温中定眩汤治疗颈性眩晕（痰湿中阻型）的临床观察

发布时间：2018-11-19 15:33

【摘要】：目的：眩晕作为临床高发病率,高复发率疾病,其有效治疗一直是临床研究重点。本临床研究通过观察温中定眩汤针对痰湿中阻型眩晕的临床效果和治疗前后相关指标变化,并与西比灵组对照,探讨其临床效果、机制、安全性,从而为今后临床治疗眩晕提供更为客观而有价值的指导作用,启发新思路,其具有深刻的理论与实际意义。方法：根据中医诊断、中医证型、西医诊断、辅助检查等制定相关纳入、排除标准,于2015年1月1日～2016年1月1日期间常州市中医医院脑病科(即神经内科)门诊以及住院病例中根据相关要求筛选出60例,随机分为治疗组(温中定眩汤组)以及对照组(西比灵组),每组各30例。治疗组给予温中定眩汤口服,一日两次,每次250m1；对照组予以西比灵5mg口服,每晚一次。总疗程为15日。治疗后随访三月,观察眩晕复发有关情况。治疗前对两组性别、年龄、基础疾病、眩晕程度、血浆粘度进行基线比较,经比较,P0.05,两组具有可比性。治疗后对两组疗效、眩晕评分、血浆粘度、三月内复发率进行组与组的比较,并对眩晕评分、血浆粘度进行治疗前后组间比较,相关结果采用统计学分析,得出结论。并在观察过程中监督患者血、尿、粪、ECG、GPT、BUN等指标,以及观察相关毒副作用,做出安全性监测结论。结果：治疗组总治疗有效率高达93.33%高于对照组有效率83.33%；治疗组与对照组治疗前后眩晕评分改善统计、治疗前后血浆粘度统计,P0.01,治疗组对血浆粘度的改善优于对照组；治疗组3月内复发率3.33%,对照组3月内复发率10%,治疗组复发率明显低于对照组。结论：温中定眩汤对于颈性眩晕痰湿中阻证具有明显疗效,根据治疗前后眩晕评分统计学分析,温中定眩汤可有效改善痰湿中阻型眩晕的相关症状,改善生活质量,且根据治疗前后血浆粘度对比分析,其能有效降低眩晕高危因素之一的血浆粘度；而温中定眩汤较其他治疗药物相比,可有效降低临床复发率。现代临床眩晕作为一高复发率的疾病之一,目前暂无明确、可靠降低复发率的方法,温中定眩汤不仅临床疗效明确,且能有效降低复发率,故在未来的临床应用上值得进一步研究。
[Abstract]:Objective: as a disease with high incidence and high recurrence rate, vertigo has been the focus of clinical research. In this clinical study, we observed the clinical effect of Wenzhong Dingxuan decoction (WZDXD) on phlegm-dampness type vertigo and the changes of related indexes before and after treatment, and compared with sibiline group to discuss its clinical effect, mechanism and safety. It provides a more objective and valuable guidance for clinical treatment of vertigo and enlightens new ideas, which has profound theoretical and practical significance. Methods: according to TCM diagnosis, TCM syndrome type, western medicine diagnosis, auxiliary examination and so on, relevant inclusion and exclusion criteria were formulated. From January 1, 2015 to January 1, 2016, 60 cases were selected from the Department of Encephalopathy (Department of Neurology) of Changzhou traditional Chinese Medicine Hospital according to the relevant requirements. They were randomly divided into treatment group (Wenzhong Dingxuan decoction group) and control group (sibiline group) with 30 cases in each group. The treatment group was treated with Wenzhong Dingxuan decoction twice a day, 250 ml per time, and the control group with sibelium 5mg once a night. The total course of treatment was 15 days. The patients were followed up for 3 months to observe the recurrence of vertigo. Sex, age, basic disease, vertigo degree and plasma viscosity were compared between the two groups before treatment (P0.05), the two groups were comparable. After treatment, the curative effect, vertigo score, plasma viscosity, recurrence rate within three months were compared between the two groups, and the vertigo score and plasma viscosity were compared before and after treatment. The indexes of blood, urine, feces and ECG,GPT,BUN were monitored during the observation, and the safety monitoring results were made. Results: the total effective rate was 93.33% in the treatment group and 83.33% in the control group. The vertigo score of treatment group and control group was improved before and after treatment, the plasma viscosity before and after treatment, P 0.01, the improvement of plasma viscosity in treatment group was better than that in control group. The recurrence rate was 3.33 in the treatment group and 10 in the control group. The recurrence rate in the treatment group was significantly lower than that in the control group. Conclusion: Wenzhong Dingxuan decoction has obvious curative effect on the syndrome of phlegm dampness and dampness of cervical vertigo. According to the statistical analysis of vertigo score before and after treatment, Wenzhong Dingxuan decoction can effectively improve the symptoms of phlegm dampness and middle dampness blocking vertigo and improve the quality of life. According to the comparative analysis of plasma viscosity before and after treatment, it can effectively reduce the plasma viscosity of one of the high risk factors for vertigo. Compared with other treatment drugs, Wenzhong Dingxuan decoction can effectively reduce the clinical recurrence rate. The modern clinical vertigo is one of the diseases with high recurrence rate. At present, there is no definite and reliable way to reduce the recurrence rate. Wenzhong Ding Xuan decoction not only has a definite clinical effect, but also can effectively reduce the recurrence rate. Therefore, in the future clinical application is worth further study.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R255.3

【相似文献】