| To know about the characteristic of Lacunar Infarction(LI); To demonstrate the clinic character of the gently stroke in the acute period; To observe the effect of Qingnao Pilular on LI; To investigate the expression of MARCKS and p-MARCKS in the hippocampus and cortex of multiple infarction in the mouse model; Furthermore, we had explored the role of Qingnao Pilular on MARCKS signal transduction pathway in acute cerebral ischemic model. Methods:(1) With a parallel group,controlled and randomized trail, a group of 33 patients were involved for studying the effect of Qingnao Pilular on LI, with 33 patients taking enteric-coated Aspirin as a control group, estimated with NIHSS and stroke syndrome of traditional Chinese medicine(TCM).The period of clinical observation was 2 weeks.(2) The multiple infarction model was established by method of Kaneko. The role of Qingnao Pilular was investigated, and Nimodipine was taken as control.(3) Microscope and electronic microscope were used to watch the structure and ultra structure of mouse brain.(4) The expression of pattern of these proteins was further analyzed for their distribution at cellular level by immunohistochemistry staining of the tissues.(5) Statistical analysis was performed with SPSS software version 10.0. The expression of MARCKS and p-MARCKS was analyzed and was considered to be statistically significant.Results:(1) Clinical results The incidence of LI was various in different age with the ratio of the male tofemale is 3 : 2. It is the most in 65~75y, but it was not infrequence during the age of35~45y. Most of LI patients have the history of high blood pressure, and sicken in thesituation of sleeping or quiet. The inducements concerned with bad emotion, weatherchanging and over drinking etc.(2)The location of pathological changes by CT or MRI showed that mostly happened inthe basic nucleusand and centrum semiovale and corna radiata, others in the internalcapsule, brain cortex, thalamic brain, cerebel and external capsule. Furthermore,Multi-encephalon infarction was more frequent than single-encephalon infarction.(3) Statistical analysis approved the curative group and control group had the sameeffect on reducing the value of NIHSS. Both of them had not obvious difference(P>0.05).(4) Qingnao Pilular could obviously improve the syndrome of pathogenic wind, fire,phlegm, blood stasis than the control group(P <0.05). The trial results showed that the most syndrome was wind, then was fire, bloodstasis, phlegm, asthenic yin causing predominant yang and asthenia of qi. By analyzing the 5 syndrome of stroke involving both collateral and meridia,showed that the most syndrome was hyperhepatic yang generating fire, then in turnwas wind phlegm and blood stasis, pyrophlegm fu syndrome, asthenia of qi and bloodstasis, asthenic yin causing predominant yang. Qingnao Pilular could obviously improve the symptoms of hyperhepatic yanggenerating fire syndrome, specially can improve 7 symptoms: amnesia, headache,vertigo, bitter taste of mouth and dry throat, restlessness and irritability , constipationand yellowish fur.(2) Experiment results The mouse mutiple infarction model by Kaneko's method was successful and thesymptome of stroke was obvious.The pathology and ultra structure of the mouse model was founded with obviousalterations of ischemic location, and we found that treatment with Qingnao Pilular andNimodipine could inhibit the change. The expression of MARCKS and p-MARCKS in hippocampus and cortex of themodel were visibly elevated comparing with the normal and control group(P<0.05),and the expression of the above two proteins were decreased after two weeks.The expression of MARCKS and p-MARCKS were found decreased in the sametissues of the model with treatments of Qingnao Pilular and Nimodipine.Conclusions:(1) Clinical conclusionsThe most syndrome of acute LI was wind, then in turn was fire, blood stasis, phlegm, asthenic yin causing predominant yang and asthenia of... |
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