天麻钩藤饮联合倍他司汀治疗眩晕症患者的价值

目的对眩晕症患者接受天麻钩藤饮联合倍他司汀进行治疗的临床疗效以及应用价值进行讨论。方法80例眩晕症患者,根据入院顺序不同分为对照组和研究组,每组40例。对照组患者给予甲磺酸倍他司汀治疗,研究组患者给予天麻钩藤饮联合甲磺酸倍他司汀治疗。比较两组患者的临床疗效以及血液粘稠度。结果研究组患者总有效率90.0%高于对照组的60.0%,差异有统计学意义(P<0.05)。对照组患者治疗后血浆粘度为(2.40±0.25)mPa·s,全血高切粘度为(5.70±0.82)mPa·s,全血低切粘度为(19.15±2.75)mPa·s;研究组患者治疗后血浆粘度为(1.11±0.38)mPa·s,全血高切粘度为(4.15±0.47)mPa·s,全血低切粘度为(15.51±3.28)mPa·s。研究组患者的血浆粘度、全血高切粘度以及全血低切粘度低于对照组,差异有统计学意义(P<0.05)。结论临床中对于眩晕症患者,为其提供天麻钩藤饮联合倍他司汀治疗的临床效果确切,能够有效缓解患者的眩晕以及耳鸣症状,帮助患者血液粘稠度获得改善。     

丹珍头痛胶囊联合倍他司汀治疗血管痉挛性头痛的临床研究

目的 探讨丹珍头痛胶囊联合倍他司汀治疗血管痉挛性头痛的临床疗效。方法 选取2021年3月—2022年3月在北京中医医院怀柔医院接受治疗的102例血管痉挛性头痛患者为研究对象,根据用药差别分为对照组和治疗组,每组各51例。对照组口服盐酸倍他司汀片,10 mg/次,3次/d;治疗组在对照组治疗基础上口服丹珍头痛胶囊,2 g/次,3次/d。两组均连续治疗2周。观察两组的临床疗效,比较两组相关评分、症状改善情况、血清细胞因子和血流动力学的变化情况。结果 治疗组总有效率是98.04%,显著高于对照组的80.39%（P<0.05）。治疗后,两组视觉模拟（VAS）评分较治疗前显著降低,而格拉斯哥预后（GOS）评分、明尼苏达满意度量表（MSQ）评分、匹兹堡睡眠质量指数（PSQI）评分、生活质量综合评定问卷（GQOLI-74）评分均显著升高（P<0.05）;治疗后,治疗组相关评分改善优于对照组（P<0.05）。治疗后,两组头痛发作次数、头痛持续时间均较治疗前显著降低（P<0.05）,并以治疗组改善的更为明显（P<0.05）。治疗后,两组血清降钙素基因相关肽（CGRP）、蛋白激酶C（PKC）、基质金属蛋白酶（MMP-9）、垂体腺苷酸环化酶激活肽（PACAP）、细胞间黏附分子-1（ICAM-1）水平均显著降低（P<0.05）,并以治疗组下降的更明显（P<0.05）。治疗后,左侧脑中动脉（LMCA）、左侧大脑后动脉（LPCA）、左侧大脑前动脉（LACA）、右侧大脑中动脉（RMCA）、右侧大脑前动脉（RACA）、右侧大脑后动脉（RPCA）平均血流流速度均较治疗前显著升高（P<0.05）,并以治疗组升高的更明显（P<0.05）。结论 丹珍头痛胶囊联合倍他司汀治疗血管痉挛性头痛可有效改善患者头痛症状,改善机体细胞因子及血流动力学情况,促进睡眠和生活质量改善,具有良好临床应用价值。     

倍他司汀联合红花注射液治疗眩晕症疗效观察

目的观察倍他司汀联合红花注射液治疗眩晕症的临床疗效。方法150例患者随机分为研究组75例和对照组75例。对照组采用盐酸川芎嗪治疗;研究组采用倍他司汀联合红花治疗,观察比较2组的临床疗效。结果研究组总有效率为90．7％,明显高于对照组的61．3％,并且显效时间研究组短于对照组,差异均有统计学意义（P〈0．05）。结论倍他司汀联合红花治疗眩晕症疗效好,见效快,价格低廉,副作用小,值得推广应用。     

Betahistine add-on therapy for treatment of subjects with posterior benign paroxysmal positional vertigo: a randomized controlled trial

IntroductionBenign paroxysmal positional vertigo is a common vestibular disorder that accounts for one fifth of hospital admissions due to vertigo, although it is commonly undiagnosed.ObjectiveTo evaluate the effects of betahistine add-on therapy in the treatment of subjects with posterior benign paroxysmal positional vertigo.MethodsThis randomized controlled study was conducted in a population of 100 subjects with posterior benign paroxysmal positional vertigo. Subjects were divided into the Epley maneuver + betahistine group (group A) and Epley maneuver only (group B) group. Subjects were evaluated before and 1-week after the maneuver using a visual analog scale and dizziness handicap inventoryResultsOne hundred subjects completed the study protocol. The Epley maneuver had an overall success rate of 95% (96% in group A; 94% in group B, p = 0.024). Groups A and B had similar baseline visual analog scale scores (6.98 ± 2.133 and 6.27 ± 2.148, respectively, p = 0.100). After treatment, the visual analog scale score was significantly lower in both groups, and was significantly lower in group A than group B (0.74 ± 0.853 vs. 1.92 ± 1.288, respectively, p = 0.000). The change in visual analog scale score after treatment compared to baseline was also significantly greater in group A than group B (6.24 ± 2.01 vs. 4.34 ± 2.32, respectively, p = 0.000). The baseline dizziness handicap inventory values were also similar in groups A and B (55.60 ± 22.732 vs. 45.59 ± 17.049, respectively, p = 0.028). After treatment, they were significantly lower in both groups. The change in score after treatment compared to baseline was also significantly greater in group A than group B (52.44 ± 21.42 vs. 35.71 ± 13.51, respectively, p = 0.000).ConclusionThe Epley maneuver is effective for treatment of benign paroxysmal positional vertigo. Betahistine add-on treatment in posterior benign paroxysmal positional vertigo resulted in improvements in both visual analog scale score and dizziness handicap inventory.     

Receptor-independent, vacuolar ATPase-mediated cellular uptake of histamine receptor-1 ligands: possible origin of pharmacological distortions and side effects

The aims of this study were to investigate whether several histamine receptor agonists and antagonists are subjected to receptor-independent ion trapping into acidic organelles, and whether this sequestration influences their pharmacological or toxicological properties. Vacuolar (V)-ATPase-dependent intracellular sequestration of agonists was recognized as morphological alterations (large fluid-filled vacuoles for betahistine and 1-methylhistamine, granular uptake for fluorescent BODIPY FL histamine) prevented by the specific V-ATPase inhibitor bafilomycin A1 in rabbit vascular smooth muscle cells. Lipophilicity was the major determinant of these cellular effects (order of potency: BODIPY FL histamine>betahistine>1-methylhistamine>histamine) that occurred at high concentrations. This ranking was dissociable from the potency order for H(1) receptor-mediated contraction of the rabbit aorta, a response uninfluenced by bafilomycin. Antihistamines are inherently more lipophilic and caused vacuolization of a proportion of cells at 5-500 microM. Agonist or antagonist-induced vacuoles were of macroautophagic nature (labeled with GFP-conjugated LC3, Rab7 and CD63; detection of LC3 II). Further, the 2 most lipophilic antihistamines tested, astemizole and terfenadine, were potentiated by V-ATPase blockade in the aortic contractility assay (13- and 3.6-fold more potent, respectively, pA(2) scale), suggesting that V-ATPase-mediated cation trapping sequesters these antagonists from the vicinity of H(1) receptors in the therapeutic concentration range. This potentiation did not apply to less lipophilic antagonists (pyrilamine, diphenhydramine). While some agonists and all tested antagonists of the histamine H(1) receptors induce the V-ATPase-dependent vacuolar and autophagic cytopathology, sequestration affects the pharmacology of only the most lipophilic antagonists, the ones prone to off-target arrhythmogenic side effects.     

HPLC法测定盐酸倍他司汀氯化钠注射液的有关物质

目的建立HPLC法测定盐酸倍他司汀氯化钠注射液有关物质的检测和控制方法。方法用CapcellPAKC18色谱柱(250mm×4.6mm,5μm),6.0×10-4mol·L-1的醋酸钠乙腈溶液-0.25%的十二烷基硫酸钠水溶液(40∶60)加1%的二乙胺,用冰醋酸调pH4.5作为流动相,流速为1.0ml·min-1,检测波长为261nm。结果盐酸倍他司汀的最低检出限为3.11ng,盐酸倍他司汀与各杂质峰分离良好。结论方法操作简便、重现性好、灵敏度高、专属性强,可用于盐酸倍他司汀氯化钠注射液的质量控制。     

甲磺酸倍他司汀治疗内耳缺血相关性眩晕的疗效研究

目的通过观察良性阵发性位置性眩晕（benign positional paroxysrnal vertigo，BPPV）、后循环缺血（posterior circulation ischemia，PCI）、偏头痛性眩晕（migrainousvertigo，MV）、青少年良性眩晕在服用不同剂量的甲磺酸倍他司汀后的临床表现，了解甲磺酸倍他司汀治疗内耳缺血性眩晕的疗效。方法BPPV、PCI、MV各30例，分成2组。组一：甲磺酸倍他司汀6mg，3／日：组二：甲磺酸倍他司汀12mg，3／El，治疗均为期1个月。观察量-效关系。青少年良性阵发性眩晕25例不分组，甲磺酸倍他司汀6mg3／19，服药治疗1月。分别观察治疗前后高刺激听性脑干测听（auditory brainstem response，ABR）和眩晕残障程度（dizziness handicap inventory，DHI）的变化。结果四类眩晕治疗后症状减轻，高刺激ABR和DHI均有改善，而眼动异常变化不明显。连续用药1个月后，BPPV、PCI、MV三类患者12mg，3／日方案疗效优于6mg，3／日方案。青少年良性眩晕6mg，3/日方案也获得满意疗效。结论甲磺酸倍他司汀对良性阵发性位置性眩晕、后循环缺血、偏头痛性眩晕和青少年良性眩晕等与内耳低灌注有关的眩晕有较好的治疗作用，并表现出量效关系，12mg，3/日方案疗效优于6mg，3／日方案。     

Inhibitory effect of betahistine on polysynaptic neurons in the lateral vestibular nucleus

Summary Effects of betahistine, an antivertigo drug, were examined on the lateral vestibular nucleus (LVN) neurons of cats anesthetized with -chloralose. Spike generation of monosynaptic LVN neurons elicited by vestibular nerve stimulation remained unaffected with intravenous administration of betahistine up to 5 mg/kg and with iontophoretic application of the drug up to 200 nA. In contrast, the spike generation of polysynaptic I neurons in the LVN was dose-dependently inhibited by intravenous as well as iontophoretic application of betahistine. These results suggest that small doses of betahistine more selectively interfere with synaptic transmission in the polysynaptic I neurons than in the monosynaptic neurons.     

血塞通注射液联合倍他司汀治疗后循环性缺血眩晕的疗效观察

目的探讨血塞通注射液联合盐酸倍他司汀治疗后循环缺血性眩晕的临床疗效。方法选取2015年10月—2016年10月在南阳市第九人民医院进行治疗的后循环缺血性眩晕患者94例,根据治疗方案的不同分为对照组(47例)和治疗组(47例)。对照组静脉滴注盐酸倍他司汀注射液,20 mg加入5%葡萄糖溶液250 m L中,1次/d。治疗组在对照组的基础上静脉滴注血塞通注射液,10 m L加入5%葡萄糖溶液250 m L中,1次/d。两组患者均连续治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者椎基底动脉平均血流速度、血液流变学指标和眩晕症状评分变化。结果治疗后,对照组和治疗组的总有效率分别为80.85%、95.74%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者左、右椎动脉及基底动脉平均血流速度均较治疗前明显升高(P0.05);且治疗后治疗组椎基底动脉平均血流速度改善更显著(P0.05)。治疗后,两组患者全血黏度(WBV)、血浆黏度(PV)、纤维蛋白原(FIB)和血小板黏附率(PAR)等指标均较治疗前显著降低(P0.05);且治疗后治疗组患者的血液流变学指标水平显著优于对照组(P0.05)。治疗后,两组患者眩晕症状评分均明显降低(P0.05);且治疗后治疗组患者眩晕症状评分降低程度显著优于对照组(P0.05)。结论血塞通注射液联合盐酸倍他司汀治疗后循环缺血性眩晕的临床效果显著,可明显改善患者眩晕症状,增加椎基底动脉血供,降低血液黏度。     

定眩汤治疗老年性眩晕的临床观察

目的 探讨定眩汤治疗老年性眩晕的临床效果.方法 选取老年性眩晕患者90例,分为对照组40例与观察组50例.对照组采用西医治疗,口服甲磺酸倍他司汀片,12 mg/次,3次/d;观察组采用中医治疗,定眩汤水煎服,每日1剂,分2～3次服用.两组均以15d为1个疗程,治疗后观察两组的临床疗效,比较治疗前后两组症状评分的变化.结果 观察组总有效率为90.0％,对照组总有效率为80.0％,两组比较,差异有统计学意义（P＜0.05）.治疗后,观察组症状评分为（1.02±0.21）分,较治疗前的（2.68±0.46）分明显降低（P＜0.05）;对照组症状评分为（2.01±0.43）分,较治疗前的（2.79±0.52）分明显降低（P＜0.05）;观察组症状评分低于对照组（P＜0.05）.结论 定眩汤治疗老年性眩晕效果显著,可明显改善患者的临床症状,值得推广应用.