薄芝糖肽注射液、注射用血塞通联合水蛭免煎颗粒治疗椎-基底动脉供血不足性眩晕的临床观察
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摘要
目的观察薄芝糖肽注射液、注射用血塞通联合水蛭颗粒治疗椎-基底动脉供血不足性眩晕的临床疗效。方法将86例椎-基底动脉供血不足性眩晕患者随机分为2组。对照组43例予盐酸氟桂利嗪胶囊治疗;治疗组43例予薄芝糖肽注射液、注射用血塞通联合水蛭免煎颗粒治疗。2组均2周为1个疗程,2个疗程后统计疗效,并比较2组治疗前后眩晕症状评分情况;比较2组治疗前后双侧椎动脉与基底动脉血液流速变化情况,包括舒张末期流速(Vd)、收缩期峰流速(Vs)及平均流速(Vm);比较2组治疗前后血液流变学指标变化情况,包括全血黏度(高切)、全血黏度(低切)、血浆黏度、红细胞比容及纤维蛋白原。结果2组治疗后眩晕症状评分与本组治疗前比较均明显降低(P<0.05),且治疗组治疗后眩晕症状评分较对照组治疗后降低更明显(P<0.05);治疗组总有效率88.4%,对照组总有效率72.1%,治疗组疗效优于对照组(P<0.05);治疗组治疗后双侧椎动脉及基底动脉血液流速各指标与本组治疗前比较均明显增加(P<0.05),且各指标均高于对照组治疗后水平(P<0.05),对照组治疗后仅左侧椎动脉Vm及右侧椎动脉Vd、Vm水平较治疗前明显增加(P<0.05);治疗组治疗后血液流变学指标与本组治疗前比较均明显降低(P<0.05),且各指标均低于对照组治疗后水平(P<0.05),对照组治疗前后血液流变学指标比较差异均无统计学意义(P>0.05)。结论薄芝糖肽注射液、注射用血塞通联合水蛭颗粒治疗椎-基底动脉供血不足性眩晕可明显提高临床疗效,改善患者眩晕症状,提高椎动脉及基底动脉血流速度,有效改善血液流变学指标,安全可靠。
Objective To observe the clinical effects of Bozhi glycopeptides injection,Xuesaitong for injection and hirudo in treating vertigo caused by vertebrobasilar ischemia.Methods 86 patients with vertigo caused by vertebrobasilar ischemia were randomly divided into two groups.43 cases in control group were treated by Flunarizine hydrochloride capsules,43 cases in treatment group were treated by Bozhi glycopeptides injection,Xuesaitong for injection and hirudo.A treatment course was 2 weeks that continuously treatment for two courses in two groups.The curative effects were evaluated after 2 treatment course.The score of vertigo symptom before and after treatment were observed and compared in two groups.The changes of blood flow velocity of bilateral vertebral artery and basilar artery including the end-diastolic velocity(Vd),systolic peak velocity(Vs) and mean velocity(Vm) before and after treatment were compared in two groups.The changes of hemorheology indexes including whole blood viscosity(high shear),whole blood viscosity(low shear),plasma viscosity,hematocrit and fibrinogen before and after treatment were compared in two groups.Results The scores of vertigo symptom after treatment were significantly reduced in both groups(P < 0.05),and the reduction in treatment group were more obvious than that in control group(P <0.05).The total effective rate was 88.4% in treatment group and 72.1% in control group,and the curative effect in treatment group was better than that in control group(P <0.05).The indexes of blood flow velocity of bilateral vertebral artery and basilar artery after treatment were significantly increased in treatment group(P < 0.05),and all indexes were higher than those in control group after treatment(P < 0.05).In control group,only the Vm of the left vertebral artery and the Vd and Vm of the right vertebral artery were significantly increased(P < 0.05).The hemorheology indexes after treatment were significantly reduced in treatment group(P < 0.05),and all indexes after treatment in treatment group were lower than those in control group(P < 0.05).There was no statistical difference on hemorheology indexes between before and after treatment in control group(P > 0.05).Conclusion Bozhi glycopeptide injection and Xuesaitong for injection and hirudo in treating vertigo caused by vertebrobasilar ischemia can significantly increase curative effects,improve vertigo symptoms,increase blood flow velocity of vertebral artery and basilar artery,and effectively improve hemorrheology indicators,safe and reliable.
Objective To observe the clinical effects of Bozhi glycopeptides injection,Xuesaitong for injection and hirudo in treating vertigo caused by vertebrobasilar ischemia.Methods 86 patients with vertigo caused by vertebrobasilar ischemia were randomly divided into two groups.43 cases in control group were treated by Flunarizine hydrochloride capsules,43 cases in treatment group were treated by Bozhi glycopeptides injection,Xuesaitong for injection and hirudo.A treatment course was 2 weeks that continuously treatment for two courses in two groups.The curative effects were evaluated after 2 treatment course.The score of vertigo symptom before and after treatment were observed and compared in two groups.The changes of blood flow velocity of bilateral vertebral artery and basilar artery including the end-diastolic velocity(Vd),systolic peak velocity(Vs) and mean velocity(Vm) before and after treatment were compared in two groups.The changes of hemorheology indexes including whole blood viscosity(high shear),whole blood viscosity(low shear),plasma viscosity,hematocrit and fibrinogen before and after treatment were compared in two groups.Results The scores of vertigo symptom after treatment were significantly reduced in both groups(P < 0.05),and the reduction in treatment group were more obvious than that in control group(P <0.05).The total effective rate was 88.4% in treatment group and 72.1% in control group,and the curative effect in treatment group was better than that in control group(P <0.05).The indexes of blood flow velocity of bilateral vertebral artery and basilar artery after treatment were significantly increased in treatment group(P < 0.05),and all indexes were higher than those in control group after treatment(P < 0.05).In control group,only the Vm of the left vertebral artery and the Vd and Vm of the right vertebral artery were significantly increased(P < 0.05).The hemorheology indexes after treatment were significantly reduced in treatment group(P < 0.05),and all indexes after treatment in treatment group were lower than those in control group(P < 0.05).There was no statistical difference on hemorheology indexes between before and after treatment in control group(P > 0.05).Conclusion Bozhi glycopeptide injection and Xuesaitong for injection and hirudo in treating vertigo caused by vertebrobasilar ischemia can significantly increase curative effects,improve vertigo symptoms,increase blood flow velocity of vertebral artery and basilar artery,and effectively improve hemorrheology indicators,safe and reliable.
引文
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[3]贺迎坤,李天晓,王子亮,等.非急性期颅内椎基底动脉闭塞介入再通的中长期随访研究[J].中华放射学杂志,2017,51(2):145-148.
[4]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007:124-125.
[5]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:23.
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[7]曹洁,齐瑞,王辉昊.颈性眩晕病因及发病机制的研究进展[J].河北中医,2016,38(9):1416-1421.
[8]李自如,郭力军.椎-基底动脉供血不足性眩晕的MRA改变及临床分析[J].中国老年学杂志,2007,27(24):2416-2418.
[9]王蕊,赵荣生,张燕娥,等.基于指南和临床路径的椎-基底动脉供血不足住院患者用药分析与评价[J].中国临床药理学杂志,2015,31(12):1205-1208.
[10]许文忠,陈分乔,梅建强.清开灵注射液联合血栓通对椎基底动脉供血不足性眩晕经颅多普勒及血液流变学指标的影响[J].河北中医,2011,33(6):897-899.
[11]朱国燕,邵国富.脑梗死和TIA间血流变学参数的差异分析[J].中国血液流变学杂志,2005,15(1):67-68,72.
[12]丁素菊,吴帅,李永生,等.盐酸氟桂利嗪对沙土鼠脑缺血后血浆降钙素基因相关肽和P物质含量的影响[J].中风与神经疾病杂志,2000,17(6):351-352.
[13]臧广霞.倍他司汀、氟桂利嗪联合异丙嗪治疗前庭周围性眩晕的效果评价[J].中国社区医师,2015,31(33):23-24.
[14]李飞.盐酸氟桂利嗪联合川芎嗪注射液治疗后循环缺血性眩晕的临床观察[J].中国处方药,2015,13(10):105-106.
[15]杜蓉,张春红,白玮婧,等.中医药治疗后循环缺血性眩晕研究进展[J].河北中医,2014,36(1):134-136.
[16]李丹,张怀亮,徐进.椎基底动脉供血不足性眩晕的中医证素初步临床研究[J].中医临床研究,2017,9(1):46-47.
[17]杨连梅.薄芝糖肽注射液临床研究进展[J].光明中医,2017,32(10):1528-1530.
[18]孙仁山,陈晓红,李文维.薄芝糖肽的临床应用[J].时珍国医国药,2009,20(8):2101-2102.
[19]张淑明.血塞通治疗心脑血管病血流变学变化的临床观察[J].中国实用医药,2008,3(30):147-148.
[20]杨洪雁,杜智恒,白秀娟.水蛭药理作用的研究进展[J].东北农业大学学报,2012,43(3):128-133.
[21]袁红霞,张莉芹,马瑾,等.水蛭药用成分及主要药理功效研究进展[J].甘肃医药,2013,32(4):270-273.
[2]宣志红,傅海斌.中西医结合治疗老年人椎-基底动脉供血不足疗效分析[J].中华老年医学杂志,2012,31(9):794-796.
[3]贺迎坤,李天晓,王子亮,等.非急性期颅内椎基底动脉闭塞介入再通的中长期随访研究[J].中华放射学杂志,2017,51(2):145-148.
[4]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007:124-125.
[5]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:23.
[6]中华人民共和国卫生部.中药新药临床研究指导原则:第1辑[M].北京,1993:24-27.
[7]曹洁,齐瑞,王辉昊.颈性眩晕病因及发病机制的研究进展[J].河北中医,2016,38(9):1416-1421.
[8]李自如,郭力军.椎-基底动脉供血不足性眩晕的MRA改变及临床分析[J].中国老年学杂志,2007,27(24):2416-2418.
[9]王蕊,赵荣生,张燕娥,等.基于指南和临床路径的椎-基底动脉供血不足住院患者用药分析与评价[J].中国临床药理学杂志,2015,31(12):1205-1208.
[10]许文忠,陈分乔,梅建强.清开灵注射液联合血栓通对椎基底动脉供血不足性眩晕经颅多普勒及血液流变学指标的影响[J].河北中医,2011,33(6):897-899.
[11]朱国燕,邵国富.脑梗死和TIA间血流变学参数的差异分析[J].中国血液流变学杂志,2005,15(1):67-68,72.
[12]丁素菊,吴帅,李永生,等.盐酸氟桂利嗪对沙土鼠脑缺血后血浆降钙素基因相关肽和P物质含量的影响[J].中风与神经疾病杂志,2000,17(6):351-352.
[13]臧广霞.倍他司汀、氟桂利嗪联合异丙嗪治疗前庭周围性眩晕的效果评价[J].中国社区医师,2015,31(33):23-24.
[14]李飞.盐酸氟桂利嗪联合川芎嗪注射液治疗后循环缺血性眩晕的临床观察[J].中国处方药,2015,13(10):105-106.
[15]杜蓉,张春红,白玮婧,等.中医药治疗后循环缺血性眩晕研究进展[J].河北中医,2014,36(1):134-136.
[16]李丹,张怀亮,徐进.椎基底动脉供血不足性眩晕的中医证素初步临床研究[J].中医临床研究,2017,9(1):46-47.
[17]杨连梅.薄芝糖肽注射液临床研究进展[J].光明中医,2017,32(10):1528-1530.
[18]孙仁山,陈晓红,李文维.薄芝糖肽的临床应用[J].时珍国医国药,2009,20(8):2101-2102.
[19]张淑明.血塞通治疗心脑血管病血流变学变化的临床观察[J].中国实用医药,2008,3(30):147-148.
[20]杨洪雁,杜智恒,白秀娟.水蛭药理作用的研究进展[J].东北农业大学学报,2012,43(3):128-133.
[21]袁红霞,张莉芹,马瑾,等.水蛭药用成分及主要药理功效研究进展[J].甘肃医药,2013,32(4):270-273.