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ObjectiveTo evaluate the effect of Huatan Tongluo prescription on the vulnerability of atherosclerotic plaques in the carotid arteries of patients with hypertension of phlegm-stasis combination syndrome. MethodA total of 132 eligible patients were randomly divided into an observation group （66 cases） and a control group （66 cases）. The control group received oral atorvastatin calcium tablets and enteric-coated aspirin tablets， while the observation group received Huatan Tongluo prescription in addition to the treatment received by the control group. The treatment duration was 6 months. A carotid artery ultrasound examination was performed to record the number of plaques， the maximum plaque area， the maximum plaque cross-sectional thickness， and the intima-media thickness （IMT） of the carotid artery. Crouse score， plaque vulnerability score， and phlegm-stasis combination syndrome score were assessed. Blood lipid levels ［total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C）］， inflammatory markers ［neutrophil-to-lymphocyte ratio （NLR）， monocyte-to-lymphocyte ratio （MLR）， interleukin-6 （IL-6）， and high-sensitivity C-reactive protein （hs-CRP）］， vascular endothelial function ［endothelin-1 （ET-1）， von Willebrand factor （vWF）， and nitric oxide （NO）］， and relevant proteins ［pentraxin 3 （PTX3） and galectin-3 （Gal-3）］ levels were measured. Safety evaluation was conducted， and comparisons were made in terms of carotid artery stenosis rate， plaque regression efficacy， and traditional Chinese medicine （TCM） syndrome efficacy. ResultCompared with the results before treatment， both groups showed significant reductions in IMT， plaque number， maximum plaque area， and maximum plaque cross-sectional thickness （P<0.05）. After treatment， the observation group exhibited more significant reductions in the above indicators compared with the control group （P<0.05）. After treatment， Crouse scores， plaque vulnerability scores， and phlegm-stasis combination syndrome scores in both groups were lower than those before treatment （P<0.05）. After treatment， the observation group had lower scores in these indicators than the control group （P<0.05）. In terms of blood lipid levels， both groups showed decreases in TC， TG， and LDL-C levels， and an increase in HDL-C levels after treatment compared to those before treatment （P<0.05）. The observation group exhibited greater improvements in these lipid parameters than the control group （P<0.05）. Inflammatory markers NLR， MLR， IL-6， and hs-CRP significantly decreased in both groups after treatment compared with those before treatment （P<0.05）. The observation group showed more significant reductions in these markers than the control group after treatment （P<0.05）. After treatment， both groups demonstrated decreases in levels of ET-1， vWF， PTX3， and Gal-3， along with an increase in NO levels compared with those before treatment （P<0.05）. The observation group showed more significant improvements in these markers than the control group after treatment （P<0.05）. After treatment， the observation group had a lower carotid artery stenosis rate than the control group （P<0.05）. The plaque regression efficacy rate was 51.72% （30/58） in the observation group， and the total effective rate of TCM syndrome was 84.48% （49/58）， both of which were higher than 18.64% （11/59） and 52.54% （31/59） in the control group （χ²=10.061， 13.799， P<0.05）. No adverse reactions related to the Huatan Tongluo prescription were observed during the treatment period. ConclusionIn addition to statin therapy， Huatan Tongluo prescription can effectively reverse carotid artery atherosclerotic plaques in patients with hypertension and carotid artery stenosis， reduce plaque vulnerability， exhibit lipid-lowering and anti-inflammatory effects， and improve vascular endothelial function. The treatment demonstrates favorable clinical efficacy and safety. Therefore， it is very worthy of clinical promotion and application.
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Objective:To evaluate the efficacy of modified Huatan Tongluo Decoction combined with acupoint massage in the treatment of acute ischemic stroke (AIS).Methods:A total of 83 patients with AIS, who met the inclusion criteria in the hospital between January 2020 and January 2021, were randomly divided into the control group ( n=41) and the observation group ( n=42). The control group received conventional western medicine treatment, and the observation group adopted modified Huatan Tongluo Decoction combined with acupoint massage therapy on the basis of the control group. Both groups were treated for 2 weeks. The TCM symptoms were scored before and after treatment. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit and Modified Barthel Index (MBI) was used for the evaluation of daily living ability of patients. The Serum levels of Ischemia Modified Albumin (IMA), matrix metalloproteinase-9 (MMP-9) and growth differentiation factor-15 (GDF-15) were detected by ELISA, and the clinical efficacy was evaluated. Results:The total effective rate was 92.9% (39/42) in observation group and that in the control group was 75.6% (31/41) ( χ2=4.67, P=0.031). After treatment, the scores of unconsciousness, consciousness trance, numbness and weakness, deviation of the eye and mouth and hemiplegia in observation group were significantly lower than those in the control group ( t=2.18, 3.11, 2.80, 2.07, 2.24, all Ps<0.05), and the NIHSS score was significantly lower than that of the control group ( t=2.58, P=0.012) while the MBI score was significantly higher than that of control group ( t=2.59, P=0.011). After treatment, the levels of serum IMA [(67.05±8.34) mg/L vs. (71.48±8.52) mg/L, t=2.39], MMP-9 [(100.72±12.49) ng/L vs. (107.66±13.05) ng/L, t=2.48] and GDF-15 [(438.16±43.20) ng/L vs. (461.93±44.19) ng/L, t=2.48] in observation group were significantly lower than those in the control group ( P<0.05). Conclusion:The modified Huatan Tongluo Decoction combined with acupoint massage can relieve the clinical symptoms and brain damage degree, improve the neurological function and living ability, and enhance the clinical efficacy of patients with AIS.
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Objective:To explore the effects of Huatan Tongluo Decoction （HTTLD） on the morphology and function of brain tissues and intestine in rats with cerebral ischemia/reperfusion based on the gut-brain axis. Method:Sixty SPF male rats were randomly divided into a sham operation group， a model group， high- （28.66 g·kg<sup>-1</sup>）， medium- （14.33 g·kg<sup>-1</sup>）， and low-dose （7.16 g·kg<sup>-1</sup>） HTTLD groups， and an edaravone （4 g·kg<sup>-1</sup>）+<italic>Clostridium butyricum</italic> （5.0×10<sup>8</sup> cfu·mL<sup>-1</sup>） group. The model was established by focal cerebral ischemia/reperfusion in rats. The drugs were administered by gavage. The brain tissue injury was determined by neurological deficit score and 2，3，5-triphenyl tetrazolium chloride （TTC） staining. The effect of cerebral ischemia/reperfusion on intestinal motility was assessed by the propulsion rate of small intestine. The intestinal mucosal cell damage was evaluated by the pathomorphological examination of the duodenal mucosa. Enzyme-linked immunosorbent assay （ELISA） was used to determine the content of <italic>D</italic>-lactate （<italic>D</italic>-LAC）， diamine oxidase （DAO）， and bacterial endotoxin （lipopolysaccharide， LPS） in serum. Western blot was used to detect the expression of Occludin， Claudin-5， and zonula occludens 1 （ZO-1） in the duodenum. Result:After cerebral ischemia/reperfusion， rats developed neurological deficit symptoms. The neurological deficit score in the model group was higher than that in the sham operation group （<italic>P<</italic>0.01）. Compared with the model group， the high- and medium-dose HTTLD groups could relieve the symptoms of neurological deficits and lower neurological deficit scores （<italic>P<</italic>0.01）. The results of TTC staining showed that the model group presented obvious infarcts in brain tissues compared with the sham operation group （<italic>P<</italic>0.01）. The cerebral infarction volumes of HTTLD groups were reduced compared with that in the model group （<italic>P<</italic>0.01）， especially the high-dose HTTLD group， and the effect was dose-dependent. Furthermore， the propulsion rate of small intestine in the model group was significantly reduced compared with that in the sham operation group （<italic>P<</italic>0.01）. Compared with the model group， HTTLD groups could increase propulsion rates of small intestine （<italic>P<</italic>0.01）， especially the high-dose HTTLD group， and the effect was dose-dependent. After cerebral ischemia/reperfusion， obvious duodenal mucosal damage could be observed， which was relieved after the administration of HTTLD. Western blot results showed that the protein expression of ZO-1， Occludin， and Claudin-5 in the model group was reduced compared with that in the sham operation group （<italic>P<</italic>0.01）. Compared with the model group， the HTTLD groups could up-regulate the expression of ZO-1， Occludin， and Claudin-5 to varying degrees （<italic>P<</italic>0.05， <italic>P<</italic>0.01）， especially the high-dose HTTLD group. ELISA showed that the serum <italic>D</italic>-LAC， DAO， and LPS of the model group were elevated compared with those in the sham operation group （<italic>P<</italic>0.01）. Compared with the model group， the HTTLD groups showed reduced <italic>D</italic>-LAC and DAO （<italic>P<</italic>0.05， <italic>P<</italic>0.01）， and the medium- and high-dose HTTLD groups showed reduced LPS （<italic>P<</italic>0.05， <italic>P<</italic>0.01）， especially the high-dose HTTLD group. Conclusion:After cerebral ischemia/reperfusion， the rats showed damaged brain tissues， neurological dysfunction， intestinal mucosal injury， weakened intestinal motility， and destroyed the intestinal mucosal barrier. HTTLD can protect against brain-gut axis injury after cerebral ischemia/reperfusion by reducing the damage on brain tissues and gastrointestinal mucosa， relieving the symptoms of neurological deficits， promoting gastrointestinal motility， improving intestinal barrier function， and reducing the release of intestinal bacterial metabolites or poisons.
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Objective To observe the clinical effect of alprostadil combined with Yiqi Huoxue Huatan Tongluo Decoction in treating arteriosclerosis obliterans.Methods 60 cases of lower extremity arteriosclerosis occlusion disease outpatient and hospitalized patients were randomly divided into treatment group and control group according to the random number table method, each group were 30, the oral administration of enteric coated aspirin experimental group is set to control group intravenous injection of alprostadil treatment for 4 weeks, the treatment group was treated with Huatan Tongluo Decoction on the basis of the control group.The clinical symptoms, blood vessel function (ABI),low density lipoprotein-cholesterol (LDL-C), total cholesterol( TC) were observed in the two groups of patients, and blood rheology indexes included whole blood viscosity, fibrinogen, liver and kidney function and adverse reactions.ResuIts Total effective rate of the treatment group was 93.33% than control group 73.33% (P<0.05), the treatment group of ankle brachial index ( ABI) was better than the control group, the treatment group TC, LDL-C, high shear whole blood viscosity, low shear whole blood viscosity, fibrinogen protein improve were better than those of the control group (P<0.05).ConcIusion Disease curative effect is better than pure alprostadil in the treatment of occlusion Huoxue Huatan Tongluo Decoction combined with alprostadil in the treatment of lower limb arteriosclerosis.
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ObjectiveTo observe the effects of Huatan Tongluo on the Bederson's scores,the permeability of blood-brain barrier and ultrastructure of hippocampus endothelial cells after thrombolysis in acute cerebral infarction.To provide experimental evidence for the prevention of bleeding after thrombolysis in acute cerebral infarction with Huatan Tongluo.Methods 120 SD male rats were randomly divided into sham group,model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tougluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group( each group was divided in 6h,24h,3d,7d four-phase).MCAO rats were prepared by self-embolus method.rt-PA group and Huatan Tongluo combined rt-PA groups were given rt-PA through tail vein injection and three doses of Huatan Tongluo to treat.To observe the Bederson's scores in rat on four-phase.To detect the permeability of blood-brain barrier(BBB) by the Evans Blue dye ( EB dye) and watch the ultrastructure of hippocampus endothelial cells in ischemic region by electron microscopy.Results 1.Bederson's scores:Compared with model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tongluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group significantly lower(P＜0.01 ) ; Compared with rt-PA group,Huatan Tongluo combined rt-PA medium-dose groups and high-dose groups was significantly lower(P ＜ 0.05).2.EB dye:Compared with model group,rt-PA group,Huatan Tongluo combined rt-PA low-dose group,Huatan Tongluo combined rt-PA medium-dose group and Huatan Tongluo combined rt-PA high-dose group (P ＜ 0.01 ) ; Compared with rt-PA group ( 6h:( 236.72 ± 79.79 ) ng/g; 24h:(229.72 ±22.18)ng/g;3d:(163.34 ±24.45)ng/g;7d:(133.21 ±25.09)ng/g),Huatan Tongluo combined rt-PA medium-dose groups (6h:( 121.63 ± 33.27) ng/g;24h:( 153.78 ± 60.67 ) ng/g;3d:( 76.05 ± 27.11 ) ng/g;7d:(72.97 ±25.81 ) ng/g) and high-dose groups (6h:( 123.11 ±23.65) ng/g;24h:( 138.36 ±52.36)ng/g;3d:(83.00 ±32.00)ng/g;7d:(75.06 ± 13.97) ng/g) was significantly lower(P＜ 0.01 ).3.Electron microscopy:Compared with model group,treatment groups all protected the endothelial cells.In 24h,the Huatan Tongluo combined rt-PA high-dose group was best.At 3d and 7d,the Huatan Tongluo combined rt-PA medium-dose group was best.ConclusionHuatan Tongluo combined rt-PA to thrombolysis can protect the blood-brain barrier and endothelial cells of hippocampal's ischemic region.After thrombolytic,to adjust the medicine drug concentration at different time can play a better treatment results.
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0.05),the clinical control rate were 67.65% and 52.94% (P