世界中医药

目的:探讨参芪四虫汤对椎动脉型颈椎病患者椎底动脉供血情况及血液流变学的影响。方法:选取2014年11月至2016年3月九江171医院收治的椎动脉型颈椎病患者112例作为研究对象，按照随机数字表法分为对照组和观察组，每组56例。对照组给予常规治疗，观察组在对照组的基础上联合参芪四虫汤治疗，2组均治疗4周。比较治疗后2组的临床疗效，统计治疗前后2组主要中医证候积分；检测治疗前后2组患者椎动脉、基底动脉血流速度；比较治疗前后2组血液流变学指标的变化。结果：治疗后观察组与对照组的临床总有效率分别为85.71%、71.43%，观察组显著高于对照组（P<0.05）。与治疗前比较，治疗后2组中医证候积分均明显降低，且观察组显著低于对照组（P<0.05或P<0.01）；治疗后2组左椎动脉、右椎动脉及基底动脉Vs、Vd、Vm均明显增大，且观察组显著大于对照组（P<0.01）；与治疗前比较，治疗后对照组仅全血低切黏度明显降低，观察组全血高切黏度、全血低切黏度、血浆黏度、红细胞压积均降低（P<0.01）；而2组红细胞电泳速度增大（P<0.01），且2组间经比较差异有统计学意义（P<0.01）。结论：参芪四虫汤可促进椎动脉型颈椎病患者的椎底动脉血流速度增加，明显改善患者血液流变学指标，缓解血液高凝状态，显著改善患者临床症状，疗效显著。

English Summary:

To investigate the effect of Shenqi Sichong Decoction on the blood supply and hemorheology of vertebrobasilar artery in cervical spondylosis.Methods:A total of 112 patients with vertebral artery type cervical spondylosis admitted to Jiujiang 171st Hospital from November 2014 to March 2016 were randomly divided into a control group(n＝56)and an observation group(n＝56).The control group was given routine treatment,while the observation group was treated with Shenqi Sichong Decoction on the basis of the control group.Both groups were treated for 4 weeks.The clinical effects of the 2 groups were compared after treatment.The blood flow velocity of vertebral artery and basilar artery were measured before and after treatment,and the changes of hemorheological indexes before and after treatment were compared.Results:After treatment,the total clinical effective rates of the observation group and the control group were 85.71% and 71.43%,respectively,and the observation group was significantly higher than the control group(P<0.05).Compared with before treatment,the scores of TCM syndromes in the 2 groups were significantly decreased after treatment,and the observation group was significantly lower than that in the control group(P<0.05 or P<0.01); After treatment,the Vs,Vd and Vm of left vertebral artery,right vertebral artery and basilar artery in the 2 groups were significantly increased,and the observation group was significantly larger than that in the control group(P<0.01); compared with before treatment,the whole blood low shear viscosity in the control group was significantly decreased after treatment.The whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and hematocrit of the 2 groups decreased(P<0.01),while the electrophoretic velocity of erythrocyte increased(P<0.01),and there was significant difference between the 2 groups(P<0.01).Conclusion:Shenqi Sichong Decoction can promote the increase of blood flow velocity of vertebral artery in patients with cervical spondylosis of vertebral artery type,significantly improve the hemorheological indexes of patients,alleviate the hypercoagulable state of blood,significantly improve the clinical symptoms of patients,and has a significant effect.

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