小柴胡汤加减对脑卒中后眩晕血液流变学指标的影响

目的探讨小柴胡汤为基础方加减对脑卒中后眩晕患者血液流变学影响。方法将2017年4月-2018年2月诊治的70例脑卒中后眩晕患者随机分为对照组与研究组,每组35例。入院后给予内科综合支持治疗,对照组予地芬尼多片25 mg/次,口服,3次/d;研究组加服中药小柴胡汤加减治疗。两组均连续治疗7 d。检测椎动脉血流动力学(左椎动脉、右椎动脉和基底动脉血流速度)、血液流变学(高切全血黏度、低切全血黏度、血浆黏度、红细胞压积)变化,采用DHI中文量表评估眩晕残余症状评分,比较临床疗效。结果与治疗前比较,两组左椎动脉、右椎动脉、基底动脉血流速度均明显升高(P<0.05),高切全血黏度、低切全血黏度、血浆黏度、红细胞压积水平均显著降低(P<0.01),躯体评分、功能评分、情绪评分、DHI总分均显著降低(P<0.01);与对照组比较,研究组左椎动脉、右椎动脉、基底动脉血流速度均显著较高(P<0.01),高切全血黏度、低切全血黏度、血浆黏度、红细胞压积水平均显著较低(P<0.01),躯体评分、功能评分、情绪评分、DHI总分均显著较低(P<0.01),治疗有效率较高(P<0.05)。结论小柴胡汤为基础方加减治疗脑卒中后眩晕疗效显著,可能与调节血液流变学有关。

Effect of Xiaochaihu Decoction on Hemorheological Indicators in Patients with Vertigo after Stroke

Objective To investigate the effect of Xiaochaihu Decoction on hemorheology in patients with vertigo after stroke. Methods From April 2017 to February 2018, 70 patients with post-stroke vertigo were randomly divided into control group and research group, 35 cases in each group. After admission, the patients in the control group were given Difenidol Tablets,25 mg/time, orally, three times a day, and the patients in the study group were given Xiaochaihu Decoction. Both groups were continuously treated for 7 days. The changes of vertebral artery hemodynamics(blood flow velocity of left vertebral artery, right vertebral artery and basilar artery), hemorheology(high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity, hematocrit) were measured. The scores of residual symptoms of vertigo were evaluated by DHI Chinese scale, and the clinical effects were compared. Results Compared with those before treatment, the blood flow velocity of left vertebral artery, right vertebral artery and basilar artery in both groups increased significantly(P<0.05). The blood viscosity of high-cut whole blood, low-cut whole blood, plasma viscosity and hematocrit decreased significantly(P<0.01), while the body score, function score, emotional score and DHI total score decreased significantly(P<0.01). Compared with the control group, the blood flow velocity of left vertebral artery, right vertebral artery and basilar artery in the study group was significantly higher(P<0.01), while the blood viscosity of high-cut whole blood, low-cut whole blood, plasma viscosity and hematocrit were significantly lower(P<0.01), and the body score, function score, emotional score and DHI total score were significantly lower(P<0.01). The effective rate of treatment was higher(P<0.05). Conclusion Xiaochaihu Decoction is effective in the treatment of vertigo after stroke, which may be related to the regulation of hemorheology.