丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕临床研究
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R441.2

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2018年度河南省医学科技攻关计划项目(2018051126)


Clinical Study on Danshen Chuanxiongqin Combined with Alprostadil for Posterior Circulation Ischemic Vertigo
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    摘要:

    目的:观察丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕的效果及对患者血液动力学和血液流变学的影响。方法:选取110 例后循环缺血性眩晕患者,按随机数字表法分为对照组和研究组各55 例。对照组给予神经内科常规药物治疗,研究组在对照组基础上给予丹参川芎嗪联合前列地尔治疗。比较2 组临床疗效,检测血液动力学指标[基底动脉(BA)、左椎动脉(LVA)、右椎动脉(RVA) 血流速度及阻力系数(RI)]、血液流变学指标[血浆黏度(PV)、红细胞压积(PCV)、全血低切黏度、全血高切黏度]、凝血功能指标[纤维蛋白原(FIB)、凝血酶原时间(PT) 及活化部分凝血活酶时间(APTT)]、血清指标[内皮素-1 (ET-1)、降钙素基因相关肽(CGRP) 及ET-1/CGRP 比值],采用眩晕障碍量表筛查表(DHI-S) 及眩晕量表(DARS) 评价2 组的眩晕症状。结果:研究组恶心呕吐、眩晕头痛、共济失调、平衡障碍等临床症状消除时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组BA、LVA、RVA 血流速度较治疗前明显升高,RI 较治疗前明显降低,且研究组各指标更优于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组PV、PCV、全血低切黏度、全血高切黏度均较治疗前降低,且研究组PV、PCV、全血低切黏度、全血高切黏度均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组PT 及APTT水平较治疗前升高,FIB 较治疗前降低,且研究组各项指标均优于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组ET-1及ET-1/CGRP 较治疗前明显降低,CGRP 较治疗前明显升高,且研究组各项指标明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组DHI-S 及DARS 评分均较治疗前明显降低,且研究组DHI-S 及DARS 评分低于对照组,差异均有统计学意义(P<0.05)。结论:丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕可促进患者临床症状迅速转归,改善血液动力学、血液流变学及凝血功能,临床安全性较高。

    Abstract:

    Abstract:Objective:To observe the curative effect of Danshen Chuanxiongqin combined with alprostadil for posterior circulation ischemic vertigo and its effect on hemodynamics and hemorheology. Methods: A total of 110 cases of patients with posterior circulation ischemic vertigo were selected and divided into the control group and the study group according to the random number table method, 55 cases in each group. The control group was given routine medicine treatment of neurology, and the study group was additionally given Danshen Chuanxiongqin combined with alprostadil based on the treatment of the control group. The clinical effect was compared between the two groups. The differences in the hemodynamics indexes [blood flow velocity of basilar artery(BA),left vertebral artery(LVA),right vertebral artery(RVA),and resistance index(RI)],the hemodynamics indexes [plasma viscosity(PV),packet cell volume(PCV),whole blood viscosity at low shear and high shear], indexes of blood coagulation function [fibrinogen(FIB), prothrombin time(PT), and activated partial thromboplastin time(APTT) , and the serum indexes [endothelin-1(ET-1) , calcitonin gene-related peptide(CGRP) , and the ratio of ET-1 to CGRP] were detected. Dizziness Handicap Inventory-Screening(DHI-S) and Dizziness Assessment Rating Scale(DARS) were applied to evaluating the vertigo symptoms in the two groups. Results: The elimination time of nausea and vomiting,vertigo and headache,ataxia,and disequilibrium in the study group was earlier than that in the control group,differences being significant(P<0.05). After treatment,blood flow velocity of BA,LVA,and RVA in the two groups were significantly increased when compared with those before treatment,and RI was significantly decreased;each index above in the study group was better than that in the control group,differences being significant(P<0.05). After treatment, PV,PCV,and whole blood viscosity at low shear and high shear in the two groups were decreased when compared with those before treatment, and the four indexes above in the study group were lower than those in the control group, differences being significant(P<0.05). After treatment, levels of PT and APTT in the two groups were increased when compared with those before treatment,and FIB was decreased;each index above in the study group was better than that in the control group, differences being significant(P<0.05). After treatment, ET- 1 and ET- 1/CGRP in the two groups were significantly decreased when compared with those before treatment, and CGRP was significantly increased; each index above in the study group was significantly better than that in the control group,differences being significant(P<0.05). After treatment, scores of DHI- S and DARS in the two groups were significantly decreased when compared with those before treatment,and the two scores in the study group were lower than those in the control group,differences being significant (P<0.05). Conclusion: In the treatment of posterior circulation ischemic vertigo, the therapy of Danshen Chuanxiongqin combined with alprostadil can promote rapid outcome of clinical symptoms,improve hemodynamics,hemorheology,and blood coagulation function,with high clinical safety.

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王希瑞,周正谦.丹参川芎嗪联合前列地尔治疗后循环缺血性眩晕临床研究[J].新中医,2021,53(5):70-75

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  • 在线发布日期: 2021-03-15
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