目的 观察天麻醒脑胶囊联合倍他司汀治疗前庭周围性眩晕的临床疗效。方法 选取2024年6月—2025年8月沧州市人民医院神经内科和耳鼻喉科收治的80例前庭周围性眩晕症患者，按随机数字法分为对照组和治疗组，每组40例。对照组口服甲磺酸倍他司汀片，6～12 mg/次，3次/d。治疗组在对照组的基础上口服天麻醒脑胶囊，2粒/次，3次/d。两组共用药28 d。观察两组的临床疗效，比较两组患者前庭周围性眩晕的次数、时间、强度、疾病症状情况、眩晕残障问卷（DHI）、眩晕评定程度的评分系统（DARS）、β淀粉样前体蛋白（β-APP）、肿瘤坏死因子α（TNF-α）降钙素基因相关肽（CGRP）、微管相关蛋白（Tau）水平。结果 治疗后，治疗组总有效率（95.00%）显著高于对照组（77.50%，P＜0.05）。治疗7、28 d，两组眩晕强度评分、眩晕时间评分、眩晕次数评分、眩晕症状评分均低于同组治疗前（P＜0.05）；且与对照组对比，治疗组治疗28 d的眩晕强度评分、眩晕时间评分、眩晕次数评分、眩晕症状评分均较低（P＜0.05）。治疗后，两组DHI评分、DARS评分均低于治疗前（P＜0.05）；且与对照组对比，治疗组DHI评分、DARS评分均降低（P＜0.05）。治疗后，两组β-APP、CGRP、TNF-α、Tau水平均低于治疗前（P＜0.05）；且与对照组对比，治疗组患者的β-APP、CGRP、TNF-α、Tau水平均较低（P＜0.05）。结论 天麻醒脑胶囊与倍他司汀联合应用在前庭周围性眩晕的治疗中具有显著的临床效果，可以改善眩晕的相关临床症状，可以抑制神经炎症和神经退行性变相关的生物标志物。

Objective To explore the clinical effect of Tianma Xingnao Capsules combined with betahistine in treatment of vestibular peripheral vertigo. Methods From June 2024 to August 2025, 80 patients with peripheral vertigo who were admitted to the Neurology Department and Otorhinolaryngology Department of Cangzhou People’s Hospital were selected. They were randomly divided into the control group and the treatment group, with 40 cases in each group. Patients in control group were given oral Betahistine Mesylate Tablets at a dose of 6—12 mg/time, three times daily. Patients in treatment group were given Tianma Xingnao Capsules in addition to control group, 2 capsules/time, three times daily. Both groups were administered the medication for 28 d. The clinical efficacy of two groups was observed, and the frequency, duration, intensity, disease symptoms, vertigo disability questionnaire (DHI), vertigo assessment scale (DARS), β-amyloid precursor protein (β-APP), tumor necrosis factor α (TNF-α), calcitonin gene-related peptide (CGRP), and microtubule-associated protein (Tau) levels of patients in two groups were compared. Results After treatment, the total effective rate of treatment group (95.00%) was significantly higher than that of control group (77.50%, P < 0.05). At 7 and 28 d of treatment, the scores of vertigo intensity, vertigo duration, vertigo frequency, and vertigo symptoms in both groups were lower than those before treatment in same group (P < 0.05). And compared with control group, the scores of vertigo intensity, vertigo duration, vertigo frequency, and vertigo symptoms in treatment group at 28 d of treatment were all lower (P < 0.05). After treatment, the DHI scores and DARS scores of both groups were lower than those before treatment (P < 0.05). And compared with control group, the DHI scores and DARS scores of treatment group were both decreased (P < 0.05). After treatment, the levels of β-APP, CGRP, TNF-α, and Tau in both groups were lower than those before treatment (P < 0.05). And compared with control group, the levels of β-APP, CGRP, TNF-α, and Tau in patients of treatment group were all lower (P < 0.05). Conclusion The combined application of Tianma Xingnao Capsules and betahistine in treatment of vestibular peripheral vertigo has significant clinical effects, and can improve the related clinical symptoms of vertigo, also can inhibit the biomarkers related to neuroinflammation and neurodegeneration.

R971

沧州市重点研发计划项目课题(23244102018)