【目的】探讨定眩汤联合前庭功能康复训练治疗梅尼埃病的疗效及其对临床症状和椎动脉血流的影响。【方法】将100例 梅尼埃病肝肾阴虚、风水上扰型患者随机分为观察组和对照组，每组各50例。对照组给予常规治疗+前庭功能康复训练，观 察组在对照组的基础上联合定眩汤治疗，疗程为4周并随访6个月。观察2组患者治疗前后中医证候积分、眩晕残障程度评 定量表（DHI）评分、耳鸣残疾量表（THI）评分、听力视觉模拟量表（VAS）评分和椎动脉血流的变化情况，比较2组患者的中医 证候疗效、听力改善疗效及随访情况。【结果】（1）中医证候疗效方面，治疗4周后，观察组的总有效率为86.00%（43/50），对 照组为62.00%（31/50），组间比较，观察组的中医证候疗效明显优于对照组（P＜0.01）。（2）听力改善疗效方面，治疗4周后， 2组患者的听力均有所改善，观察组的总有效率为76.00%（38/50），对照组为46.00%（23/50），组间比较，观察组的听力改善 疗效明显优于对照组（P＜0.01）。（3）量表评分方面，治疗后，2组患者的中医证候积分、DHI、THI和听力VAS评分均较治疗 前降低（P＜0.05或P＜0.01），且观察组的降低幅度均明显优于对照组（P＜0.01）。（4）椎动脉血流方面，治疗后，2组患者的左 椎动脉（LVA）和右椎动脉（RVA）平均血流速度均较治疗前升高（P＜0.05），且观察组的升高幅度均明显优于对照组（P＜0.05 或P＜0.01）。（5）随访情况方面，治疗后随访6个月，观察组的发作人数和发作次数均较对照组明显减少，发作时间较对照组 明显缩短，差异均有统计学意义（P＜0.05或P＜0.01）。【结论】定眩汤联合前庭功能康复训练治疗梅尼埃病肝肾阴虚、风水 上扰型患者疗效显著，在改善患者临床症状和椎动脉血流方面效果明显，可有效降低疾病复发风险，提高患者生活质量。

Objective To investigate the efficacy of Dingxuan Decoction combined with vestibular function rehabilitation training in the treatment of Meniere’s disease and to observe its effect on clinical symptoms and blood flow of vertebral artery. Methods A total of 100 patients with Meniere’s disease of liver-kidney yin deficiency complicated with wind-water upward stirring type were randomly divided into an observation group and a control group，with 50 patients in each group. The control group was given conventional treatment and vestibular function rehabilitation training，and the observation group was treated with Dingxuan Decoction on the basis of treatment for the control group. The two groups were treated for 4 weeks and then were followed up for 6 months. The changes of traditional Chinese medicine（TCM）syndrome score， Dizziness Handicap Inventory（DHI）score， Tinnitus Handicap Inventory（THI）score，hearing visual analogue scale（VAS）score and vertebral artery blood flow in the two groups were observed before and after the treatment. After treatment， the TCM syndrome efficacy， hearing improvement and follow-up results were compared between the two groups. Results（1）After 4 weeks of treatment， 广州中医药大学学报 Journal of Guangzhou University of Traditional Chinese Medicine 2024年3月第41卷第3期 646 March 2024，Vol. 41，No. 3 the total effective rate for TCM syndrome efficacy of the observation group was 86.00%（43/50），and that of the control group was 62.00%（31/50），and the intergroup comparison showed that the TCM syndrome efficacy in the observation group was significantly superior to that in the control group（P＜0.01）.（2）After 4 weeks of treatment， the hearing of patients in both groups was improved， and the total effective rate for the efficacy of hearing improvement in the observation group was 76.00%（38/50），while that in the control group was 46.00%（23/50）. The intergroup comparison showed that the efficacy of hearing improvement in the observation group was significantly superior to that in the control group（P＜0.01）.（3）After treatment，the TCM syndrome scores，DHI score， THI score and hearing VAS scores in the two groups were all decreased compared with those before treatment（P＜0.05 or P＜0.01），and the decrease in the observation group was significantly superior to that in the control group（P＜0.01）.（4）After treatment， the average blood flow velocity of the left vertebral artery （LVA）and the right vertebral artery（RVA）in the two groups were both increased compared with those before treatment（P＜0.05），and the increase in the observation group was significantly superior to that in the control group（P＜0.05 or P＜0.01）.（5）The results of 6-month follow-up after treatment showed that the incidence of Meniere’s disease and the frequency of attack in the observation group were significantly reduced compared with those in the control group，and the episode duration in the observation group was significantly shorter than that in the control group，the differences being all statistically significant（P＜0.05 or P＜0.01）. Conclusion Dingxuan Decoction combined with vestibular function rehabilitation training exert certain effect in treating patients with Meniere’s disease of liver-kidney yin deficiency complicated with wind-water upward stirring type， and the therapy is effective on improving patients’clinical symptoms and vertebral artery blood flow，reducing the risk of recurrence and improving the quality of life of the patients.

R764.3；R276.1

河南省医学科技攻关计划项目（编号：LHGJ20191249）