ABSTRACT
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.
ABSTRACT
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.