| ObjectVertebrobasilar ischemic vertigo is common in the elderly, frequently-occurring disease.It is characterized by recurrent, refractory touching,and it is easy to lead to acute cerebrovascular disease.Now with the wider use of drugs as cinepazide,sibelium, the efficiency significantly increased on on Patients with vertebrobasilar insufficiency treatment of vertigo.But the use of drug therapy or surgical therapy,the relapse rates are higher.So how to further improve their efficiency significantly and reducing the recurrence clinicians remains unswerving pursuit of the goal.In recent years,Chinese medicine treatment of vertebroba silar ischemic vertigo had been made large progress,in Chinese medicine for the acute attack only when the halo,the role of antiemetic rapidly than Western medicine,but the overall improvement of symptoms accompanied by a clear advantage,which can effectively reduce the vertigo relapse.Yinxingdamo proprietary Chinese medicines for injection for the compound preparation containing the total ginkgo flavonoids and dipyridamole.Modern studies have shown that with the expansion of total flavonoids of Ginkgo biloba coronary vascular,cerebrovascular,ischemic symptoms and improve memory function.Dipyridamole inhibition of platelet aggregation,high concentrations can inhibit the platelet release.Arteries to expand the drug can reduce the permeability of the blood vessel wall to improve the edema;lower viscosity ischemia,inhibition ofplatelet and red bloodcellaggregationof the high and increasing deformability of red blood cells;reduce myocardial oxygen consumption,and enhance the ischemic myocardial cells hypoxia tolerance;improved organizational metabolism,cell membrane stability,the maintenance of normal cell structure and function;the direct protection of neurons,nerve conduction strengthen and speed up the update neurotransmitter;of brain, heart and peripheral vascular,especially vertebral -- basilar artery was more visible role.To be the subject of clinical symptoms through changes in head hemorrheology TCD and to observe changes in Ginkgo biloba leaf extract and dipyridamole injection of vertebral - basilar artery insufficiency in patients with the treatment of vertigo,and to explore its therapeutic mechanism,to improve the clinical efficacy and expand the scope of traditional Chinese medicine to provide a scientific basis.Methods:This issue a total of 105 cases of differentiation into the brain network card for the Stagnation of the vertebral - basilar artery insufficiency in patients with vertigo,the treatment group were randomly divided into 60 cases and 45 cases of the control group. The basis of the treatment:two patients were given blood pressure, control blood sugar,lipid-lowering,of Cerebroprotein aydrolyzate nutrition,such as the treatment of brain cells;treatment group 30ml Ginkgo biloba leaf extract and dipyridamole injection by adding 0.9%sodium chloride injection 250ml,day 1;control group, Danshen injection to 20 ml by adding 0.9%sodium chloride injection 250ml,on time,all 7 Tianyi treatment.After the treatment the overall efficacy of the two groups,traditional Chinese medicine syndromes of the efficacy of intracranial hemodynamics and hemorheology in contrast to observation.Results:(1) the overall effects between the two groups:treatment group, 36 cases recovered,11 cases markedly improved in 6 cases,7 cases of invalidity,the more significant rate of 78.33%;control group, 19 cases fully recovered,7 cases markedly effective,12 cases improved,invalid seven cases,the more significant rate of 57.78%; efficacy comparison between the two groups by Ridit test,u=2.13, P<0.05,compare that effect between the two groups was significant difference in efficacy of the treatment group than the control group.(2) two sets of effects of traditional Chinese medicine syndromes:two groups of drugs on TCM syndrome in patients with vertigo of the total effective rate was significant difference(P <0.05),Ginkgo biloba leaf extract and dipyridamole injection prompt treatment group on the improvement of traditional Chinese medicine syndromes of apparent better than the control group.(3) the two groups before and after treatment TCD mean velocity (cm/s) compared:pre-treatment group and control group treatment of vertebral artery,basilar artery blood flow between the average no significant difference(P> 0.05);the treatment group after treatment with control group,vertebral artery,basilar artery mean blood flow velocity were significantly higher than before treatment (P <0.05);the treatment group after treatment of vertebral artery, basilar artery blood flow velocity higher than the average,more significant difference(P <0.05).(4) compared two groups of blood rheology:Comparison of the treatment group before and after treatment,erythrocyte aggregation index,whole blood reduced viscosity,hematocrit,high shear whole blood,whole blood low-shear reduction and increased erythrocyte deformability index were significantly(P <0.01), plasma high shear significantly lower(P<0.05);the control group before and after treatment,erythrocyte aggregation index,whole blood reduced viscosity was significantly lower(P <0.01), hematocrit,whole blood low shear,high shear plasma significantly reduced(P <0.05).Comparison of the two groups after treatment difference was significant(P <0.05).(5) the treatment of 14 cases for all invalid DSA examination of patients with vertigo.The result of congenital bilateral vertebral artery 2 cases of thinning,thinning the side of the vertebral artery in 3 cases,not the side of the vertebral artery imaging in 4 cases,the start-side vertebral artery atherosclerotic stenosis in 5 cases.Suggest that pathological changes of vertebral artery leading to vertebral - basilar artery ischemic vertigo an important cause of refractory.(6) to observe the safetyThe two groups before and after treatment of blood,urine,stool routine,liver function,renal function,electrocardiogram and other major indexes,see Table 7,the two groups before and after treatment of blood,urine,stool routine,liver function,renal function,electrocardiogram and other major indicators were not significantly increase the damage by the X2 test,the two groups before and after treatment showed no significant difference. Control group:three cases of headache,flushing,after drug withdrawal symptoms.Conclusion:The above studies show that Ginkgo biloba leaf extract and dipyridamole injection syndrome in clinical efficacy and vertebral - basilar artery to increase blood flow velocity is superior to the control group.VBIV mechanism of its therapeutic potential for the effective expansion of vertebral - basilar artery to alleviate vasospasm,thus reducing the average peak flow velocity,blood flow returned to normal once the blood supply restored,symptoms of ischemia and hypoxia is an immediate improvement in clinical symptoms as well as rapidly reduce disappear.It could be that the Ginkgo biloba leaf extract and dipyridamole injection is an effective treatment method VBIV,clinical use of safe and reliable; drug therapy in patients with poor efficacy of many organic Vertebrobasilar change.
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