标题：昂丹司琼联合倍他司汀治疗老年急性眩晕症的效果及对患者脑血流参数的影响

      作者：李素君 1，张国栋 2，郭莉君 3，贾晓涛 4    1.千阳县中医院内科，陕西 宝鸡 721100；2.宝鸡市中医院脑病一科，陕西 宝鸡 721001；3.千阳县中医院神经内科，陕西 宝鸡 721100；4.西安市中心医院神经内科，陕西 西安 710000

      卷次： 2021年32卷20期

      【摘要】 目的 观察昂丹司琼联合倍他司汀治疗老年急性眩晕症的临床疗效，并探讨其对患者脑血参数的影响。方法 选取千阳县中医院2019年1月至2020年1月收治的86例老年急性眩晕症患者为研究对象，按随机数表法分为对照组和观察组，每组43例。对照组患者行倍他司汀治疗，观察组在此基础上联合昂丹司琼治疗，两组均治疗7 d。比较两组患者的临床疗效以及治疗前后的眩晕症状评分[中文版眩晕残碍程度评定量表(DHI)、颈性眩晕症状与功能评估量表(ESCV)]和经颅多普勒超声(TCD)参数[基底动脉(BA)、左椎动脉(LVA)、右椎动脉(RVA)]；同时比较两组患者治疗前后的血清25-羟维生素D [25(OH)D]、内皮素-1 (ET-1)水平和不良反应发生情况。结果 观察组患者的治疗总有效率为 93.03%，明显高于对照组的 76.74%，差异有统计学意义(P<0.05)；两组患者治疗后的DHI、ESCV评分较治疗前均降低，且观察组患者治疗后的DHI、ESCV评分分别为(25.41±2.11)分、(10.36±1.38)分，明显低于对照组的(35.96±1.16)分、(14.63±1.59)分，差异均有统计学意义(P<0.05)；两组患者治疗后的BA、LVA、RVA较治疗前升高，且观察组患者治疗后的BA、LVA、RVA分别为(49.82±4.25) cm/s、(50.36±5.62) cm/s、(49.52±5.95) cm/s，明显高于对照组的(44.79±4.36) cm/s、(46.25±5.74) cm/s、(44.23±5.72) cm/s，差异均具有统计学意义(P<0.05)；两组患者治疗后的 ET-1水平较治疗前降低，25(OH)D水平较治疗前升高，且观察组患者治疗后的 ET-1水平为(113.42±10.26) ng/L，明显低于对照组的(152.69±10.52) ng/L，25(OH)D水平为(49.77±8.75) ng/L，明显高于对照组的(40.63±7.63) ng/L，差异均具有统计学意义(P<0.05)；观察组和对照组患者治疗后的不良反应发生率分别为4.64%、6.96%，差异无统计学意义(P>0.05)。结论 昂丹司琼联合倍他司汀治疗老年急性眩晕症可减轻患者的眩晕症状，改善脑部血流状态，用药后不良反应较低，临床疗效确切。
      【关键词】 老年人；急性眩晕症；昂丹司琼；倍他司汀；治疗效果；脑血流参数
      【中图分类号】 R441.2 【文献标识码】 A 【文章编号】 1003—6350（2021）20—2600—04

Effect of ondansetron combined with betahistine in the treatment of senile acute vertigo and its influence on theparameters of cerebral blood flow in patients.
LI Su-jun 1, ZHANG Guo-dong 2, GUO Li-jun 3, JIA Xiao-tao 4. 1.Department of Medicine, Qianyang Hospital of Traditional Chinese Medicine, Baoji 721100, Shaanxi, CHINA; 2. FirstDepartment of Encephalopathy, Baoji Traditional Chinese Medicine Hospital, Baoji 721001, Shaanxi, CHINA; 3. Departmentof Neurology, Qianyang Hospital of Traditional Chinese Medicine, Baoji 721100, Shaanxi, CHINA; 4. Department ofNeurology, Xi'an Central Hospital, Xi'an 710000, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical efficacy of ondansetron combined with betahistine in the treat-ment of senile acute vertigo and to explore its effect on cerebral blood parameters. Methods Eighty-six elderly patientswith acute vertigo treated in Qianyang Hospital of Traditional Chinese Medicine from January 2019 to January 2020were selected as the research objects. They were randomly divided into a control group and an observation group, with43 patients in each group. The control group was treated with betahistine for 7 days, and the observation group was treat-ed with ondansetron on this basis. The clinical efficacy and vertigo symptom scores before and after treatment [Chinesevertigo Disability Assessment Scale (DHI), cervical vertigo symptom, and function assessment scale (ESCV)] and tran-scranial Doppler (TCD) parameters [basilar artery (BA), left vertebral artery (LVA), right vertebral artery (RVA)] werecompared between the two groups. At the same time, the levels of serum 25 hydroxyvitamin D [25(OH)D], endothelin-1(ET-1), and adverse reactions were compared between the two groups before and after treatment. Results The total ef-fective rate of the observation group was 93.03%, which was significantly higher than 76.74% of the control group (P<0.05). The scores of DHI and ESCV in the two groups after treatment were lower than those before treatment, and the