CAJ | 학술논문

目的：通督益颈汤对气滞血瘀型椎动脉型颈椎病（CSA）血流动力学的影响。方法对195例气滞血瘀型CSA 患者随机分为2组。2组均予以对症基础治疗，对照组92例予盐酸氟桂利嗪胶囊口服治疗，治疗组105例予通督益颈汤治疗。2组均治疗21 d后，观察比较2组证候量化积分变化，经颅多普勒检测双侧椎动脉及基底动脉血管搏动指数（ PI）及脑血管阻力指数（ RI）的变化，颈部彩超检测双侧椎动脉内径及血流峰值变化。结果2组治疗后中医证候量化积分均有明显减少（P＜0．05），且治疗组改善优于对照组（P＜0．05）；对照组治疗前后双侧椎动脉及基底动脉PI和RI无明显变化（P＞0．05），治疗组治疗后均明显降低（P＜0．05），与对照组比较差异有统计学意义（P＜0．05）；2组治疗后双侧椎动脉内径均无明显变化（P＞0．05）；对照组治疗前后双侧椎动脉血流峰值无明显变化（P＞0．05），治疗组治疗后均明显增加（P＜0．05），与对照组比较差异有统计学意义（ P＜0．05）。结论通督益颈汤治疗气滞血瘀型CSA可明显改善患者中医证候表现，纠正椎-基底动脉血液动力学紊乱，临床疗效显著，值得进一步应用推广。
목적：통독익경탕대기체혈어형추동맥형경추병（CSA）혈류동역학적영향。방법대195례기체혈어형CSA 환자수궤분위2조。2조균여이대증기출치료，대조조92례여염산불계리진효낭구복치료，치료조105례여통독익경탕치료。2조균치료21 d후，관찰비교2조증후양화적분변화，경로다보륵검측쌍측추동맥급기저동맥혈관박동지수（ PI）급뇌혈관조력지수（ RI）적변화，경부채초검측쌍측추동맥내경급혈류봉치변화。결과2조치료후중의증후양화적분균유명현감소（P＜0．05），차치료조개선우우대조조（P＜0．05）；대조조치료전후쌍측추동맥급기저동맥PI화RI무명현변화（P＞0．05），치료조치료후균명현강저（P＜0．05），여대조조비교차이유통계학의의（P＜0．05）；2조치료후쌍측추동맥내경균무명현변화（P＞0．05）；대조조치료전후쌍측추동맥혈류봉치무명현변화（P＞0．05），치료조치료후균명현증가（P＜0．05），여대조조비교차이유통계학의의（ P＜0．05）。결론통독익경탕치료기체혈어형CSA가명현개선환자중의증후표현，규정추-기저동맥혈액동역학문란，림상료효현저，치득진일보응용추엄。
Objective To explore the effect of Tongduyijing decoction on hemodynamics of vertebral artery typecervicalspondylosiswithqistagnationandbloodstasistype.Methods 195vertebralarterytypecervicalspon-dylosis patients with qi stagnation and blood stasis type were randomly divided into two groups .Two groups are to suit the foundation treatment .92 patients in control group were treated by flunarizine hydrochloride .105 cases in treatment group were treated by Tongduyijing decoction .Syndrome quantitative integral change , transcranial Doppler bilateral vertebral artery and basilar artery pulsatility index (PI)and cerebral vascular resistance index (RI)changes,neck ul-trasound to detect bilateral vertebral artery diameter and blood flow changes in peak were observed after 21 days of treatment.Results Traditional Chinese medicine syndrome quantitative integral after treatment were obviously de -creased in two groups (P<0.05).The improvement in the treatment group was more than that in the control group (P<0.05).There was no difference between before and after treatment on bilateral vertebral artery and basilar artery PI and RI in control group (P>0.05).Bilateral vertebral artery and basilar artery PI and RI after treatment were sig-nificantly decreased in treatment group (P<0.05).There was significant difference between two groups (P<0.05). There was no difference between before and after treatment on bilateral vertebral artery blood flow peak in control group (P>0.05).Bilateral vertebral artery blood flow peak after treatment were significantly increased in treatment group (P<0.05).There was significant difference between two groups (P<0.05).Conclusion Tongduyijing de-coction can obviously improve the traditional Chinese medicine syndrome in cervical spondylosis patients with qi stag -nation and blood stasis type ,correct vertebral -basilar artery hemodynamics disorders ,clinical curative effect is dis-tinct,is worth popularizing further application .