祛风化痰逐瘀法联合西药治疗中风后眩晕的疗效及对血流动力学参数的影响
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R743.3

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河南省中医药科学研究专项课题(2017ZY3015)


Curative Effect of Qufeng Huatan Zhuyu Method Combined with Western Medicine on Dizziness After Stroke and Its Effect on Hemodynamic Parameters
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    摘要:

    目的:观察祛风化痰逐瘀法联合西药治疗中风后眩晕的疗效及对血流动力学参数、外周血人降钙素基因相关肽(CGRP) 及可溶性CD40 配体(sCD40L) 的影响。方法:选取105 例中风后眩晕患者作为研究对象,按治疗方式的不同分为西药组52 例及中西组53 例。2 组均接受常规治疗,西药组在常规治疗基础上加用西药治疗,中西组在西药组基础上给予祛风化痰逐瘀法治疗。比较2 组治疗前后中医证候评分、血流动力学参数[左侧椎动脉(LVA)、右侧椎动脉(RVA)、基底动脉(BA) 的收缩期峰流速(Vs)、舒张期末峰流速(Vd)、平均流速(Vm)],血清相关因子[CGRP、sCD40L、乳脂肪球表皮生长因子Ⅷ(MFG-E8)、内皮素-1(ET-1)] 水平的变化,观察2 组不良反应发生情况。结果:治疗2 个月后,2 组眩晕、头痛、耳鸣、胸闷中医证候评分均较治疗前下降(P<0.05),中西组中医证候各评分均低于西药组(P<0.05)。治疗2 个月后,2 组RVA-Vs、RVA-Vd、RVA-Vm、LVA-Vs、LVA-Vd、LVA-Vm、BA-Vs、BA-Vd、BA-Vm 水平均较治疗前升高(P<0.05),中西组血流动力学各参数均高于西药组(P<0.05)。治疗2 个月后,2 组ET-1、MFG-E8、sCD40L 水平均较治疗前下降,CGRP 水平均较治疗前上升,差异均有统计学意义(P<0.05);中西组ET-1、MFG-E8、sCD40L 水平均低于西药组,CGRP 水平高于西药组,差异均有统计学意义(P<0.05)。中西组不良反应发生率为3.77%,西药组为7.69%,2 组比较,差异无统计学意义(P>0.05)。结论:祛风化痰逐瘀法联合西药治疗中风后眩晕可提高其临床疗效,调节血清相关因子水平,缓解临床症状,调控血流动力学参数,安全性较高。

    Abstract:

    Abstract: Objective: To observe the curative effect of the Qufeng Huatan Zhuyu method combined with western medicine on dizziness after stroke and its effect on hemodynamic parameters, calcitonin gene- related peptide(CGRP) of peripheral blood and soluble CD40 ligand(sCD40L). Methods: A total of 105 patients with dizziness after stroke were selected as the research objects and divided into the western medicine group and the Chinese and western medicine group according to different treatment methods, with 52 and 53 cases in each group respectively. Both groups were treated with routine treatment. The western medicine group was additionally treated with western medicine based on the routine treatment, and the Chinese and western medicine group was additionally treated with the Qufeng Huatan Zhuyu method based on the treatment of the western medicine group. Before and after treatment,the changes of traditional Chinese medicine(TCM syndrome scores, hemodynamic parameters, including the peak systolic velocity(Vs), end diastolic velocity(Vd) and mean velocity(Vm) of left vertebral artery(LVA), right vertebral artery(RVA) and basilar artery(BA), and levels of serum related factors, including CGRP, sCD40L, milk fat globule- epidermal growth- factor VIII(MFG- E8) and endothelin- 1(ET- 1), were compared between the two groups. The incidence of adverse reactions in the two groups was observed. Results:After two months of treatment,the TCM syndrome scores of dizziness,headache,tinnitus and chest oppression in the two groups were decreased when compared with those before treatment(P< 0.05),and the above four scores in the Chinese and western medicine group were lower than those in the western medicine group(P<0.05). After two months of treatment,the levels of RVA-Vs,RVA-Vd,RVAVm, LVA-Vs,LVA-Vd,LVA-Vm,BA-Vs,BA-Vd and BA-Vm in the two groups were increased when compared with those before treatment(P<0.05), and the above nine hemodynamic parameters in the Chinese and western medicine group were higher than those in the western medicine group(P<0.05). After two months of treatment,the levels of ET- 1,MFG- E8 and sCD40L in the two groups were decreased when compared with those before treatment,and the levels of CGRP were increased,differences being significant(P<0.05);the levels of ET-1,MFG-E8 and sCD40L in the Chinese and western medicine group were lower than those in the western medicine group,and the level of CGRP was higher than that in the western medicine group, differences being significant(P<0.05). The incidence of adverse reactions was 3.77% in the Chinese and western medicine group and 7.69% in the western medicine group,there being no significance in the difference(P>0.05). Conclusion: The therapy of the Qufeng Huatan Zhuyu method combined with western medicine for dizziness after stroke can enhance the clinical effect, regulate the levels of serum related factors,improve the Chinese medicine syndrome scores,and regulate and control the hemodynamic parameters,with high safety.

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梁行,孔林,刘夏.祛风化痰逐瘀法联合西药治疗中风后眩晕的疗效及对血流动力学参数的影响[J].新中医,2022,54(23):74-78

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  • 在线发布日期: 2022-12-11
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