中医综合治疗椎动脉狭窄颈性眩晕的疗效观察

摘要

目的 观察中医综合治疗椎动脉狭窄颈性眩晕(CV)的疗效.方法 将44例椎动脉狭窄CV患者随机分为2组,对照组22例给予盐酸倍他司汀片配合牵引治疗,治疗组22例在口服盐酸倍他司汀片基础上给予香丹注射液静脉滴注,并予中医手法+针刺回阳九针穴治疗,2组疗程均30 d.分别比较2组治疗前后左椎动脉(LVA)、右椎动脉(RVA)血流速度及口径,记录CV症状与功能评分,测定血清一氧化氮(NO)及内皮源性超极化因子(EDHF)水平,并统计疗效.结果 2组治疗2、3周后CV症状与功能评分较治疗前均明显升高(P<0.05);治疗组治疗1、2、3周后CV症状与功能评分均高于对照组(P<0.05).2组治疗后LVA、RVA血流速度及口径较治疗前均升高(P<0.05);治疗组治疗后LVA、RVA血流速度及口径高于对照组(P<0.05).治疗1周后,2组血清NO水平均无明显变化(P>0.05),血清EDHF水平较治疗前明显升高(P<0.05);治疗2周后,2组血清NO、EDHF水平较治疗前均明显升高(P<0.05),且治疗组均高于对照组(P<0.05);治疗3周后,2组血清NO水平高于治疗2周后(P<0.05),血清EDHF水平低于治疗2周后(P<0.05).治疗2、3周后,治疗组血清NO水平均高于对照组(P<0.05);治疗1、2周后,治疗组血清EDHF水平均高于对照组(P<0.05).治疗组临床疗效明显优于对照组,差异有统计学意义(P<0.05).结论 中医综合治疗椎动脉狭窄CV可提高疗效,促进症状和功能改善.%Objective To observe the effects of Traditional Chinese medicine (TCM) orthopaedics treatment on vertebral artery stenosis cervical vertigo (CV) with stasis blocking collaterals type.Methods 44 vertebral artery stenosis CV patients were randomly divided into two groups.22 cases in control group were treated by betahistine hydrochloride tablets combined with traction treatment, 22 cases in treatment group were treated by intravenous administration of Xiangdan injection combined with modified TCM orthopaedics treatment and Huiyang-jiuzhen acupuncture on the basis of control group treatment, continuously treatment for 30 d.The blood flow velocity and vessel caliber of left vertebral artery (LVA) and right vertebral artery (RVA) before and after treatment were compared in two groups, and the CV symptoms and function scores were recorded.The serum NO and endothelium-derived hyperpolarizing factor (EDHF) were measured, and the curative effect was evaluated.Results The CV symptoms and function scores 2 and 3 weeks after treatment were obviously increased in two groups (P<0.05).The CV symptoms and function scores 1, 2 and 3 weeks after treatment in treatment group were higher than those in control group (P<0.05).The blood flow velocity and vessel caliber of LVA and RVA after treatment were increased in two groups (P<0.05).After 1 week treatment, the level of serum NO was no obvious change in two groups (P<0.05), and the serum EDHF level was obvious higher than before treatment (P<0.05).After 2 weeks treatment, the levels of NO and EDHF were significantly increased in two groups (P<0.05), and the increase in treatment group was superior to control group (P<0.05).After 3 weeks treatment, the level of serum NO was significantly higher than that after 2 weeks treatment in two groups (P<0.05), and the serum EDHF level was lower (P<0.05).After 2 and 3 weeks treatment, the level of serum NO in treatment group was higher than control group (P<0.05).After 1 and 2 weeks treatment, the level of serum EDHF in treatment group was higher than control group at the same period (P<0.05).The curative effect in treatment group was superior to that in control group, with statistical differences (P<0.05).Conclusion TCM orthopaedics treatment can enhance curative effects on the treatment of vertebral artery stenosis CV, and promote the improvement of symptoms and function