摘要
目的 探讨眩晕项贴联合半夏白术天麻汤加减治疗肝火上炎型耳石症复位后残余眩晕的临床疗效.方法 前瞻性选取2020年1月至2023年1月北京中医药大学东直门医院通州院区收治的肝火上炎型耳石症复位后残余眩晕患者74例作为研究对象,按随机数字表法将其分为对照组(n =37)和试验组(n =37). 对照组采用单纯予以甲磺酸倍他司汀片治疗,餐后口服,12 mg/次,3次/d,7d 为1个疗程,共治疗1个疗程;试验组采用眩晕项贴联合半夏白术天麻汤加减治疗,早晚各服1次,疗程2周.观察两组患者的临床疗效,比较两组患者治疗前和治疗2周后的眩晕障碍量表(DHI)评分、前庭症状指数(VSI)评分、血流动力学(血浆黏度、纤维蛋白原、红细胞比容)指标、血流速度[左侧椎动脉(LVA)、右侧椎动脉(RVA)和基底动脉(BA)]的差异.结果 治疗后,试验组临床总有效率为100.00％,显著高于对照组(83.78％),差异有统计学意义(P＜0.05).治疗2周后,两组DHI评分和VSI评分均较治疗前显著降低,且试验组DHI评分和VSI评分分别为(10.57±2.31)、(14.62±3.56)分,均显著低于对照组[(15.71±2.63)、(25.14 ±4.62)分],差异均有统计学意义(P＜0.05).治疗2周后,两组血浆黏度、红细胞比容及纤维蛋白原水平均较治疗前显著降低,且试验组血浆黏度、红细胞比容及纤维蛋白原水平分别为(0.83±0.15)mPa·s、(0.24±0.06)％、(41.24 ±4.52)％,均显著低于对照组[(1.12±0.23)mPa·s、(0.36±0.07)％、(47.51±3.56)％],差异均有统计学意义(P＜0.05).治疗2周后,两组LVA、RVA、BA水平均较治疗前升高,且试验组LVA、RVA、BA水平分别为(31.24±4.28)、(28.79±4.01)、(40.52±4.73)cm/s,均显著高于对照组[(22.45±4.67)、(22.71±4.58)、(29.42±5.01)cm/s],差异均有统计学意义(P＜0.05).结论 眩晕项贴联合半夏白术天麻汤加减治疗肝火上炎型耳石症复位后残余眩晕患者可提高临床疗效,减轻眩晕障碍及前庭症状,同时还可有效改善其血流动力学,值得临床推广应用.
Abstract
Objective To investigate the clinical effect of vertigo patch combined with Banxia Baizhu Tianma Decoction modified in the treatment of residual sizziness after reduction of hyperpyrexia of liver syndrome.Methods A total of 74 patients with residual sizziness after reduc-tion of hyperpyrexia of liver syndrome treated in Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine from January 2020 to January 2023 were prospectively selected as the study subjects.They were divided into the control group(n=37)and the experimental group(n=37)according to the random number table method.The control group was treated with betahistine mesylate tablets alone,and oral administra-tion after meals,12 mg/ci,3 times/d,and a course of 7 days,a total of 1 course of treatment,while the experimental group was treated with verti-go patch combined with Banxia Baizhu Gastrodia decoction,once in the morning and once in the evening,and the treatment lasted for 2 weeks.The clinical efficacy of two groups of patients was observed.The differences in dizziness handicap inventory(DHI)scores,vestibular symptom in-dex(VSI)scores,hemodynamic(plasma viscosity,fibrinogen,hematocrit)indicators,and blood flow velocity[(left vertebral artery(LVA),right vertebral artery(RVA),and basilar artery(BA)]between two groups of patients before and after 2 weeks of treatment were compared.Results After treatment,the total clinical effective rate of the experimental group was 100.00％,which was significantly higher than that of the control group(83.78％),the difference was statistically significant(P＜0.05).After 2 weeks of treatment,the DHI score and VSI score of two groups were significantly lower than those before treatment,and the DHI score and VSI score of the experimental group were(10.57±2.31)and(14.62±3.56)points,respectively,which were significantly lower than those of the control group[(15.71±2.63)and(25.14±4.62)points],the differences were statistically significant(P＜0.05).After 2 weeks of treatment,the levels of average plasma viscosity,hematocrit,and fibrinogen of two groups were significantly lower than those before treatment,the plasma viscosity,hematocrit,and fibrinogen levels in the ex-perimental group were(0.83±0.15)mPa·s,(0.24±0.06)％,and(41.24±4.52)％,respectively,which were significantly lower than those in the control group[(1.12±0.23)mPa·s,(0.36±0.07)％,and(47.51±3.56)％],and the differences were statistically signifi-cant(P＜0.05).After 2 weeks of treatment,the levels of LVA,RVA,and BA of two groups were significantly higher than those before treat-ment,and the levels of LVA,RVA,and BA in the experimental group were(31.24±4.28),(28.79±4.01),and(40.52±4.73)cm/s,re-spectively,which were significantly higher than those in the control group[(22.45±4.67),(22.71±4.58),and(29.42±5.01)cm/s],and the differences were statistically significant(P＜0.05).Conclusion The vertigo patch combined with Banxia Baizhu Tianma Decoction modi-fied in the treatment of residual sizziness after reduction of hyperpyrexia of liver syndrome can improve clinical efficacy,alleviate dizziness and ves-tibular symptoms,and effectively improve hemodynamics.It is worthy of clinical promotion and application.
基金项目
北京市通州区高层次人才发展支持计划(YHLD2019019)
维普
万方数据