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引用本文:雷华斌1，张恒2.半夏白术天麻汤配合耳石复位法治疗良性阵发性位置性眩晕的临床疗效及对血脂代谢影响[J].世界中医药,2016,(10):.

半夏白术天麻汤配合耳石复位法治疗良性阵发性位置性眩晕的临床疗效及对血脂代谢影响

Clinical Efficacy of Banxia Baizhu Tianma Decoction Plus Canalith Repositioning Procedure in Treating Benign Paroxysmal Positional Vertigo (BPPV) and Their Influence on Blood Lipid Metabolism

投稿时间：2015-10-12

DOI：10.3969/j.issn.1673-7202.2016.10.027

中文关键词: 良性阵发性位置性眩晕半夏白术天麻汤辨证论治耳石复位法临床疗效血清血脂代谢

English Keywords:Benign Paroxysmal Positional Vertigo(BPPV) Banxia Baizhu Tianma Decoction Treatment based on syndrome differentiation Canalith repositioning procedure Clinical curative effect Serum Blood lipid metabolism

基金项目:

作者	单位
雷华斌1，张恒2	1 铜川市人民医院，铜川，727000； 2 铜川市中医医院，铜川，727000

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中文摘要:

目的：观察半夏白术天麻汤配合改良耳石复位法治疗良性阵发性位置性眩晕的临床疗效及探讨血脂代谢异常对本病发病机制的相关性；方法：将我院中医内科2013年1月至2015年1月门诊就诊符合诊断标准的BPPV患者53例，采用PEMS 3.0 for Windows“完全随机（2组或多组）设计，将入选标准的患者按先后顺序随机分为治疗组（23例）和对照组（30例）；2组患者在发作期均先卧床休息，持续低流量吸氧，对照组给予改良Epley复位法，治疗组在对照组基础上给予半夏白术天麻汤辨证加减，分别观察2组在治疗后第2天、2周、3个月临床疗效及治疗前后血脂水平变化并进行分析。结果：治疗后第2天总有效率相比较，治疗组总有效率为73.91%，对照组总有效率为60.00%，总有效率相比较，差异有统计学意义（χ2=6.782，P=0.002<0.05）；治疗后2周总有效率相比较，治疗组总有效率为86.96%，对照组总有效率为73.33%，总有效率相比较，差异有统计学意义（χ2=7.540，P=0.000<0.05）；3个月后总有效率相比，治疗组总有效率为95.65%，对照组总有效率为83.33%，总有效率相比较，差异有统计学意义（χ2=8.351，P=0.000<0.05）；血脂水平变化方面，治疗后3个月治疗组在TG、TC、LDL、Apo-A1与对照组相比较，差异有统计学意义（P<0.05）,在HDL、Apo-B方面与对照组相比较，差异无明显统计学意义（P>0.05）。结论：半夏白术天麻汤配合耳石复位法治疗良性阵发性位置性眩晕的临床疗效确切，血脂代谢的异常与良性阵发性位置性眩晕关系密切，该治疗方法科学，患者依存性高，值得临床推广应用。

English Summary:

To observe the clinical efficacy of Banxia Baizhu Tianma Decoction combined with canalith repositioning procedure in treating benign paroxysmal positional vertigo, and to explore the correlation between its pathogenesis and blood lipid metabolic abnormalities. Methods: A total of 53 cases conforming to the diagnostic criteria in department of internal medicine of traditional Chinese medicine of our hospital from January 2013 to January 2015 were selected and divided into two groups under completely random design by PEMS 3.0, with 23 cases in the treatment group and 30 cases in the control group based on sequential order. Patients of the two groups were asked to stay in bed during the stage of attack, being given the persistent low flow oxygen therapy. At the same time, improved Epley respositioning procedure was applied to patients in the control group, while those in the treatment group were treated with both modified Epley respositioning procedure and modified Banxia Baizhu Tianma Decoction. Then clinical curative effect of two days, two weeks and three months after treatment in both groups were recorded respectively, as well as changes of blood lipid level before and after treatment. Results: The total effective rate of two days in the treatment group was 73.91%, while that in the control group was only 60.00%, showing a significant difference between two groups(χ2=6.782, P=0.002<0.05); After treatment of two weeks, the treatment group total effective rate was 86.96%, while the control group total effective rate was 73.33%, indicating a statistical difference between two groups(χ2=7.540, P=0.000<0.05); After treatment of three months, the treatment group total effective rate was 95.65%, while that in the control group was 83.33%, which showed a statistically significant difference between two groups(χ2=8.351, P=0.000<0.05); As for changes of blood lipid level, compared with the control group, TG, TC, LDL and Apo-A1 in the treatment group after treatment of three months had a statistically significant difference(P<0.05), whereas there was no obvious statistical significance in HDL and Apo-B(P>0.05). Conclusion: Banxia Baizhu Tianma Decoction combined with canalith repositioning procedure has a good clinical efficacy in treating BPPV, and lipid metabolism abnormality is closely associated with CRP, therefore, this scientific method, with high dependability, is worthy of clinical popularization and application.

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