Article(id=1322912328718614624, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322912162913596032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.01.009, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793336477689, onlineDateStr=2026-10-30, pubDate=1736438400000, pubDateStr=2025-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793336477689, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793336477689, creator=13701087609, updateTime=1793336477689, updator=13701087609, issue=Issue{id=1322912162913596032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='1', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1736438400000', pubDateStr='2025-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793336438157, creator='13701087609', updateTime=1793340633627, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929760048906989, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322912162913596032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929760048906990, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322912162913596032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=51, endPage=54, ext={EN=ArticleExt(id=1322912329016410209, articleId=1322912328718614624, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Application of Yiqi Congming Decoction(益气聪明汤)Combined with Acupuncture on Vertigo with Deficiency of Qi and Blood, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the effect of Yiqi Congming Decoction(益气聪明汤)combined with acupuncture on dizziness caused by deficiency of Qi and blood.

Methods

A total of 100 cases of vertigo with deficiency of Qi and blood in the hospital from January 2020 to January 2023 were selected as research objects. By simple random number table,they were divided into observation group and control group with 50 cases in each group. Both groups received acupuncture treatment for 4 weeks,and the observation group was treated with Yiqi Congming Decoction for 4 weeks. Maximum vertebrobasilar blood systolic flow velocity,the levels of serum total cholesterol(TC)and fibrinogen(Fib)of the two groups were compared before and after treatment,and the vertigo scores of the two groups were compared before and after treatment. At the end of treatment,the therapeutic efficacy of the two groups and the occurrence of adverse reactions during treatment were compared according to the relevant standards of the Guiding Principles for Clinical Research of New Chinese Medicine Drugs.

Results

The clinical recovery rates of the observation group and the control group were 38.00%(19/50)and 18.00%(9/50),respectively,and the difference was statistically significant(P<0.05). After treatment,the levels of serum TC and Fib in the two groups were lower than those before treatment,and the levels of the observation group were lower than those of the control group. The difference was statistically significant(P<0.05). After treatment,the maximum systolic flow velocities of left vertebral artery,right vertebral artery and basilar artery in both groups were significantly higher than those before treatment,and the values in the observation group were significantly higher than those of the control group. The difference was statistically significant(P<0.05). After treatment,the vertigo score in both groups was higher than that before treatment,and the score of the observation group was significantly higher than that of the control group. The difference was statistically significant(P<0.05). No adverse reactions occurred in both groups during treatment.

Conclusion

Yiqi Congming Decoction combined with acupuncture in the treatment of vertigo with deficiency of Qi and blood has better effect than acupuncture alone. It can significantly improve the maximum systolic flow velocity of vertebra-basilar artery in patients and has high safety,which is suitable for promotion.

, authors=Dan LIU1, Nan LI2, Jialian YU2, Gaotongli ZHONG2, Haitao XIAO3, authorsList=Dan LIU, Nan LI, Jialian YU, Gaotongli ZHONG, Haitao XIAO, authorCompany=null, correspAuthors=Haitao XIAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322912330320838762, articleId=1322912328718614624, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=益气聪明汤联合针刺对气血两虚型眩晕的临床运用分析, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

观察益气聪明汤联合针刺治疗气血两虚型眩晕的效果。

方法

选择医院2020年1月—2023年1月收治气血两虚型眩晕患者100例作为研究对象,使用随机数字表通过简单随机的方法将其分为观察组与对照组,每组50例。两组均接受针刺治疗4周,观察组在此基础上给予益气聪明汤治疗4周,比较两组治疗前后椎-基底动脉血流收缩期最大流速、血清总胆固醇(total cholesterol,TC)、血清纤维蛋白原(fibrinogen,Fib)水平,并比较两组治疗前后眩晕评分,在疗程结束时,按照《中医新药临床研究指导原则》相关标准比较两组治疗疗效,比较两组治疗期间不良反应发生情况。

结果

观察组与对照组临床痊愈率分别为38.00%(19/50)和18.00%(9/50),差异具有统计学意义(P<0.05);治疗后两组血清TC、Fib水平均较本组治疗前降低,其中观察组低于对照组,差异具有统计学意义(P<0.05);治疗后两组左椎动脉、右椎动脉以及基底动脉血流收缩期最大流速均较本组治疗前明显升高,其中观察组明显高于对照组,差异具有统计学意义(P<0.05);治疗后两组眩晕评分均高于本组治疗前,且观察组明显高于对照组,差异具有统计学意义(P<0.05)。两组治疗期间均无不良反应发生。

结论

益气聪明汤联合针刺治疗气血两虚型眩晕较单纯应用针刺治疗效果更佳,能显著提升患者椎-基底动脉血流收缩期最大流速,且具有较高安全性,适合推广。

, authors=刘丹1, 栗楠2, 喻家莲2, 钟高童丽2, 肖海涛3, authorsList=刘丹, 栗楠, 喻家莲, 钟高童丽, 肖海涛, authorCompany=null, correspAuthors=肖海涛, authorNote=

刘丹(1972-),女,辽宁大连人,主任医师,博士,研究方向:针刺防治神经系统疾病的临床与基础。

, correspAuthorsNote=
肖海涛(1974-),男,黑龙江绥化人,主任医师,学士,研究方向:中医药及针灸治疗神经系统疑难病。E-mail:。
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刘丹(1972-),女,辽宁大连人,主任医师,博士,研究方向:针刺防治神经系统疾病的临床与基础。

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刘丹(1972-),女,辽宁大连人,主任医师,博士,研究方向:针刺防治神经系统疾病的临床与基础。

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journalId=1255847919539208197, articleId=1322912328718614624, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数临床痊愈显效有效无效
观察组5019(38.00)21(42.00)9(18.00)1(2.00)
对照组509(18.00)19(38.00)18(36.00)4(8.00)
χ2组4.960
P值0.026
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两组气血两虚型眩晕患者临床痊愈率比较

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组别例数临床痊愈显效有效无效
观察组5019(38.00)21(42.00)9(18.00)1(2.00)
对照组509(18.00)19(38.00)18(36.00)4(8.00)
χ2组4.960
P值0.026
), ArticleFig(id=1322912438487757024, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322912328718614624, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间TC/(mmol/L)Fib/(g/100 mL)
观察组50治疗前5.53±1.034.11±0.23
治疗后4.62±0.98*3.95±0.32*
t值4.5262.871
P值<0.0010.003
对照组50治疗前5.56±1.124.14±0.20
治疗后5.02±0.974.05±0.18
t值2.5772.365
P值0.0060.010
), ArticleFig(id=1322912438869438689, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322912328718614624, language=CN, label=表2, caption=

两组气血两虚型眩晕患者治疗前后血清TC、Fib水平比较(±s)

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组别例数时间TC/(mmol/L)Fib/(g/100 mL)
观察组50治疗前5.53±1.034.11±0.23
治疗后4.62±0.98*3.95±0.32*
t值4.5262.871
P值<0.0010.003
对照组50治疗前5.56±1.124.14±0.20
治疗后5.02±0.974.05±0.18
t值2.5772.365
P值0.0060.010
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组别例数时间左椎动脉右椎动脉基底动脉
观察组50治疗前38.33±4.6533.02±3.8743.69±4.69
治疗后50.15±5.18#51.36±3.15#53.26±4.78#
t值12.00725.98910.105
P值<0.001<0.001<0.001
对照组50治疗前38.65±4.5833.10±3.4943.97±4.25
治疗后45.69±6.0345.69±3.4748.96±4.35
t值6.57418.0895.802
P值<0.001<0.001<0.001
), ArticleFig(id=1322912439305646307, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322912328718614624, language=CN, label=表3, caption=

两组气血两虚型眩晕患者治疗前后椎-基底动脉血流收缩期最大流速比较(±s)

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组别例数时间左椎动脉右椎动脉基底动脉
观察组50治疗前38.33±4.6533.02±3.8743.69±4.69
治疗后50.15±5.18#51.36±3.15#53.26±4.78#
t值12.00725.98910.105
P值<0.001<0.001<0.001
对照组50治疗前38.65±4.5833.10±3.4943.97±4.25
治疗后45.69±6.0345.69±3.4748.96±4.35
t值6.57418.0895.802
P值<0.001<0.001<0.001
), ArticleFig(id=1322912439708299492, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322912328718614624, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
观察组501.35±0.374.13±0.5131.199<0.001
对照组501.39±0.353.29±0.4922.311<0.001
t值0.5558.398
P值0.290<0.001
), ArticleFig(id=1322912441369243878, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322912328718614624, language=CN, label=表4, caption=

两组气血两虚型眩晕患者治疗前后眩晕评分比较(±s)

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组别例数治疗前治疗后t值P值
观察组501.35±0.374.13±0.5131.199<0.001
对照组501.39±0.353.29±0.4922.311<0.001
t值0.5558.398
P值0.290<0.001
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益气聪明汤联合针刺对气血两虚型眩晕的临床运用分析
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刘丹 1 , 栗楠 2 , 喻家莲 2 , 钟高童丽 2 , 肖海涛 3
中华中医药学刊 | 国家项目点击 2025,43(1): 51-54
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中华中医药学刊 |国家项目点击 2025 , 43 (1) : 51 -54
益气聪明汤联合针刺对气血两虚型眩晕的临床运用分析
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刘丹(1972-),女,辽宁大连人,主任医师,博士,研究方向:针刺防治神经系统疾病的临床与基础。

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刘丹(1972-),女,辽宁大连人,主任医师,博士,研究方向:针刺防治神经系统疾病的临床与基础。

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刘丹1, 栗楠2, 喻家莲2, 钟高童丽2, 肖海涛3
作者信息
  • 1.黑龙江中医药大学附属第一医院,黑龙江 哈尔滨 150040
  • 2.黑龙江中医药大学,黑龙江 哈尔滨 150040
  • 3.绥化市中医医院,黑龙江 绥化 152000
通讯作者:
肖海涛(1974-),男,黑龙江绥化人,主任医师,学士,研究方向:中医药及针灸治疗神经系统疑难病。E-mail:。
作者简介:

刘丹(1972-),女,辽宁大连人,主任医师,博士,研究方向:针刺防治神经系统疾病的临床与基础。

Clinical Application of Yiqi Congming Decoction(益气聪明汤)Combined with Acupuncture on Vertigo with Deficiency of Qi and Blood
Dan LIU1, Nan LI2, Jialian YU2, Gaotongli ZHONG2, Haitao XIAO3
Affiliations
  • 1.The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, Heilongjiang, China
  • 2.Heilongjiang University of Chinese Medicine, Harbin 150040, Heilongjiang, China
  • 3.Suihua Hospital of Traditional Chinese Medicine, Suihua 152000, Heilongjiang, China
出版时间: 2025-01-10 doi: 10.13193/j.issn.1673-7717.2025.01.009
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目的

观察益气聪明汤联合针刺治疗气血两虚型眩晕的效果。

方法

选择医院2020年1月—2023年1月收治气血两虚型眩晕患者100例作为研究对象,使用随机数字表通过简单随机的方法将其分为观察组与对照组,每组50例。两组均接受针刺治疗4周,观察组在此基础上给予益气聪明汤治疗4周,比较两组治疗前后椎-基底动脉血流收缩期最大流速、血清总胆固醇(total cholesterol,TC)、血清纤维蛋白原(fibrinogen,Fib)水平,并比较两组治疗前后眩晕评分,在疗程结束时,按照《中医新药临床研究指导原则》相关标准比较两组治疗疗效,比较两组治疗期间不良反应发生情况。

结果

观察组与对照组临床痊愈率分别为38.00%(19/50)和18.00%(9/50),差异具有统计学意义(P<0.05);治疗后两组血清TC、Fib水平均较本组治疗前降低,其中观察组低于对照组,差异具有统计学意义(P<0.05);治疗后两组左椎动脉、右椎动脉以及基底动脉血流收缩期最大流速均较本组治疗前明显升高,其中观察组明显高于对照组,差异具有统计学意义(P<0.05);治疗后两组眩晕评分均高于本组治疗前,且观察组明显高于对照组,差异具有统计学意义(P<0.05)。两组治疗期间均无不良反应发生。

结论

益气聪明汤联合针刺治疗气血两虚型眩晕较单纯应用针刺治疗效果更佳,能显著提升患者椎-基底动脉血流收缩期最大流速,且具有较高安全性,适合推广。

益气聪明汤  /  针刺  /  气血两虚型眩晕  /  椎-基底动脉供血不足  /  中医药
Objective

To observe the effect of Yiqi Congming Decoction(益气聪明汤)combined with acupuncture on dizziness caused by deficiency of Qi and blood.

Methods

A total of 100 cases of vertigo with deficiency of Qi and blood in the hospital from January 2020 to January 2023 were selected as research objects. By simple random number table,they were divided into observation group and control group with 50 cases in each group. Both groups received acupuncture treatment for 4 weeks,and the observation group was treated with Yiqi Congming Decoction for 4 weeks. Maximum vertebrobasilar blood systolic flow velocity,the levels of serum total cholesterol(TC)and fibrinogen(Fib)of the two groups were compared before and after treatment,and the vertigo scores of the two groups were compared before and after treatment. At the end of treatment,the therapeutic efficacy of the two groups and the occurrence of adverse reactions during treatment were compared according to the relevant standards of the Guiding Principles for Clinical Research of New Chinese Medicine Drugs.

Results

The clinical recovery rates of the observation group and the control group were 38.00%(19/50)and 18.00%(9/50),respectively,and the difference was statistically significant(P<0.05). After treatment,the levels of serum TC and Fib in the two groups were lower than those before treatment,and the levels of the observation group were lower than those of the control group. The difference was statistically significant(P<0.05). After treatment,the maximum systolic flow velocities of left vertebral artery,right vertebral artery and basilar artery in both groups were significantly higher than those before treatment,and the values in the observation group were significantly higher than those of the control group. The difference was statistically significant(P<0.05). After treatment,the vertigo score in both groups was higher than that before treatment,and the score of the observation group was significantly higher than that of the control group. The difference was statistically significant(P<0.05). No adverse reactions occurred in both groups during treatment.

Conclusion

Yiqi Congming Decoction combined with acupuncture in the treatment of vertigo with deficiency of Qi and blood has better effect than acupuncture alone. It can significantly improve the maximum systolic flow velocity of vertebra-basilar artery in patients and has high safety,which is suitable for promotion.

Yiqi Congming Decoction(益气聪明汤)  /  acupuncture  /  dizziness with deficiency of Qi and blood  /  vertebrobasilar artery insufficiency  /  traditional Chinese medicine
刘丹, 栗楠, 喻家莲, 钟高童丽, 肖海涛. 益气聪明汤联合针刺对气血两虚型眩晕的临床运用分析. 中华中医药学刊, 2025 , 43 (1) : 51 -54 . DOI: 10.13193/j.issn.1673-7717.2025.01.009
Dan LIU, Nan LI, Jialian YU, Gaotongli ZHONG, Haitao XIAO. Clinical Application of Yiqi Congming Decoction(益气聪明汤)Combined with Acupuncture on Vertigo with Deficiency of Qi and Blood[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (1) : 51 -54 . DOI: 10.13193/j.issn.1673-7717.2025.01.009
椎-基底动脉缺血综合征又被称为颈性眩晕,中医认为颈性眩晕的原因是外伤或者颈椎退行性变造成椎-基底动脉供血不足[1-2]。眩晕患者最常见的表现是耳聋耳鸣、肢体麻木等,中医将其归为“眩晕”范畴,临床上较为常见的类型是气血两虚型眩晕。相关研究发现[3-4],血液黏稠度的升高造成了椎-基底动脉的血液供应减少,造成患者出现眩晕。本病的具体发病机制尚未完全明确,但已有相关研究发现可通过对交感神经的传导进行抑制,可以起到舒张血管的作用,进而使中枢神经系统的血液供应恢复,从而减轻患者的症状。该病无论是对患者的生活还是工作都造成了严重的影响,因此需按照积极有效的手段治疗具有非常重要的意义[5-6]。中医学源远流长、博大精深,其中针刺治疗与中药汤剂治疗是中医较为常用的手段,能从本质上治疗疾病,在临床上治疗眩晕也具有较为显著的效果。因此本研究重点观察益气聪明汤联合针刺对气血两虚型眩晕治疗效果以及安全性,为临床治疗本病提供更多参考依据,具体报道如下。
选择我院2020年1月—2023年1月收治的气血两虚型眩晕患者100例作为研究对象。纳入标准:(1)中医诊断符合气血两虚型眩晕,西医诊断符合颈性眩晕;(2)经颅多普勒检查显示椎-基底动脉供血不足;(3)近期未使用过抗组胺类药物或皮质类固醇药物;(4)对本研究知情,并签署知情同意书,且具有良好的治疗依从性。排除标准:(1)有接触性药物或全身过敏史;(2)合并严重心血管、内分泌、肝肾、血液等系统疾病;(3)孕妇以及哺乳期妇女;(4)椎动脉解剖异常;(5)合并颈椎肿瘤、椎管狭窄、颈椎结核;(6)梅尼埃病;(7)神经官能症、脑动脉硬化以及高血压病。使用随机数字表通过简单随机的方法将其分为观察组与对照组,每组50例。观察组男21例,女29例,年龄41~75岁,平均(55.69±6.15)岁,病程10~68 d,平均(35.35±5.16)d;对照组男20例,女30例,年龄42~74岁,平均(56.12±6.38)岁,病程11~65 d,平均(36.12±5.38)d。本研究经医院伦理委员会批准,两组患者基线资料差异无统计学意义(P>0.05)。
西医诊断标准:根据《第二届颈椎病专题座谈会纪要》[7]关于颈性眩晕的诊断标准:(1)眩晕症;(2)颈扭转试验阳性;(3)枕颈神经痛;(4)有交感神经激惹表现;(5)影像学检查显示椎体不稳、椎间盘突出等;(6)经颅多普勒超声(transcranial doppler ultrasound,TCD)检查示椎-基底动脉供血不足。中医诊断标准:根据《中医病证诊断疗效标准》[8]关于颈椎病符合气血两虚型标准:(1)视物旋转;(2)面色苍白,倦怠乏力,脉细弱。
两组均接受针刺治疗4周,观察组在此基础上,给予益气聪明汤治疗4周。
主穴:大椎、百会、风池、完骨、C3-C5颈夹脊穴,配穴:三阴交、血海、肝俞、肾俞、脾俞、胃俞。患者取仰卧体位,首先常规对针刺部位进行消毒处理,使用1.5寸毫针斜刺大椎0.5~0.8寸,采用1.0寸毫针平刺百会穴0.5~0.8寸,采用1.0寸毫针向脊柱方向对夹脊穴斜刺0.5~0.8寸,其余部位以常规方法进行穿刺,1次/d,每次30 min,治疗4周时间。
观察组在针刺治疗的基础上,服用益气聪明汤,药方组成:黄芪10~15 g,人参10~15 g,蔓荆子10~15 g,葛根10~12 g,升麻6~9 g,黄柏6~9 g,白芍10~15 g,丹参10~15 g,半夏10~12 g,白术10~12 g,炙何首乌10~12 g,甘草10~15 g。一剂煎熬2次,而后混合,分为2次进行口服,1剂/d,治疗4周时间。
(1)疗效:根据《中药新药临床研究指导原则》中关于眩晕疗效的评价标准。①临床痊愈:眩晕等症状消失;②显效:眩晕等症状明显好转,尚有轻微的头晕目眩,但不影响日常工作与生活;③有效:眩晕减轻,尚有轻微自身、景物旋转感,对日常生活或工作造成一定的影响;④无效:症状无缓解甚至加重。比较两组临床痊愈率。(2)血清总胆固醇(total cholesterol,TC)、血清纤维蛋白原(fibrinogen,Fib):分别与治疗前和治疗后采集外周静脉血5 mL,3000 r/min离心10 min,而后置于-80℃冰箱保存待检。Fib采用固相夹心酶联免疫吸附法,检测试剂盒(上海盈公生物)。TC采用酶标仪比色法检测,试剂盒(江苏森贝加生物)。(3)椎-基底动脉血流收缩期最大流速:采用TCD检查两组治疗前后左椎动脉、右椎动脉、基底动脉血流收缩期最大流速。(4)眩晕评分:参照第二届颈椎病专题座谈会纪要,共5分,分数越高则眩晕程度越轻。(5)不良反应:观察两组治疗期间不良反应情况。
本研究采用SPSS 23.0对数据进行统计学处理,计量资料首先进行正态性分析,本研究数据均符合正态分布,以±s表示,组内治疗前后比较采用配对样本t检验,组间比较采用独立样本t检验,计数资料以百分比(%)表示,组间以χ2检验进行比较,若P<0.05,则差异具有统计学意义。
观察组与对照组临床痊愈率分别为38.00%和18.00%,差异具有统计学意义(P<0.05)。见表1。
两组治疗前比较差异无统计学意义(P>0.05),治疗后两组血清TC、Fib水平均较本组治疗前降低,其中观察组低于对照组,差异具有统计学意义(P<0.05)。详见表2。
两组治疗前椎-基底动脉血流收缩期最大流速比较,差异无统计学意义(P>0.05),治疗后两组左椎动脉、右椎动脉以及基底动脉血流收缩期最大流速均较本组治疗前明显升高,其中观察组明显高于对照组,差异具有统计学意义(P<0.05)。见表3。
两组治疗前眩晕评分比较,差异无统计学意义(P>0.05),治疗后两组眩晕评分均高于本组治疗前,且观察组明显高于对照组,差异具有统计学意义(P<0.05)。见表4。
两组治疗期间均无不良反应发生。
现代医学研究认为,眩晕的主要原因是椎动脉受到各种因素的影响而血流受阻,再加上血液黏稠度的升高,流动的阻力明显增大,共同导致大脑供血不足,患者产生眩晕感[9-10]。中医学认为眩晕主要是因为机体体虚劳损或者气血亏虚,认为“虚”是造成眩晕的根本病因,因此在治疗方面重视对患者气血的补充以及通络祛瘀[11-12]。头乃诸阳之会,“乙癸同源”,若肝阳不升,则中下焦虚冷,进而导致气血不足,清窍失聪最终产生眩晕。在颈性眩晕的治疗中,中药汤剂和针刺治疗是较为常用的手段,具有较好的效果。本研究对观察组患者采用针刺联合益气聪明汤治疗,针刺疗法作为中华传统医学的常用手法,其能促进机体紧张的肌肉得到缓解,改善皮下肌肉的黏稠紧密状态,缓解因炎症刺激导致的水肿,改善局部微循环状态,最终实现改善脑血管供血的效果。大椎、风池、百会等穴位乃头部的重要穴位,针刺以上穴位能取得活络经脉、缓解头痛以及促进局部血液供应的功效。选择三阴交、脾俞、肝俞、肾俞、胃俞作为配穴,针刺可获得护胃之功效。对上述穴位进行针刺治疗,达到宁静安神、舒缓头痛以及通经活络之功效。
本研究结果显示,观察组与对照组临床痊愈率分别为38.00%和18.00%(P<0.05),治疗后两组左椎动脉、右椎动脉以及基底动脉血流收缩期最大流速均较本组治疗前明显升高,其中观察组明显高于对照组(P<0.05),治疗后两组眩晕评分均高于本组治疗前,且观察组明显高于对照组(P<0.05)。益气聪明汤源自《东垣试效方》,其主治耳鸣耳聋、头昏,或治疗饮食不节造成的脾胃虚弱,患者服用本方可达清阳上升、肝肾受益之功效,目障耳聋等病证获愈[13-14]。该方在治疗脑外伤方面效果显著,对受损脑神经的恢复具有显著作用,同时可显著改善脑血流供应,延缓衰老进程。现代医学研究认为,葛根、黄芪、蔓荆子等对微循环的改善效果显著,并且具有改善血液流通,升清阳、清风热之功效[15-16]。黄芪、人参等发挥补中益气之功效,葛根发挥升发清阳之功效,丹参则能活血化瘀,白芍具有养血活血之功效,上述诸药共同作用发挥上升清阳、益脑平肝和益血补气之功效,最终获得标本兼治的效果。在中药汤剂发挥作用的同时,加以针刺治疗,对局部痉挛的肌肉起到缓解作用,减轻组织的粘连,对于水肿的吸收以及无菌性炎性组织的吸收具有明显促进作用,局部微循环得到改善,脑血管供血得到缓解。相关研究表明[17-18],颈性眩晕发病过程中,血清Fib、TC占据了重要的角色地位,其造成了局部血流动力学的改变以及全身各个系统血管的舒张和收缩失衡。张珍等[19]研究表明,当TC>5.72 mmol/L时,对血管活性将产生明显的抑制作用,使血液黏稠度增加,血流速度明显降低,患者也将因脑供血不足而出现眩晕。本研究结果显示,治疗后两组血清TC、Fib水平均较本组治疗前降低,其中观察组低于对照组,差异具有统计学意义(P<0.05)。从结果可以得出以下结论:(1)血清Fib、TC是造成颈性眩晕的重要影响因素;(2)通过针刺和中药汤剂的联合应用,能明显降低血清Fib、TC水平,降低血液黏稠度,促进血流速度的加快,改善大脑血液供应状态[20-22]。但益气聪明汤联合针刺疗法使血清Fib、TC水平降低更明显的机制,还需要进一步地深入研究。通过本研究,我们总结了益气聪明汤联合针刺疗法的优势所在:(1)治疗方法灵活,疗效显著;(2)治疗方法易于被患者接受;(3)针刺治疗能促进机体对中药汤剂的吸收,提升疗效[23-24]。相关研究表明[25-26],中药汤剂与针刺治疗联合应用,能显著舒张血管,改善其收缩状态,促进血管内皮细胞功能的改善,从而实现缓解患者眩晕症状的效果。在下步研究中,进一步深化对针药结合疗法作用机制的研究,可进一步明确中医药治疗眩晕的价值,提高广大医务工作者对中医的认识和对中医疗效的肯定。
综上所述,益气聪明汤联合针刺治疗气血两虚型眩晕较单纯应用针刺治疗效果更佳,能显著提升患者椎-基底动脉血流收缩期最大流速,且具有较高安全性,适合推广。
  • 国家中医药管理局科研基金项目(JDZX2015192)
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doi: 10.13193/j.issn.1673-7717.2025.01.009
  • 首发时间:2026-10-30
  • 出版时间:2025-01-10
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国家中医药管理局科研基金项目(JDZX2015192)
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    1.黑龙江中医药大学附属第一医院,黑龙江 哈尔滨 150040
    2.黑龙江中医药大学,黑龙江 哈尔滨 150040
    3.绥化市中医医院,黑龙江 绥化 152000

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肖海涛(1974-),男,黑龙江绥化人,主任医师,学士,研究方向:中医药及针灸治疗神经系统疑难病。E-mail:。
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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