化痰解郁方治疗后循环短暂性脑缺血发作（痰热上扰证）眩晕症状的临床研究

发布时间：2018-06-10 14:39

本文选题：化痰解郁方 + 后循环短暂性脑缺血发作　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：评价化痰解郁方治疗后循环短暂性脑缺血发作(痰热上扰证)眩晕症状的疗效与安全性,为其临床应用提供科学依据。方法：采用随机数字表法,将60例符合后循环短暂性脑缺血发作(痰热上扰证)的患者,随机分为2组,试验组和对照组比例为1：1,两组各30例。治疗方案为试验组：在基础用药上,使用化痰解郁方,每日1剂,每次1袋(200m1),每日3次,口服,同时合用敏使朗(甲磺酸倍他司汀片),每次1片,每日3次,口服；对照组：在基础用药上,使用敏使朗(甲磺酸倍他司汀片),每次1片,每日3次,口服。疗程共2周。治疗前及治疗2周后分别进行中医证候量表、眩晕残障程度评定量表(DHI)及欧洲眩晕评价量表评分,进行经颅多普勒(TCD)超声检查,记录双侧椎动脉(VA)及基底动脉(BA)的平均血流速度(Vm)及动脉搏动指数(PI),试验期间观察患者的生命体征及不良反应,进行安全性评价。结果：(1)中医证候量表评分比较：治疗2周后试验组及对照组评分较前均有下降,两组内比较差异均有统计学意义(P0.05),治疗后两组间比较差异有统计学意义(P0.05),试验组总有效率为93.10%,对照组为60.71%,经比较后差异有统计学意义(P0.05),试验组的疗效优于对照组。(2)眩晕残障程度评定量表(DHI)评分比较：治疗2周后试验组及对照组评分较前均有下降,两组内比较差异均有统计学意义(P0.05),治疗后两组间比较差异有统计学意义(P0.05)；DHI各因子评分较前均有下降,两组内比较差异均有统计学意义(P0.05),治疗后两组间比较差异均有统计学意义(P0.05)；试验组总有效率为79.31%,对照组为53.57%,经比较后差异有统计学意义(P0.05)试验组疗效优于对照组。(3)欧洲眩晕评价量表评分比较：治疗2周后试验组及对照组评分较前均有下降,两组内比较差异均有统计学意义(P0.05),治疗后两组间比较差异有统计学意义(P0.05),试验组总有效率为89.66%,对照组为60.71%,差异有统计学意义(P0.05),试验组疗效优于对照组。(4)经颅多普勒(TCD)超声检查比较：治疗2周后试验组及对照组左侧椎动脉的平均血流速度(Vm)及搏动指数(PI)较前均改善,组内比较差异均有统计学意义(P0.05),治疗后两组间比较差异无统计学意义(P0.05),在左侧椎动脉的Vm及PI的改善上两组间疗效相当：治疗2周后试验组及对照组右侧椎动脉、基底动脉的Vm及PI较前均改善,组内比较差异均有统计学意义(P0.05),治疗后两组间比较差异有统计学意义(P0.05),在右侧椎动脉、基底动脉Vm及PI的改善上试验组优于对照组。(5)试验期间两组患者的生命体征未发生异常变化,未见明显不良反应。结论：化痰解郁方可以明显改善后循环短暂性脑缺血发作(痰热上扰证)患者的中医证候量表、眩晕残障程度评定量表(DHI)及欧洲眩晕评价量表评分,可以改善患者经颅多普勒(TCD)超声检查相关指标,并且安全无明显不良反应出现。
[Abstract]:Objective: to evaluate the efficacy and safety of Huatan Jieyu prescription (Huatan Jieyu recipe) in treating vertigo symptoms of transient ischemic attack (phlegm heat disturbance syndrome) after circulation, so as to provide scientific basis for its clinical application. Methods: 60 patients with transient ischemic attack of posterior circulation (phlegm heat disturbance) were randomly divided into two groups. The ratio of experimental group and control group was 1: 1, 30 cases in each group. The treatment group was treated with Huatan Jieyu prescription, one dose of Huatan Jieyu prescription, 3 times a day, 3 times a day, combined with benazepam (Betastine mesylate, 1 tablet per day, 3 times a day, oral); Control group: on the basis of medication, use Minzheng (betastatin mesylate tablet, 1 tablet per time, 3 times a day, oral. The course of treatment was 2 weeks. Before treatment and 2 weeks after treatment, TCM syndrome scale, dizziness degree assessment scale (DHI) and European vertigo evaluation scale were scored, and transcranial Doppler TCD ultrasound examination was performed. The mean blood flow velocity (Vm) and arterial pulsatility index (PIV) of bilateral vertebral artery (VA) and basilar artery (BA) were recorded. The vital signs and adverse reactions were observed during the trial, and the safety was evaluated. Results (1) comparison of TCM syndrome scale scores: after 2 weeks of treatment, the scores of the experimental group and the control group were all lower than before. After treatment, the difference between the two groups was statistically significant (P 0.05). The total effective rate of the experimental group was 93.10% and the control group was 60.71%. After comparison, the difference was statistically significant. The curative effect of the experimental group was better than that of the control group. Comparison of dizziness assessment scale (DHI): after 2 weeks of treatment, the scores of both the experimental group and the control group were lower than before. The difference between the two groups was statistically significant (P 0.05). After treatment, there was a significant difference between the two groups (P 0.05) and the DHI scores of the two groups were all lower than those before treatment. The total effective rate of the trial group was 79.31 and that of the control group was 53.57. After comparison, the curative effect of the test group was better than that of the control group. Comparison of the European Vertigo Evaluation scale: after 2 weeks of treatment, the scores of the experimental group and the control group were lower than before. After treatment, the difference between the two groups was statistically significant (P 0.05). The total effective rate was 89.66 in the experimental group and 60.71 in the control group (P 0.05). The curative effect of the test group was better than that of the control group. Comparison of left vertebral artery flow velocity (Vm) and pulsatile index (PII) of left vertebral artery in the experimental group and the control group after 2 weeks of treatment. There was no significant difference between the two groups after treatment. The improvement of VM and Pi in the left vertebral artery was similar between the two groups: after 2 weeks of treatment, the right vertebral artery in the experimental group and the control group were improved. The VM and Pi of basilar artery were improved compared with the former, and the differences were statistically significant in both groups. After treatment, there was a significant difference between the two groups in the right vertebral artery, and the right vertebral artery. The improvement of VM and Pi in the basilar artery was better in the experimental group than in the control group. Conclusion: Huatan Jieyu prescription can obviously improve the scores of TCM syndrome scale, dizziness assessment scale and European vertigo evaluation scale in patients with transient cerebral ischemic attack (phlegm-heat disturbance syndrome) after circulation. It can improve the relevant indexes of transcranial Doppler TCD, and there is no significant adverse reaction.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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