CAJ | 학술논문

目的：后循环缺血多表现为眩晕，脑动脉粥样硬化是其主要病因和发病机制。文中观察丁苯酞软胶囊联合纳洛酮治疗后循环缺血性眩晕（ posterior circulation ischemic vertigo ， PCIV）的临床疗效及对血流动力学的影响。方法将162例PCIV患者分为治疗组与对照组。治疗组每日静脉滴注纳洛酮2．4 mg，并口服丁苯酞软胶囊；对照组每日静脉滴注三七总苷（血栓通）300 mg。疗程均为14 d。2组病例治疗前后均进行经颅多普勒超声（transcranial doppler， TCD）检查，对比治疗前后双侧椎-基底动脉的平均血流速度（ Vm）和收缩期峰流速（ Vs）的变化情况，并统计临床治愈率。结果对照组治疗后基底动脉Vm和Vs较治疗前增快[（30．15±3．84）cm/s vs （26．95±3．72）cm/s，（40．87±4．54）cm/s vs （37．16±4．72）cm/s，P＜0．05]，治疗组治疗后基底动脉Vm和Vs较治疗前增快[（34．47±3．53）cm/s vs （27．53±3．68）cm/s，（42．25±5．29）cm/s vs （35．87±4．85）cm/s，P＜0．05]，组间比较差异亦有统计学意义[（34．47±3．53）cm/s vs （30．15±3．84）cm/s，（42．25±5．29） cm/s vs （40．87±4．54）cm/s，P＜0．05]；治疗组的治愈率和总有效率均明显优于对照组（58．8％vs 31．7％，93．8％vs 75．6％， P＜0．05）。结论丁苯酞软胶囊联合纳洛酮治疗PCIV，临床疗效确切，副作用少。
목적：후순배결혈다표현위현훈，뇌동맥죽양경화시기주요병인화발병궤제。문중관찰정분태연효낭연합납락동치료후순배결혈성현훈（ posterior circulation ischemic vertigo ， PCIV）적림상료효급대혈류동역학적영향。방법장162례PCIV환자분위치료조여대조조。치료조매일정맥적주납락동2．4 mg，병구복정분태연효낭；대조조매일정맥적주삼칠총감（혈전통）300 mg。료정균위14 d。2조병례치료전후균진행경로다보륵초성（transcranial doppler， TCD）검사，대비치료전후쌍측추-기저동맥적평균혈류속도（ Vm）화수축기봉류속（ Vs）적변화정황，병통계림상치유솔。결과대조조치료후기저동맥Vm화Vs교치료전증쾌[（30．15±3．84）cm/s vs （26．95±3．72）cm/s，（40．87±4．54）cm/s vs （37．16±4．72）cm/s，P＜0．05]，치료조치료후기저동맥Vm화Vs교치료전증쾌[（34．47±3．53）cm/s vs （27．53±3．68）cm/s，（42．25±5．29）cm/s vs （35．87±4．85）cm/s，P＜0．05]，조간비교차이역유통계학의의[（34．47±3．53）cm/s vs （30．15±3．84）cm/s，（42．25±5．29） cm/s vs （40．87±4．54）cm/s，P＜0．05]；치료조적치유솔화총유효솔균명현우우대조조（58．8％vs 31．7％，93．8％vs 75．6％， P＜0．05）。결론정분태연효낭연합납락동치료PCIV，림상료효학절，부작용소。
Objective Vertigo is the main clinical feature and cerebral atherosclerosis is the major etiological factor and pathogenesy of posterior circulation ischemia (PCIV).The objective of this study was to observe the clinical effect of butylphthalide combined with naloxone on PCIV and hemodynamics . Methods One hundred and sixty two patients with PCIV were classified into treatment group and control group .In the treatment group , butylphthalide soft capsules were administrated by oral and naloxone 2.4 mg were administrated by intravenous drip per day .In the control group , Xueshuantong at the dose of 300 mg was given by intravenous drip per day.All the treatment lasted for 14 days.Transcranial doppler (TCD) examination was performed for all patients before and after the treatment.The mean velocity (Vm) and the systolic velocity (Vs) of bilateral vertebral arteries were recorded .Clinical cure rate was evaluated . Results Basilar artery Vm and Vs increased after treatment in the control group compared with those before treatment ([30.15 ±3.84])cm/s vs ([26.95 ±3.72])cm/s, ([40.87 ±4.54])cm/s vs ([37.16 ±4.72])cm/s.Basilar artery Vm and Vs increased after treatment compared with before treatment in the treatment group ([34.47 ±3.53]) cm/s vs ([27.53 ± 3.68])cm/s, ([42.25 ±5.29])cm/s vs ([35.87 ±4.85])cm/s, (P<0.05).Basilar artery Vm and Vs increased in the treatment group compared with the control group after the treatment ([34.47 ±3.53])cm/s vs ([30.15 ±3.84])cm/s, ([42.25 ±5.29])cm/s vs ([40.87 ±4.54])cm/s, (P<0.05).The cure rate and total effective rate in the treatment group (58.8%, 93.8%) were higher than thoes in the control group, respectively (31.7%, 75.6%)(P<0.05). Conclusion Butylphthalide soft capsules combined with naloxone have definite clinical curative effect and few side for PCIV treatment.