A Clinical Study on the Effect of Yinxing Damo (银杏达莫) Combined with Betahistine Hydrochloride Injection on Vertebral Basilar Artery Ischemic Vertigo

Objective: To evaluate the therapeutic efficacy of Yinxing Damo (银杏达莫, YXDM) combined with Betahistine Hydrochloride Injection (BHI) on vertebra basilar artery ischemic vertigo (VBIV).Methods: Ninety patients with VBIV were randomly divided into two groups; 45 patients (the treated group)were treated with YXDM and BHI intravenous dripping, once a day for 14 days. Another 45 patients (control clinical syndromes and the index of the transcranial Doppler (TCD) and hemorheology were observed. Results: The total effective rate was 100% in the treated group, which was better than that in the control group90.5%, (P＜0.05). The indexes of TCD and hemorheology in the treated group were obviously improved after treatment, (P＜0.01). Conclusion: YXDM combined with BHT injection had better effect in treating patients with VBIV is an ideal drug for VBIV.     

The vascular mechanism of action of betahistine in the inner ear of the guinea pig

The aim of this study was to investigate the mechanism and site of action of betahistine dihydrochloride in the inner ear of the guinea pig. Betahistine-evoked increases in cochlear blood flow (CBF) have been presumed to be due to the drug effect on the later wall capillary bed or larger feeding vessels in the cochlea vascular system. As such, the mechanism of action could be due to inhibition of H₃ receptors. Betahistine may also have a direct effect on postsynaptic H₁/H₂ receptors and/or an effect modulated by other autonomic receptors. Betahistine-evoked CBF responses were assessed by laser Doppler flowmetry in the presence of an H₃ agonist (^α N-methylhistamine dihydrochloride), an H₃ antagonist (thioperamide), an H₂ antagonist (cimetidine) or an α₂ antagonist (idazoxan). The effects of betahistine on circulation in the anterior inferior cerebellar artery (AICA) and ipsilateral stria vascularis (SV) were assessed using intravital microscopy (IVM). Findings showed that betahistine increased CBF and reduced systemic blood pressure (BP). In contrast, ^α N-methylhistamine dihydrochloride had no effect on baseline CBF or BP and did not influence betahistine-induced increases in CBF. Thioperamide reversed the effects of betahistine on CBF, but had no effect on baseline CBF or BP. Cimetidine had no marked effect on baseline CBF or betahistine-induced increases in CBF Idazoxan had no consistent effects on baseline CBF, but abolished the effect of betahistine on CBF. The mean increase of red blood cell velocity in SV capillaries was 15% and occurred without a demonstrable change in capillary diameters. In contrast, the diameter of the AICA increased by 17–20%, indicating that betahistine-evoked increases in CBF resulted primarily from vasodilatation of the AICA. We suggest that this effect may be mediated via presynaptic H₃ heteroreceptors and autonomic α₂ receptors. Received: 25 June 1997 / Accepted: 20 August 1997     

疏血通倍他司汀治疗椎-基底动脉缺血性眩晕

目的观察疏血通联合倍他司汀治疗椎-基底动脉缺血性眩晕的疗效。方法椎-基底动脉缺血性眩晕患者65例随机分为治疗组(35例)及对照组(30例);治疗组予倍他司汀40mg(加入0.9%生理盐水250ml中)联合疏血通8mg(加入0.9%生理盐水250ml中)静脉滴注,每天一次,治疗10天。对照组予丹参30m(l加入0.9%生理盐水250ml中)联合脉络宁30m(l加入0.9%生理盐水250ml中)静脉滴注,每天一次,治疗10天。全部病例治疗前后均做经颅多普勒(TCD)检查。结果治疗标准按痊愈,好转,无效划分:治疗组分别为29例、4例、2例,总有效率为95%;对照组分别为18例、4例、8例,总有效率为73%(P<0.01)。结论疏血通联合倍他司汀治疗椎-基底动脉缺血性眩晕的效果优于丹参联合脉络宁的治疗效果。     

倍他司汀治疗椎基底动脉供血不足血流动力学的研究

目的探讨盐酸倍他司汀对椎基底动脉供血不足的临床疗效。方法对120例椎基动脉供血不足患者随机分为两组，倍他司汀组和西比灵组，各组60例，倍他司汀8mg，1次／d，口服，西比灵5mg，1次/d，疗程均为10d，每周行经颅多普勒（TCD）检测，评价颅底血流动力学的变化。结果治疗组痊愈57例（95％）、有效2例（3．3％）、无效1例（1．6％），总有效率98.3％；对照组痊愈42例（70％）、有效11例（18．3％）、无效7例（11．6％），总有效率86．6％。结论倍他司汀缓解脑血管痉挛及改善脑动脉的血流量，治疗椎基动脉供血不足疗效明显，均优于西比灵，两组比较差异有显著性（P〈0．05）。     

凯时(PGE1)联合倍他司汀治疗椎-基底动脉缺血性眩晕35例疗效观察

目的观察凯时联合倍他司汀治疗椎-基底动脉缺血性眩晕疗效。方法椎-基底动脉缺血性眩晕65例随机分为治疗组(35例)及对照组(30例);治疗组予倍他司汀40mg(加入0·9%生理盐水250mL中)联合凯时10μg(加入0·9%生理盐水250mL中)静脉滴注,1次/d,治疗10d。对照组予丹参30mL(加入0·9%生理盐水250mL中)联合脉络宁30mL(加入0·9%生理盐水250mL中)静脉滴注,1次/d,治疗10d。全部病例治疗前后均作经颅多普勒(TCD)检查。结果治疗标准按痊愈、好转,无效划分;治疗组分别为29,4,2例;总有效率为95%;对照组分别为18,4,8例,总有效率为73%(P<0·01)。结论凯时联合倍他司汀治疗椎-基底动脉缺血性眩晕的效果优于丹参联合脉络宁的治疗效果。     

HPLC法测定盐酸倍他司汀片的含量

目的建立HPLC法测定盐酸倍他司汀片的含量。方法采用Kromasil C18色谱柱(250mm×4.6mm,5μm),流动相为磷酸三乙胺缓冲液(pH4.5);流速为1.0mL.min-1;检测波长为261nm。结果盐酸倍他司汀在20.316~60.984μg.mL-1浓度范围内呈良好的线性关系(r=0.9999),其平均回收率为99.86%,RSD=0.37%(n=9)。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片的质量控制。     

葛根素与培他啶治疗眩晕疗效比较

目的 比较葛根素与培他啶治疗眩晕的疗效.方法 65例眩晕患者,随机分为葛根素组32例,男性21例,女性11例,年龄32～72岁平均(52.3±12.5)岁,给予葛根素注射液500mg加入5%葡萄糖注射液250ml中,静脉点滴,1次/d;培他啶组33例,男性22例,女性11例,年龄32～74岁,平均(54.6±11.7)岁,培他啶组给盐酸培他啶注射液500ml静脉滴注1次/d;两组均连续治疗7d.结果 葛根素组总有效率93.7%,培他啶组总有效率94%,两组无显著差异,(P＞0.05).结论 葛根素治疗眩晕疗效与培他啶相相仿,但葛根据素更适用于伴高血压、冠心病的眩晕患者,值得临床推广应用.     

改良Epley复位法联合倍他司丁治疗良性阵发性位置性眩晕

目的:探讨改良Epley复位法联合倍他司汀治疗后半规管性良性阵发性位置性眩晕(posterior semicircular canal benign paroxysmal positional vertigo,PC-BPPV)的疗效.方法:单侧PC-BPPV患者88例,随机分为治疗组42例、对照组46例.治疗组使用改良Epley复位法,在此基础上加服倍他司汀,每次6 mg,每日3次,连续服用1个月.对照组在就诊当日视患者耐受程度及病情缓解情况给予改良Epley手法复位1次.结果:1个月后评价两组疗效,治疗组较对照组相比,有效率明显改善,P＜0.05.结论:手法复位联合倍他司丁治疗BPPV有相互补充的作用,效果好,值得推广应用.     

甲磺酸倍他司汀微孔渗透泵控释片包衣处方的优化

目的:制备甲磺酸倍他司汀微孔渗透泵控释片,并对其包衣处方进行优化。方法:采用相似因子法考察影响释药的主要因素,采用正交试验以致孔剂聚乙二醇的用量、增塑剂邻苯二甲酸二丁酯(DBP)的用量和包衣增重为因素,以释放度的综合指标L值为指标优化包衣处方,并进行验证试验及体外释药模型拟合。结果:相似因子值均小于50,表明聚乙二醇、DBP的用量及包衣增重对制剂的释放均有显著影响;优化的最佳包衣处方中聚乙二醇为30%,DBP为20%,包衣增重为4%;验证试验中3批样品L值分别为13.99、11.15、8.37,12h累积释药百分率大于90%,释药模型特征为零级释药。结论:按最佳处方制得的甲磺酸倍他司汀微孔渗透泵控释片在12h内可稳定释药,且释放完全。