| Background:Vertigo is one of the most common clinical diseases, due to the often with vomiting, eating difficulties, sweat and other symptoms, severe disturbances of the patient’s daily life and physiological function. Cause vertigo disease involves many clinical disciplines, the cause of vertigo is very complex, especially senile vertigo is often associated with cardiovascular and cerebrovascular diseases and other related. Traditional Chinese Medicine called "vertigo" for "vertigo","spin transport ","Huangdi Neijing" put forward "the wind fell dizzy, all belong to the liver", a common clinical syndrome with Yin deficiency and Yang hyperactivity syndrome, liver-fire ascending syndrome, phlegm turbidity syndrome, deficiency of Qi and Yin deficiency of liver and kidney, nourishing the liver and kidney Yin deficiency type method is the treatment of vertigo the basic treatment of nourishing Yin deficiency of liver and kidney, commonly used formula with Gastrodia and Uncaria Decoction and Decoction for Sedating the Liver to Calm Wind. This kind of medicine to treat law has similar place already, also there are different, but in clinical practice in different type of Yin deficiency of liver and kidney nourishing prescription treating vertigo syndrome differentiation methods reported in literature is not much; How from clinical practice summary of applying nourishing liver Yin compounds experience, grasp the syndrome differentiation and treatment of vertigo of the law, to improve the clinical efficacy of vertigo has certain significance.Objective:Study of Gastrodia and Uncaria Decoction and Decoction for Sedating the Liver to Calm Wind in the treatment of vertigo syndrome differentiation regularity, provide the reference for future clinical application.Methods:Using retrospective study method. Strictly according to the diagnostic criteria and exclusion criteria incorporated,2010October to2012February in Department of XiYuan Hospital Encephalopathy Division One outpatient clinic and inpatient ward of the53cases of vertigo patients as research object. With Gastrodia and Uncaria Decoction of30cases, with Decoction for Sedating the Liver to Calm Wind in23cases. Observation and recording two cases in these groups and the groups after treatment for second weeks the vertigo symptom severity rating scale, dizziness handicap inventory, Traditional Chinese Medicine symptom observation table, records of decoction of Traditional Chinese Medicine decoction, western medicine prescription usage and comorbidity and etiology. According to the dizziness handicap inventory rating scale as the primary efficacy evaluation standards were calculated the total efficiency, the results were statistically analyzed.Results:①Dizziness handicap inventory scores as indicators of efficacy, Gastrodia and Uncaria Decoction group30cases, effective in28cases, efficiency is93.33%, Decoction for Sedating the Liver to Calm Wind group23cases, effective in19cases, efficiency is82.61%, the chi-square test of P=0.216>0.05was not statistically significant, description of Gastrodia and Uncaria Decoction group and Decoction for Sedating the Liver to Calm Wind group was no significant difference between the efficiency;(2)Dizziness handicap inventory minus score, Gastrodia and Uncaria Decoction group was better than that of Decoction for Sedating the Liver to Calm Wind group was statistically significant (P=0.028). The secondary efficacy parameters vertigo symptom severity score, TCM symptom observation scale scores, comparison between the two groups was not statistically significant (P>0.05). The two groups before and after treatment the curative effect index mean significant differences (P<0.01). On two value variable Logistic regression analysis, to effect (1=is valid,0=is invalid) as dependent variables, gender, age, concomitant diseases, drug combination, the causes of such as independent variable. The results of correlation analysis is the Posterior Circulation Ischemia P=0.048<0.05, with statistical significance, we can think of the posterior circulation ischemia being associated with effect, but the logistic regression analysis of P=0.086>0.05, without statistical significance, we can think of the Posterior Circulation Ischemia and effect of dependency is not.(3)With Gastrodia and Uncaria Decoction as main prescription improvement of symptoms being statistically significant (P<0.05) is vertigo, dizziness, nausea, vomiting, stretching, tinnitus, upset, emotional depression, irritability, loss of appetite, satisfied that the small or anorexia, dry mouth and thirsty, bitter taste, shy, nervous, depressed shu, fatigue, forgetful, headache, dry eyes, evil heat, shortness of breath, palpitation. No improvement or degree of improvement was not statistically significant (P>0.05) symptoms such as head sink or head as heavy as up, abdominal distension or stomach bloated, hiccups, loose stools, constipation, insomnia, spontaneous sweating, night sweats, deaf, neck stiff, hand and foot tremor, blurred vision, two flank distension, cough white sputum, cough yellow sputum, chills or afraid of wind, acoustic low timid, lumbar debility.(4)With Decoction for Sedating the Liver to Calm Wind as main prescription improvement of symptoms being statistically significant (P<0.05) is vertigo, dizziness, nausea, vomiting, head sink or head as heavy as up, dry mouth and thirsty, insomnia, depressed shu, night sweats. No improvement or degree of improvement was not statistically significant (P>0.05) symptoms such as stretching, tinnitus, bitter taste, loose stools, constipation,nervous, atigue, forgetful, spontaneous sweating, neck stiff,headache, dry eyes, two flank distension, chills or afraid of wind, evil heat, shortness of breath, palpitation, acoustic low timid, lumbar debility.(5) Accompanied Liver-Stomach Disharmony, effect of Gastrodia and Uncaria Decoction group in21cases, ineffective in1cases, effective cases add mentha haplocalyx, bupleurum, ligusticum chuanxiong, pueraria lobata, pericarpium citri reticulatae, radix curcumae, cyperus rotundus, corydalis yanhusuo, prunellavulgaris L.,fructus aurantii, fructus aurantii immaturus, atractylodes macrocephala, pinellia ternata, arisaema cum bile, caulis bambusae in taeniam, invalid cases does not add other drugs.While effect of Decoction for Sedating the Liver to Calm Wind in11cases, ineffective in1cases, effective cases add mentha haplocalyx, bupleurum, ligusticum chuanxiong,pueraria lobata,pericarpium citri reticulatae, radix curcumae, inula japonica, amomumkravanh pierreex gagnep, invalid cases add ligusticum chuanxiong, corydalis yanhusuo. Effective case using frequency to achieve effective case more than30%drugs for ligusticum chuanxiong,pueraria lobata.(6)Accompanied Liver-depression, effect of Gastrodia and Uncaria Decoction group in10cases, ineffective in1cases, effective cases add ligusticum chuanxiong, eclipta prostrata, fructus ligustri lucidi, mentha haplocalyx, bupleurum, pericarpium citri reticulatae, angelica sinensis, radix rehmanniae, cyperus rotundus, corydalis yanhusuo, radix curcumae, fructus aurantii immaturu, invalid cases add ligusticum chuanxiong,angelica sinensis, pueraria lobata,radix paeoniae alba. While effect of Decoction for Sedating the Liver to Calm Wind in10cases, ineffective in2cases, effective cases add ligusticum chuanxiong, bupleurum, radix curcumae. Effective case using frequency to achieve effective case more than30%drugs for ligusticum chuanxiong.Conclusions:(1)Dizziness handicap inventory scores as indicators of efficacy, description of Gastrodia and Uncaria Decoction group and Decoction for Sedating the Liver to Calm Wind group was no significant difference between the efficiency;(2)Dizziness handicap inventory minus score, Gastrodia and Uncaria Decoction group was better than that of Decoction for Sedating the Liver to Calm Wind group was statistically significant.The secondary efficacy parameters vertigo symptom severity score, TCM symptom observation scale scores, comparison between the two groups was not statistically significant. The two groups before and after treatment the curative effect index mean significant differences. On two value variable Logistic regression analysis, the results of correlation analysis is the Posterior Circulation Ischemia with statistical significance, we can think of the posterior circulation ischemia being associated with effect, but the logistic regression analysis without statistical significance, we can think of the Posterior Circulation Ischemia and effect of dependency is not.(3) Gastrodia and Uncaria Decoction and Decoction for Sedating the Liver to Calm Wind both can effectively improve the vertigo, dizziness, nausea, vomiting, dry mouth and thirsty, depressed shu; The effect of Gastrodia and Uncaria Decoction improved stretching, tinnitus, upset, emotional depression, irritability, loss of appetite, satisfied that the small or anorexia, pain, fear, tension, fatigue, forgetful, headache, eyes, evil heat, shortness of breath, palpitation symptoms better than Decoction for Sedating the Liver to Calm Wind. Decoction for Sedating the Liver to Calm Wind group improved head sink or head as heavy as up, insomnia, night sweats symptoms better than Gastrodia and Uncaria Decoction.(4)Ligusticum chuanxiong,pueraria lobata both are good for Liver-Stomach Disharmony; Ligusticum chuanxiong is good for Liver-depression. |
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