沈勤康　严民力　戚观树　张丽萍

1.浙江省中医院下沙院区急诊内科，浙江杭州310018；2.浙江省中医院下沙院区神经内科，浙江杭州310018

补阳还五汤加减治疗后循环缺血性眩晕的临床观察

沈勤康1严民力2戚观树2张丽萍2

1.浙江省中医院下沙院区急诊内科，浙江杭州310018；2.浙江省中医院下沙院区神经内科，浙江杭州310018

目的观察补阳还五汤加减联合西药治疗后循环缺血性眩晕（PCIV）的临床疗效。方法将2014年1月～2015年12月期间在我院治疗的84例后循环缺血性眩晕患者，随机分为治疗组42例，对照组42例。对照组予基础治疗+甲磺酸倍他司汀片，治疗组在对照组的基础上加用补阳还五汤加减，治疗2周后观察疗效，并行治疗前后椎基底动脉血流速度、血液流变学检查。结果治疗组总有效率92.9%，对照组总有效率76.2%，组间比较差异有统计学意义（P＜0.05）；治疗后两组患者的椎基底动脉血流速度、血液流变学指标均有所改善（P＜0.05），但治疗组改善优于对照组，差异有统计学意义（P＜0.05）。结论补阳还五汤加减联合西药治疗后循环缺血性眩晕具有显著的临床疗效，值得临床推广应用。

补阳还五汤；后循环缺血性眩晕；甲磺酸倍他司汀片；中西医结合治疗

［Abstract］Objective To observe the clinical curative effect of Modified Buyanghuanwu decoction combined with western medicine in the treatment of posterior circulation ischemic vertigo（PCIV）.Methods 84 cases of PCIV Treated in our hospital from January 2014 to December 2015 were randomly divided into the treatment group and the control group，42 cases in each group.The control group was treated with basic treatment+Betahistine Mesilate Tablets，the treatment group was treated with Buyanghuanwu decoction on basis of the control group.After 2 weeks of treatment，curative effect was observed，The blood flow velocity of the vertebral basilar artery and blood rheology were also observed before and after treatment.Results The total effective rate of the treatment group was 92.9%，the control group was 76.2%，and the difference was statistically significant（P＜0.05）.After treatment，the blood flow velocity of the ver tebral basilar artery and blood rheology in the two groups were improved（P＜0.05），but the treatment group was better than the control group，and the difference was statistically significant（P＜0.05）.Conclusion Modified Buyanghuanwu decoction combined with western medicine in treatment of PCIV has significant clinical effect，it is worthy of clinical application.

［Key words］Buyanghuanwu decoction；Posterior circulation ischemia vertigo；Betahistine mesilate tablets；Traditional Chinese and western medicine treatment

后循环主要给脑干、小脑、丘脑、枕叶、部分颞叶及上段脊髓供血，又称椎-基底动脉系统，由椎动脉、基底动脉和大脑后动脉组成。后循环缺血性眩晕（posterior circulation ischemia vertigo，PCIV）以往称为椎基底动脉供血不足性眩晕（vertebral basilar artery insufficiency vertigo，VBIV），是临床常见的缺血性脑血管疾病，多见于中老年人［1］。脑动脉粥样硬化、血管痉挛、血流动力学改变、高血脂、高血黏度是其发生的主要病因［2，3］。……