Objective

2

To explore the curative effect and mechanism of Tongnao pill in the treatment of senile posterior circulation ischemic vertigo with phlegm and blood stasis type.

Method

2

The 80 elderly patients with posterior circulation ischemic vertigo (phlegm and blood stasis type) admitted to Gansu Provincial Hospital of Traditional Chinese Medicine were selected as the research subjects and were randomly divided into two groups according to the hospital admission number. Those with odd numbers were classified into control group and those with even numbers were classified into observation group

with 40 cases in each group. All of the patients in both groups were given basic treatment

and the patients in control group additionally received intravenous infusion of vinpocetine on the basis of basic treatment

while the patients in observation group additionally received Tongnao pill on the basis of the treatment in control group. The clinical efficacy

traditional Chinese medicine (TCM) syndrome score

European Evaluation of Vertigo(EEV) score

dizziness handicap inventory-screening (DHI-S) score

vertebral basilar artery average blood flow velocity(Vm) and pulsatility index(PI)

hemodynamic changes[mean arterial pressure(MAP)

central venous pressure(CVP)

right atrial pressure (RAP)

left atrial pressure(LAP)

cardiac output(CO)

cardiac stroke volume(SV)]

changes in blood viscosity and blood lipid levels，symptom disappearance time

and safety of the two groups were compared.

Result

2

The total effective rate in the observation group was 95.00% (38/40)

significantly higher than 75.00% (30/40) in the control group (

χ

2

=4.804

P

<

0.05). After treatment

the symptoms were significantly improved in both groups (

P

<

0.05)

and the scores of dizziness

nausea and vomiting

tinnitus and deafness

tiredness and fatigue in the observation group were lower than those in the control group (

P

<

0.05)

the EEV and DHI-S scores were decreased significantly in both groups(

P

<

0.05)

and such scores in the observation group were significantly lower than those in the control group(

P

<

0.05)

the Vm of bilateral vertebral artery (VA) and basilar artery (BA) on both sides were significantly increased in both groups

while the PI was significantly reduced (

P

<

0.05)

and these two indicators in the observation group were better than those in the control group (

P

<

0.05)

the MAP

CVP

RAP and LAP were significantly reduced in both groups after treatment

while the CO and SV were increased after treatment(

P

<

0.05)

and the SV of the observation group was significantly higher than that of the control group(

P

<

0.05). The high blood viscosity

low blood viscosity

plasma viscosity and TG

TC

LDL-C levels were decreased significantly while HDL-C increased significantly in both groups (

P

<

0.05)

and the blood viscosity and blood lipid levels in the observation group were significantly better than those in the control group(

P

<

0.05). The time to disappearance of dizziness

nausea

vomiting

tinnitus and deafness

malaise

fatigue

and confused mind in observation group was less than that in the control group (

P

<

0.05)

no serious adverse events occurred in both groups.

Conclusion

2

Tongnao pills for the treatment of senile posterior circulation ischemic vertigo (phlegm and blood stasis type) can significantly alleviate the symptoms of vertigo

improve hemorrheology

increase the blood flow velocity of the vertebrobasilar artery

improve the abnormal blood supply to the brain

and improve the quality of life for patients

with fewer adverse reactions

high safety

and good therapeutic effect. Therefore

it is worth to be applied in clinical use.