Clinical Study On Tianma Gouteng Decoction Combined With Acupuncture In Treating Posterior Circulation Ischemic Vertigo With Hyperactivity Of Liver Yang Syndrome

Objective:To observe the clinical efficacy and safety of Tianma Gouteng Decoction combined with acupuncture in treating hyperactivity of liver yang syndrome in patients with posterior circulation ischemic vertigo,and observe the temperature changes of triple-Jiao area on the body surface before and after treatment with infrared thermal imaging technology,and detect the link between the temperature changes and curative effect,for offering a clinical foundation for treating this disease by a combination of acupuncture and medicine and the objective assessment of the curative effect by infrared thermal imaging technology.Methods:64 posterior circulation ischemic vertigo patients with the hyperactivity of liver yang syndrome who were hospitalized in the Department of Neurology II of Shandong Provincial Hospital of Traditional Chinese Medicine and compliance with the inclusion criteria from November 2021 to October 2022 were divided into a test group and a control group randomly of32 patients each.The control group was given a basic treatment for administrating the risk factors and took Tianma Gouteng Decoction simultaneously;while,acupuncture was supplemented in the test group on top of that,including Baihui(reducing method),Fengchi(bilateral,reducing method),Neiguan(bilateral,reducing method),Taichong(bilateral,reducing method),Hegu(bilateral,reducing method),Taixi(bilateral,reducing method),and Sanyinjiao(bilateral,reinforcing method).The treatment cycle was 14 days in both groups.The scores of vertigo clinical symptoms and dizziness handicap inventory before and after the treatment were compared between the two groups,and the adverse reactions were also documented to evaluate the clinical effectiveness and safety.The temperature changes of the triple-Jiao area on the body surface were observed before and after treatment through the infrared thermogram,and the temperature change of the triple-Jiao area was analyzed with the correlation between the efficacy.Results:1.Study subject completion:A total of 64 subjects were included,of which3 cases were shed and eliminated,therefore,a total of 61 cases completed the trial.2.Baseline data analysis:The aspects of gender,age,vertigo syndrome condition,vertigo disorder condition,and heat of the triple-Jiao area before treatment had no statistical differences between the two groups(P>0.05),accordingly,the test group and control group were comparable.3.Comparison of clinical efficacy:After treating,the score of vertigo clinical symptoms and dizziness handicap inventory in those two groups were significantly reduced(P<0.01).After the treatment,both scores between the two groups had significant statistical differences(P<0.01).The total clinical apparent efficiency rate and total effective rate of TCM clinical symptoms in the test group were 58.06%and 93.55%,respectively,compared with23.33%and 90.00%in the control group,which display significant statistical differences(P<0.05).4.Safety analysis:One subject in the experimental group was given proper treatment immediately after the needle fainting occurred during the acupuncture process,and the condition recovered after resting and no other discomfort remained,and the remaining subjects did not have adverse reactions and drug toxic side effects,with good safety.5.Comparison of the temperature of the triple-Jiao area on the body surface:As for the intra-group comparison of the temperature on the body surface of the triple-Jiao area,significant statistical differences appeared in both two groups before and after treatment(P<0.01),in which the temperature of the upper and middle jiao declined significantly after treatment,however,the temperature of the lower jiao rose significantly.The difference in the body surface temperature of the triple-Jiao area for intergroup comparison was also statistically significant after the treatment(P<0.05).6.Correlation analysis:The changes in heat between upper and middle Jiao before and after treatment were significantly positively correlated(P<0.01,r_s﹥0).The changes in heat between upper and lower Jiao displayed a negative correlation obviously,and so did the changes between middle and lower Jiao(P<0.01,r_s<0).The variations in both scores before and after treatment were significantly positively correlated with the heat changes between upper and middle Jiao(P<0.01,r_s﹥0),and were significantly negatively correlated with lower Jiao(P<0.01,r_s<0).Conclusion:Tianma Gouteng Decoction combined with acupuncture in the treatment of posterior circulation ischemic vertigo with hyperactivity of liver yang syndrome can effectively improve the patients’TCM clinical symptoms and vertigo disorder and affect the body surface temperature in the triple-Jiao area on the body surface,and its clinical efficacy is better than that of herbal treatment alone with good safety.The heat measured by infrared thermal imaging technology proved that the body surface heat in the triple-Jiao area of the patients with the syndrome of hyperactivity of liver yang in the posterior circulation ischemic vertigo generally showed the distribution characteristics of upper heat and lower cold,and the significant increase of the upper Jiao temperature objectively confirmed the theory of"predominance of yang generating heat"in traditional Chinese medicine.The correlation between the temperature changes of the triple-Jiao area on the body surface before and after the treatment observed by infrared thermography and the therapeutic efficacy can provide an auxiliary objective basis for the evaluation of the therapeutic efficacy of posterior circulation ischemic vertigo with hyperactivity of liver and yang syndrome.