【摘要】：目的：眩暈作為臨床高發(fā)病率,高復(fù)發(fā)率疾病,其有效治療一直是臨床研究重點。本臨床研究通過觀察溫中定眩湯針對痰濕中阻型眩暈的臨床效果和治療前后相關(guān)指標(biāo)變化,并與西比靈組對照,探討其臨床效果、機制、安全性,從而為今后臨床治療眩暈提供更為客觀而有價值的指導(dǎo)作用,啟發(fā)新思路,其具有深刻的理論與實際意義。方法：根據(jù)中醫(yī)診斷、中醫(yī)證型、西醫(yī)診斷、輔助檢查等制定相關(guān)納入、排除標(biāo)準(zhǔn),于2015年1月1日～2016年1月1日期間常州市中醫(yī)醫(yī)院腦病科(即神經(jīng)內(nèi)科)門診以及住院病例中根據(jù)相關(guān)要求篩選出60例,隨機分為治療組(溫中定眩湯組)以及對照組(西比靈組),每組各30例。治療組給予溫中定眩湯口服,一日兩次,每次250m1；對照組予以西比靈5mg口服,每晚一次�？偗煶虨�15日。治療后隨訪三月,觀察眩暈復(fù)發(fā)有關(guān)情況。治療前對兩組性別、年齡、基礎(chǔ)疾病、眩暈程度、血漿粘度進(jìn)行基線比較,經(jīng)比較,P0.05,兩組具有可比性。治療后對兩組療效、眩暈評分、血漿粘度、三月內(nèi)復(fù)發(fā)率進(jìn)行組與組的比較,并對眩暈評分、血漿粘度進(jìn)行治療前后組間比較,相關(guān)結(jié)果采用統(tǒng)計學(xué)分析,得出結(jié)論。并在觀察過程中監(jiān)督患者血、尿、糞、ECG、GPT、BUN等指標(biāo),以及觀察相關(guān)毒副作用,做出安全性監(jiān)測結(jié)論。結(jié)果：治療組總治療有效率高達(dá)93.33%高于對照組有效率83.33%；治療組與對照組治療前后眩暈評分改善統(tǒng)計、治療前后血漿粘度統(tǒng)計,P0.01,治療組對血漿粘度的改善優(yōu)于對照組；治療組3月內(nèi)復(fù)發(fā)率3.33%,對照組3月內(nèi)復(fù)發(fā)率10%,治療組復(fù)發(fā)率明顯低于對照組。結(jié)論：溫中定眩湯對于頸性眩暈痰濕中阻證具有明顯療效,根據(jù)治療前后眩暈評分統(tǒng)計學(xué)分析,溫中定眩湯可有效改善痰濕中阻型眩暈的相關(guān)癥狀,改善生活質(zhì)量,且根據(jù)治療前后血漿粘度對比分析,其能有效降低眩暈高危因素之一的血漿粘度；而溫中定眩湯較其他治療藥物相比,可有效降低臨床復(fù)發(fā)率�，F(xiàn)代臨床眩暈作為一高復(fù)發(fā)率的疾病之一,目前暫無明確、可靠降低復(fù)發(fā)率的方法,溫中定眩湯不僅臨床療效明確,且能有效降低復(fù)發(fā)率,故在未來的臨床應(yīng)用上值得進(jìn)一步研究。
[Abstract]:Objective: as a disease with high incidence and high recurrence rate, vertigo has been the focus of clinical research. In this clinical study, we observed the clinical effect of Wenzhong Dingxuan decoction (WZDXD) on phlegm-dampness type vertigo and the changes of related indexes before and after treatment, and compared with sibiline group to discuss its clinical effect, mechanism and safety. It provides a more objective and valuable guidance for clinical treatment of vertigo and enlightens new ideas, which has profound theoretical and practical significance. Methods: according to TCM diagnosis, TCM syndrome type, western medicine diagnosis, auxiliary examination and so on, relevant inclusion and exclusion criteria were formulated. From January 1, 2015 to January 1, 2016, 60 cases were selected from the Department of Encephalopathy (Department of Neurology) of Changzhou traditional Chinese Medicine Hospital according to the relevant requirements. They were randomly divided into treatment group (Wenzhong Dingxuan decoction group) and control group (sibiline group) with 30 cases in each group. The treatment group was treated with Wenzhong Dingxuan decoction twice a day, 250 ml per time, and the control group with sibelium 5mg once a night. The total course of treatment was 15 days. The patients were followed up for 3 months to observe the recurrence of vertigo. Sex, age, basic disease, vertigo degree and plasma viscosity were compared between the two groups before treatment (P0.05), the two groups were comparable. After treatment, the curative effect, vertigo score, plasma viscosity, recurrence rate within three months were compared between the two groups, and the vertigo score and plasma viscosity were compared before and after treatment. The indexes of blood, urine, feces and ECG,GPT,BUN were monitored during the observation, and the safety monitoring results were made. Results: the total effective rate was 93.33% in the treatment group and 83.33% in the control group. The vertigo score of treatment group and control group was improved before and after treatment, the plasma viscosity before and after treatment, P 0.01, the improvement of plasma viscosity in treatment group was better than that in control group. The recurrence rate was 3.33 in the treatment group and 10 in the control group. The recurrence rate in the treatment group was significantly lower than that in the control group. Conclusion: Wenzhong Dingxuan decoction has obvious curative effect on the syndrome of phlegm dampness and dampness of cervical vertigo. According to the statistical analysis of vertigo score before and after treatment, Wenzhong Dingxuan decoction can effectively improve the symptoms of phlegm dampness and middle dampness blocking vertigo and improve the quality of life. According to the comparative analysis of plasma viscosity before and after treatment, it can effectively reduce the plasma viscosity of one of the high risk factors for vertigo. Compared with other treatment drugs, Wenzhong Dingxuan decoction can effectively reduce the clinical recurrence rate. The modern clinical vertigo is one of the diseases with high recurrence rate. At present, there is no definite and reliable way to reduce the recurrence rate. Wenzhong Ding Xuan decoction not only has a definite clinical effect, but also can effectively reduce the recurrence rate. Therefore, in the future clinical application is worth further study.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R255.3

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