ABSTRACT
Objective:To explore the clinical efficacy of modified Ditantang combined with acupuncture in the treatment of dysphagia after apoplexy （DAS） syndrome of phlegm and blood stasis blocking collaterals. Method:One hundred and eight patients were randomly divided into control group （54 cases） and observation group （54 cases） by number table. Both groups underwent nutritional management，rehabilitation training and acupuncture. Patients in control group additionally took Tongluo Huatan capsules， 3 granules/time， 3 times/day， while patients in observation received modified Ditantang. Both groups had two weeks of treatment. The Kubota's drinking water test， swallowing contrast examination （VFSS）， and standard swallowing function assessment （SSA） were conducted. Swallowing disorder specific quality of life scale （SWAL-QOL） and sputum collateral stasis syndrome were scored before and after treatment. The levels of brain-derived neurotrophic factor （BDNF）， nerve growth factor （NGF） and neuron-specific enolase （NSE） before and after treatment. The occurrence of pneumonia， malnutrition， dehydration and aspiration were then recorded. Result:The clinical effective rate was （47/49） 95.92%in the observation group， higher than （41/50） 82.00% in the control group's （<italic>χ</italic><sup>2</sup>=4.854，<italic>P</italic><0.05）. The grade of Kubota's drinking water test in observation group was lower than that in the control group（<italic>Z</italic>=2.211，<italic>P</italic><0.05）. VFSS swallowing dysfunction in observation group was lighter than that in control group（Z=1.969，<italic>P</italic><0.05）. The scores of Kubota's drinking water test， SSA and phlegm and blood stasis blocking collateral syndrome in the observation group were all lower than those in the control group（<italic>P</italic><0.01）， while the VFSS score was higher than that in control group （<italic>P</italic><0.01）. The swallowing symptom score， other symptom scores and total SWAL-QOL scores of the observation group were higher than those of the control group（<italic>P</italic><0.01）. The levels of BDNF and NGF in the observation group were higher than those in the control group （<italic>P</italic><0.01）， but the NSE level was lower than that in the control group（<italic>P</italic><0.01）. The complication rate in the observation group was （6/49）12.24%， which was lower than （15/50）30.00% in the control group（<italic>χ</italic><sup>2</sup>=4.668，<italic>P</italic><0.05）. Conclusion:On the basis of nutrition management and rehabilitation training， modified Ditantang combined with acupuncture can reduce the risk of dysphagia and aspiration， improve the degree of neurological deficits， improve the quality of life， and reduce complications in treatment of DAS syndrome of phlegm and blood stasis， with significant clinical efficacy.
ABSTRACT
Objective:To discuss clinical effect of addition and subtraction therapy of Ditantang combined with Taohong Siwutang to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and to study protection to brain nerve. Method:One hundred and fifty-two patients were randomly divided into control group （76 cases） and observation group （76 cases） by random number table， 71 patients in control group completed the therapy （5 patients were falling off， missing visit or eliminated）， and 70 patients in observation group completed the therapy. Both groups' patients got comprehensive rehabilitation measures. Patients in control group got Zhongfeng Huichun pills， 1.5 g/time， 3 times/day. Patients in observation group got addition and subtraction therapy of Ditantang combined with Taohong Siwutang in the morning and at night， 1 dose/day. The treatment was continued for 12 weeks. Before and after treatment， scores of degree of neurological deficit， Barthel （BI） index， Fugl-Meyer scale （FMA）， modified Rankin scale （MRS） and syndrome of phlegm and blood stasis blocking collaterals were graded. And levels of malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， advanced oxidation protein products （AOPP）， vascular endothelial growth factor （VEGF）， brain-derived neurotrophic factor （BDNF） and neuron specific enolase （NSE）. And cerebral hemodynamics were detected， and peak flow velocity （VS）， vascular resistance index （RI）， pulsatility index （PI） and cerebrovascular reserve function （CVR） were recorded. Safety was evaluated. Result:After the 6th week and 12th week of treatment， scores of degree of neurological deficit， BI， FMA， MRS， syndrome of phlegm and blood stasis blocking collaterals， AOPP， MDA， NSE， RI and PI were lower than those in control group （P<0.01）， levels of SOD， GSH-Px， BDNF， VEGF， Vs and CVR were higher than those in control group （P<0.01）. The clinical effect was better than which in control group （Z=2.109， P<0.05）. Besides， there was no adverse reaction caused by Ditantang combined with Taohong Siwutang. Conclusion:Ditantang combined with Taohong Siwutang can ameliarate the hemodynamics， reduce the lipid peroxidation damage， regulate the neurovascular repair factor， so it can promote the repair of nerve tissue and function， clinically reduce the degree of nerve function defect， improve the ability of daily life and exercise when it used to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and it is good for clinical effect and safe using.
ABSTRACT
Objective:To observe the clinical efficacy of Ditantang on phlegm turbid-blocked obstruction type tetan-burst twins in children with epilepsy and its effect on immunoglobulin, Peripheral blood helper T cells 17（Th17）， interleukin-6 (IL-6) and interleukin-17A（IL-17A）in children with epilepsy. Method:The random distribution sequences of 100 children generated by the random number table method were placed in sealed envelopes, and the subjects were divided into the corresponding experimental group and treatment group. Control group was treated with sodium valproate oral solution, and treatment group was also treated with Ditantang in addition to the therapy of control group. The total course of treatment was 3 months. The changes of immunoglobulin M（IgM）， immunoglobulin A（IgA），immunoglobulin G（IgG）, peripheral blood Th17 cells，IL-6，IL-17A, C-reactive protein (hs-CRP), blood homocysteine (Hcy) and the adverse reactions were detected before and after treatment in two groups. The changes in the number of seizures, duration of seizures and EEG before treatment and 3 months after treatment were compared between the two groups. Result:Three months after the treatment of phlegm-blocking obstruction type tetan-burst twin epilepsy with Ditantang combined with sodium valproate, the results showed that the total effective rate of treatment group was superior to that of control group, with statistically significant differences (P<0.05). After treatment, treatment group was superior to control group in the reduction of epilepsy score (P<0.05). Compared with before treatment, the levels of IgG，IgA and IgM in treatment group were significantly increased (P<0.05), while the levels of Th17，IL-6，IL-17A，hs-CRP and Hcy in peripheral blood were significantly decreased. Compared with control group, the levels of Th17，IL-6，IL-17A，hs-CRP and Hcy in peripheral blood decreased significantly after treatment (P<0.05). The incidence of adverse reactions in control group was significantly higher than that in treatment group (P<0.05). Conclusion:Ditantang is effective and safe in treating phlegm turbidness and obstruction type epilepsy (tetan-episode twin), and can improve the clinical symptoms of children and electroencephalogram. Besides, it can improve the level of immunoglobulin in children, significantly reduce the levels of Th17，IL-6 and IL-17A in their peripheral blood, regulate the immune function of the body, and reduce the incidence of adverse reactions.
ABSTRACT
Objective:To investigate the effect of modified Ditantang on autophagy and relevant proteins in brain cells of rats with cerebral ischemia reperfusion injury. Method:The cerebral ischemic reperfusion (CIR) injury model in rats was built by reversible middle cerebral artery occlusion artery suture of middle cerebral embolism method, and randomly divided into sham group, model group, high-dose modified Ditantang group(H-dose), low-dose modified Ditantang group (L-dose, 0.384 g·kg-1) and PLXT group (0.1 g·kg-1). Sham and model groups were given normal saline by gastric perfusion, H-dose and L-dose groups were given modified Ditantang, and the PLXT group were given Piracetam tablets, intragastric volume 10 mL·kg-1. The treatment lasted for 7 d. Within 24 hours after administration, the histopathological examination was performed, the volume of cerebral infarction, neuronal apoptosis and serum levels of inflammatory factors were compared, and the expressions of autophagy related microtuble-associated protein 1 light chain 3(LC3)Ⅱ, Beclin1, B-cell lymphoma-2(Bcl-2) and p62 in brain tissues were determined. Result:Cells and blood vessel necrosis, neuron swelling and interstitial edema were observed in model group, a few neurons died, edema was reduced, swelling of nerve cells was alleviated in H-dose, L-dose and PLXT groups. The volume of cerebral infarction and neuronal apoptosis in H-dose, L-dose and PLXT groups were lower than those in model group (Pα, intedeukin (IL)-2 and IL-8 in H-dose, L-dose and PLXT groups were lower than those in model group (PPConclusion:Modified Ditantang can improve brain injury and interfere with autophagy after MCAO/R, alleviate inflammation, and regulate autophagic activity, which may be related to the down-regulation of expressions of LC3 Ⅱ, Beclin1 and the up-regulation of expression of p62.