【目的】 基于痰气交阻理论，探讨大薯蓣膏（薯蓣丸合紫菀汤加减）治疗持续性姿势-感知性头晕（PPPD）的疗效。【方法】 前瞻性选取2022年1月至2023年7月山东中医药大学附属医院收治的120例PPPD患者作为研究对象，采用随机数字表法将 患者随机分为联合组和对照组，每组各60例。对照组给予常规西药（敏使朗+甲钴胺）治疗，联合组在对照组的基础上联合大 薯蓣膏治疗，疗程为 2 个月。观察 2 组患者治疗前后中医证候积分、躯体症状分类量表（SSSRS）、汉密尔顿焦虑量表 （HAMA）、汉密尔顿抑郁量表（HAMD）、匹兹堡睡眠质量指数量表（PSQI）评分以及头晕发作次数和持续时间的变化情况，比 较2组患者治疗2个月后的临床疗效。【结果】（1）治疗2个月后，联合组的总有效率为93.33%（56/60），对照组为78.33%（47/60）， 组间比较（χ2 检验），联合组的临床疗效明显优于对照组（P＜0.05）。（2）治疗后，2组患者的头晕、耳鸣、急躁、易怒、口干、 口苦等各项中医证候积分均较治疗前改善（P＜0.05），且联合组的改善幅度均明显优于对照组（P＜0.01）。（3）治疗后，2组患 者SSSRS量表的认知性、想象性、生物性、激惹性、抑制性评分及总分均较治疗前明显改善（P＜0.05），且联合组的改善幅 度均明显优于对照组（P＜0.01）。（4）治疗后，2组患者的HAMA、HAMD和PSQI评分均较治疗前明显降低（P＜0.05），且联合 组的降低幅度均明显优于对照组（P＜0.01）。（5）治疗后，2组患者的头晕发作次数和持续时间均较治疗前明显减少（P＜0.05）， 且联合组的减少幅度均明显优于对照组（P＜0.01）。【结论】 基于痰气交阻理论与临床实践经验设计的大薯蓣膏对PPPD患者疗 效显著，可有效降低中医证候积分，缓解患者躯体症状，改善患者焦虑与抑郁等情绪障碍以及睡眠质量，并能有效减少其 头晕发作次数和持续时间，提高患者生活质量，可为临床治疗PPPD提供新思路。

Objective To explore the efficacy of Da Shuyu Gao（DSG， a formulation developed from the modification of Shuyu Wan and Ziwan Decoction） in treating persistent postural-perceptual dizziness （PPPD） based on the theory of phlegm-qi obstruction. Methods A prospective study was conducted on 120 cases of PPPD patients admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2022 to July 2023. The patients were randomly divided into a combination group and a control group using a random number table，with 60 patients in each group. The control group received conventional western medicine treatment （Betahistine + Mecobalamin）， while the combination group was treated with the decoction of DSG orally in addition to the conventional treatment. The treatment course for the two groups lasted for 2 months. Before and after treatment，the two groups were observed in the changes of traditional Chinese medicine （TCM） syndrome score， Somatic Symptom Self-Rating Scale （SSSRS）， Hamilton Anxiety Scale （HAMA） score， Hamilton Depression Scale （HAMD） score，Pittsburgh Sleep Quality Index （PSQI） score，and the frequency and duration of dizziness episodes. After two months of treatment，the clinical efficacy of the two groups was compared. Results （1） After 2 months of treatment， the total effective rate of the combination group was 93.33%（56/60）， and that of the control group was 78.33%（47/60）. The intergroup comparison （tested by chi-square test） showed that the clinical efficacy of the combination group was significantly superior to that of the control group（P＜0.05）.（2）After treatment，the scores of TCM symptoms of dizziness，tinnitus，vexation，irritability，dry mouth，and bitterness in the mouth in both groups were improved compared to those before treatment（P＜0.05），and the combination group showed significant improvement compared with the control group（P＜0.01）.（3） After treatment，the scores of the cognitive，imaginative，biological，irritability，and inhibitory dimension of SSSRS，as well as the total scores on the SSSRS were significantly improved in both groups compared to those before treatment （P＜0.05）， and the combination group showed significant improvement compared with the control group（P＜0.01）.（4）After treatment， HAMA， HAMD， and PSQI scores were significantly decreased in both groups compared to those before treatment （P＜0.05），and the decrease in the combination group was superior to that in the control group （P＜0.01）.（5） After treatment，the frequency and duration of dizziness episodes were significantly decreased in both groups compared to those before treatment （P＜0.05）， and the decrease in the combination group was superior to that in the control group （P＜0.01）. Conclusion DSG，formulated based on the theory of phlegm-qi obstruction and clinical practice，demonstrates significant efficacy in treating PPPD. It is effective in decreasing TCM syndrome scores， alleviating somatic symptoms， improving emotional disorders such as anxiety and depression， enhancing sleep quality， and reducing the frequency and duration of dizziness episodes， thereby improving patients’ quality of life. The application of DSG will provide a new approach for the clinical treatment of PPPD.

R276.1

山东省中医药科技计划项目（编号：Z-2023048）