标题：尼麦角林联合银丹心脑通软胶囊治疗颈性眩晕的疗效及对TCD参数的影响

      作者：乔晶晶 1，董建彬 2，刘霞 1，薛瑶 1，乔子梅 1    榆林市第一医院神经内科 1、骨科 2，陕西 榆林 719000

      卷次： 2021年32卷24期

      【摘要】 目的 观察尼麦角林联合银丹心脑通软胶囊治疗颈性眩晕的疗效及经颅多普勒超声(TCD)参数的变化。方法 采用随机数表法将2018年10月至2020年10月榆林市第一医院收治的84例颈性眩晕住院患者分为观察组和对照组各42例。住院期间，对照组患者给予尼麦角林片治疗，观察组患者在对照组治疗的基础上给予银丹心脑通软胶囊治疗，连续治疗2个月后评估临床疗效。于治疗前后，采用颈性眩晕症状与功能评估量表(ESCV)评估症状改善情况；采用 JYQ-TCD-2000超声经颅多普勒血流分析仪检测左侧椎动脉(LVA)、右侧椎动脉(RVA)及基底动脉(BA)的平均血流速度；采用淄博恒拓HT-100型血液黏度检测仪检测血浆黏度、全血还原黏度、红细胞比容(HCT)；并比较两组患者用药期间的不良反应发生情况。结果 观察组患者的治疗总有效率为95.24%，明显高于对照组的80.95%，差异有统计学意义((P<0.05)；观察组患者治疗后的肩颈痛、头痛、日常生活及工作、心理及社会适应、眩晕各部分评分分别为(3.12±0.37)分、(1.58±0.21)分、(3.32±0.26)分、(3.19±0.38)分、(13.04±1.42)分，明显高于对照组的(2.44±0.35)分、(1.34±0.25)分、(2.78±0.49)分、(2.84±0.40)分、(10.63±2.32)分，差异均有统计学意义((P<0.05)；观察组患者治疗后LVA、RVA及BA的平均血流速度分别为(33.82±4.39) cm/s、(34.57±4.28) cm/s、(34.87±4.25) cm/s，明显高于对照组的(30.45±4.21) cm/s、(30.96±4.23) cm/s、(31.42±4.56) cm/s，差异均有统计学意义(P<0.05)；观察组患者治疗后的血浆黏度、全血还原黏度及HCT水平分别为(1.24±0.27) mPa/s、(6.13±0.92) mPa/s、0.41±0.04，明显低于对照组的(1.55±0.34) mPa/s、(6.54±0.93) mPa/s、0.44±0.05，差异均有统计学意义((P<0.05)；治疗期间，两组患者均无严重不良反应，对照组 1例轻微胃痛，观察组 1例恶心，组间不良反应发生率比较差异无统计学意义(P>0.05)。结论 尼麦角林联合银丹心脑通软胶囊治疗颈性眩晕效果良好，能改善TCD参数、降低血液黏度，有助于改善临床症状，且安全性较好。
      【关键词】 颈性眩晕；尼麦角林；银丹心脑通软胶囊；临床疗效；经颅多普勒超声
      【中图分类号】 R441.2 【文献标识码】 A 【文章编号】 1003—6350（2021）24—3191—04

Curative effect of nicergolent combined with Yindan Xinnaotong Soft Capsule on cervical vertigo and theinfluences on TCD parameters.
QIAO Jing-jing 1, DONG Jian-bin 2, LIU Xia 1, XUE Yao 1, QIAO Zi-mei 1. Department ofNeurology 1, Department of Orthopaedics 2, Yulin First Hospital, Yulin 719000, Shaanxi, CHINA
【Abstract】 Objective To observe the curative effect of nicergolent combined with Yindan Xinnaotong SoftCapsule on cervical vertigo and changes of transcranial Doppler (TCD) parameters. Methods According to randomnumber table method, 84 inpatients with cervical vertigo admitted to Yulin First Hospital between October 2018 and Oc-tober 2020 were divided into observation group and control group, with 42 patients in each group. During hospitaliza-tion, patients in the control group were treated with nicergolent tablets, while patients in the observation group were addi-tionally treated with Yindan Xinnaotong Soft Capsules. The clinical curative effect was evaluated after 2 months of con-tinuous treatment. Before and after treatment, improvement of symptoms was evaluated by Evaluation Scale for CervicalVertigo (ESCV). The mean flow velocity values of left vertebral artery (LVA), right vertebral artery (RVA), and basilarartery (BA) were detected by JYQ-TCD-2000 ultrasonic transcranial Doppler blood flow analyzer. Plasma viscosity,whole blood reduced viscosity, and hematocrit (HCT) were detected by HT-100 Blood Viscosity Tester in Zibo Hengtuo.The occurrence of adverse reactions during medication was compared between the two groups. Results The total re-sponse rate of treatment in the observation group was significantly higher than that in the control group (95.24% vs80.95%, P<0.05). After treatment, scores of shoulder-neck pain, headache, daily life and work, psychological and socialadaptation, and vertigo in the observation group were (3.12±0.37) points, (1.58±0.21) points, (3.32±0.26) points, (3.19±0.38) points, and (13.04±1.42) points, significantly higher than (2.44±0.35) points, (1.34±0.25) points, (2.78±0.49) points,(2.84±0.40) points, (10.63±2.32) points in the control group (P<0.05). After treatment, mean flow velocity values ofLVA, RVA, and BA in the observation group were (33.82±4.39) cm/s, (34.57±4.28) cm/s, and (34.87±4.25) cm/s, signifi-cantly higher than (30.45±4.21) cm/s, (30.96±4.23) cm/s, (31.42±4.56) cm/s in the control group (P<0.05). After treat-ment, plasma viscosity, whole blood reduced viscosity, and HCT in the observation group were (1.24 ± 0.27) mPa/s,(6.13±0.92) mPa/s, and 0.41±0.04, significantly lower than (1.55±0.34) mPa/s, (6.54±0.93) mPa/s, 0.44±0.05 in the con-trol group (P<0.05). During treatment, there were no severe adverse reactions in the two groups. There was 1 case withstomachache in the control group and 1 case with nausea in the observation gro