM)and syndrome score,vertigo disorder scale score(DHI),cerebral hemodynamic blood index,low density lipoprotein cholesterol(LDL-C),Hcy before and after treatment of the two groups were observed and recorded,and the clinical efficacy of the two groups was compared.Results:Compared with the control group,the TCM syndrome score of the observation group decreased(P<0.05),and the total effective rate of clinical treatment was higher(P<0.05).Compared with the control group,the mean vertebral artery(VA)blood flow velocity and mean basilar artery(BA)blood flow velocity in the observation group increased after treatment(P<0.05),DHI score,LDL-C and Hcy decreased(P<0.05).Compared with data before treatment,the TCM syndrome score,DHI score,LDL-C and Hcy in both groups decreased after treatment(P<0.05).The average blood flow velocity of VA and BA increased(P<0.05).Conclusion:Acupuncture five acupoints of skull base combined with Huatan Tongluo decoction shows remarkable clinical effect for the treatment of acute posterior circulation infarct vertigo with phlegm and blood stasis blocking collaterals,which can improve the patients′daily living ability and quality of life,improve the state of cerebral blood flow,regulate lipid metabolism and protect cerebral vessels.
作者
方浩涛
叶宇旋
赵贝贝
金远林
黄汝成
张芷如
梁欢欢
FANG Haotao;YE Yuxuan;ZHAO Beibei;JIN Yuanlin;HUANG Rucheng;ZHANG Zhiru;LIANG Huanhuan(The Seventh Clinical Medical College of Guangzhou University of Chinese Medicine,Shenzhen 518000,Guangdong,China)
出处
《中西医结合心脑血管病杂志》
2024年第13期2451-2456,共6页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
后循环梗死性眩晕
急性脑梗死
颅底五穴
痰瘀阻络
posterior circulation infarct vertigo
acute cerebral infarction
five acupoints of skull base
phlegm and blood stasis blocking collaterals
