葛根二藤汤治疗椎动脉型颈椎病的临床观察

目的:观察葛根二藤汤治疗椎动脉型颈椎病的临床疗效,并探讨其对椎-基底动脉血流动力学的影响。方法:将60例患者随机分为治疗组和对照组,治疗组服用葛根二藤汤治疗,对照组服用盐酸氟桂利嗪治疗。两组均以两周为1个疗程,连续治疗2个疗程。分别观察两组患者治疗后的临床疗效,同时对两组患者治疗前后经颅多普勒(TCD),椎动脉彩色多普勒血流显像(CDFI)相关参数以及症状体征积分进行比较。结果:经过2个疗程治疗后,治疗组的临床总有效率93.3%,对照组的临床总有效率为73.3%,治疗组疗效显著高于对照组(P0.01);治疗后两组症状体征评分较治疗前明显下降(P0.05),治疗后治疗组症状体征评分明显低于对照组(P0.05);治疗后两组左右椎动脉及基底动脉收缩期峰值流速(Vs),平均流速(Vm)明显加快(P0.05),治疗后治疗组上述参数明显高于对照组(P0.05);治疗后两组左右椎动脉血管内径D明显变粗、收缩期峰值血流速度(PSV),平均血流(TAV),舒张末期血流速度(EDV)明显加快(P0.05),治疗后治疗组上述参数明显高于对照组(P0.05)。结论:葛根二藤汤对椎动脉型颈椎病患者有良好疗效,其治疗机制可能与改善椎-基底动脉的血流动力学有关。

Clinical Observation on Gegen Erteng Decoction for Cervical Spondylotic Arteriopathy

Objective: To observe the clinical efficacy of Gegen Erteng decoction in the treatment of cervical spondylosis arteriopathy, and explore its effect on hemodynamics of vertebral-basilar arteries. Method: The 60 patients were randomly divided into treatment group and control group. Patients in treatment group took Gegen Erteng decoction, and patients in control group took flunarizine hydrochloride capsules treatment. 2 weeks were regarded as one treatment course, and both groups took 2 treatment courses. The clinical efficacy was observed after treatment in both groups. Related parameters of transcranial doppler (TCD) and Color Doppler flow imaging (CDFI) of vertebral artery, and scores of symptoms and signs were compared between two groups pre-post treatment. Result: After two courses of treatment, the clinical total effective rate was as high as 93.3%in treatment group, significantly higher than 73.3% in control group (P<0.01), the scores of symptoms and signs after treatment were significantly decreased in both groups (P<0.05), and the scores of symptoms and signs in treatment group were significantly lower than those in control group after treatment (P<0.05), the peak systolic velocity (Vs) and mean velocity (Vm) of basilar arteries and vertebral arteries were significantly accelerated after treatment in both groups (P<0.05), and the above parameters in treatment group were significantly higher than those in control group after treatment (P<0.05), the vessel diameter D of vertebral arteries was significantly enlarged, and the peak systolic velocity (PSV), time average flow velocity (TAV), and end-diastolic velocity (EDV) were accelerated significantly (P<0.05) in both groups after treatment, and the above parameters in treatment group were significantly higher than those in control group after treatment (P<0.05). Conclusion: Gegen Erteng decoction has good curative effect in patients with cervical spondylosis arteriopathy, and the treatment mechanism may be related to improvement in hemodynamics of vertebral-basilar arteries.