Study Of Regularity Of Syndrome's Change And Intervention Effect Of Xiongqi Composition In The Stage Of Cerebral Infarction Before And After Revascularization

1 Reasons and objectives of the researchThe reasons of cerebral infarction include acute thrombogenesis,or thrombus displace,or angiostegnosis,which can induce cerebral vessels stegnosis or even obstruction.The most important therapy is to rebuild cerebral blood flow through various kinds of methods,meanwhile to retrieve the brain tissue condition of blood and oxygen deficience.The revascularization therapy after cerebral infarction has miscellaneous complications,although it can retrieve cerebral blood flow rapidly.Firstly,the study summarizes the application and common complications of the revascularization therapy in the ischemic cerebrovascular disease.On the basis of the review,we pose the treatment viewpoint of complications after revascularization therapy using Chinese medicine.Secondly,we design questionnaire of syndrome to discuss the regularity of syndrome's change through the investigation aiming at cerebral infarction patients after revascularization.Simultaneously,we use xiongqi composition to treat one of the revascularization animal model-ischemical reperfusion injury model, and to approach the possible mechanism of action through the directions of oxidative stress,exitotoxicity,immunization and Inflammatory reaction,etc.2 Methods2.1 clinical syndrome investigationAdopting cross-sectional study method,we design syndrome questionnaire of stroke to investigate cerebral infarction patients' syndrome in six time points,such as 0-3 days before revascularization therapy,and 14±3 days, 30±3 days,60±3 days,90±3 days after revascularization therapy,and then to study the cerebral infarction patients' syndrome before and after revascularization therapy,regularity of change,and the difference between two different therapy of revascularization.2.2 animal experimental studyWe establish one of the main revascularization animal model-ischemical reperfusion injury model.By applying tissue biochemical detection, pathological HE staining immunohistochemistry methods,we detect relevant indicators of oxidative stress:SOD,MDA determination;of the relevant amino acids:Glu and Asp,Gln,gaba determination;relevant indicators of immune and inflammatory response determination:MPO content,ICAM-1 protein expression determination.Then we analyze the intervention mechanism of xiongqi composition in cerebral ischemia-reperfusion injury.3 Results3.1 clinical research results3.1.1 regularity of syndrome' s change in the stage of cerebral infarction before and after revascularization3.1.1.1 regularity of syndrome' s combination and distribution in different time pointsBefore revascularization in patients with cerebral infarction,the combination of sthenia syndrome related syndromes is the main combination, such as wind+phlegm+stasis,wind+phlegm+stasis+fire,wind+phlegm+stasis+Qi deficiency,and so on.Since then,with the progress of the disease,syndrome combination changes from the type of more syndrome combination(3,4 ingredients)to the type of combination of less syndrome combination(1,2,3 ingredients),and from the combination of sthenia related syndromes mainly to the combination of deficiency related syndromes mainly.3.1.1.2 the change of single ingredient in the stage of cerebral infarction before and after revascularizationAfter revascularization in patients with Cerebral infarction,the sthenia related syndromes,such as wind,fire,phlegm,blood stasis,all show a downward trend,with the exception of the wind syndrome,fire syndrome may be due to the naturalevolution of stroke,blood stasis syndrome,phlegm syndrome also decline obviously,especially the blood stasis syndrome.But the asthenia related syndromes,such as Qi,Yin deficiency,all show a obvious upward trend.3.1.1.3 the integral change of single ingredient in the stage of cerebral infarction before and after revascularizationApart from wind syndrome,fire syndrome,phlegm syndrome,Yin deficiency and Yang excess syndrome before and after treatment in 1-3 days,there are no significant changes,the rest of the time points of all syndromes after treatment change obviously compared with syndromes before treatment.Of the total,blood stasis syndrome improves gradually after revascularization treatment.The wind syndrome,the fire syndrome and the phlegm syndrome in the treatment after 1-3 days,compared with syndromes before treatment without noticeably improved,but after the treatment of 14±3 days and beyond other than the time have clearly improved.The Qi deficiency syndromes of all time points after revascularization treatment become significantly than that before treatment.Yin deficiency and Yang excess syndromes in the treatment of 14±3 days and after the time become significantly than that before treatment.3.1.2 the difference of regularity of Syndrome' s change between two revascularization therapyIn the two groups,the distribution of Qi deficiency,fire,blood stasis, phlegm,Yin deficiency and Yang excess syndromes are basically the same before and after the revascularization treatment.Wind syndrome before and after revascularization treatment within 1-3 days in thrombolytic therapy group is significantly higher than angioplasty therapy group,which is possible because that most patients with thrombolytic therapy are during the stage of acute cerebral infarction,the condition is unstable;but most patients with angioplasty therapy are during the stage of recovery of cerebral infarction, the condition is relatively stable.Therefore,the wind syndrome in thrombolytic treatment group is significantly higher than that in angioplasty therapy group.3.2 animal experimental study3.2.1 the xiongqi composition's effect of oxidative stress injury after cerebral ischemia-reperfusionXiongqi composition can regulate the content of SOD and MDA of ischemia side brain tissue in MCAO rat after ischemia-reperfusion,and can cause them trend to normal.But urokinase hasn't the same role;The effect of urokinase plus xiongqi composition is similar compared with single xiongqi composition. It demonstrates that xiongqi composition can resist brain ischemia-reperfusion injury by reducing the damage extent of oxidative stress.3.2.2 the xiongqi composition's effect of immune inflammatory injury after cerebral ischemia-reperfusionXiongqi composition can inhibit the increasing of MPO content of ischemia side brain tissue induced by ischemia-reperfusion in MCAO rat.HE staining demonstrates that the extent of leukocyte adhesion and infiltration of ischemic brain tissue reduces significantly in group treated by xiongqi Composition;xiongqi composition also can inhibit the increasing of ICAM-1 protein expression induced by ischemia-reperfusion;urokinase hash't the same role,The effect of urokinase plus xiongqi composition is similar compared with single xiongqi composition.It demonstrates that xiongqi composition can resist brain ischemia-reperfusion injury by reducing the damage extent of inflammatory immune.3.2.3 the xiongqi composition's effect of excitatory amino acids after cerebral ischemia-reperfusionXiongqi composition can inhibit the increasing of excitatory amino acids GLU and ASP content of ischemia side brain tissue induced by ischemia-reperfusion in MCAO rat,and can cause them trend to normal.Xiongqi composition also can increase the content of inhibitory amino acids Gln,Gaba induced by ischemia-reperfusion in MCAO rat.It demonstrates that xiongqi composition can reduce brain ischemia-reperfusion injury in excitotoxicity by adjusting the content of excitatory amino acids and inhibitory amino acids.4 COnclusions4.1 clinical syndrome investigationThe regularity of syndrome' s change in the stage of cerebral infarction before and after revascularization is as follows:Syndrome combination before revascularization in patients with cerebral infarction changes from the type of more syndrome combination(3,4 ingredients)to the type of combination of less syndrome combination(1,2,3 ingredients)after revascularization,and from the combination of sthenia related syndromes mainly to the combination of deficiency related syndromes mainly.It demonstrates that the revascularization therapy can remove evil factors affecting health(mainly blood stasis,phlegm evil),but at the same time it may have some harmful effects to the vital Qi of human body.4.2 animal experimental studyThe reperfusion injury after thrombolytic therapy of acute cerebral infarction is one of the major complications after revascularization treatment, xiongqi composition has a protective effect to brain ischemia-reperfusion injury through influencing oxidative stress,immune and inflammatory, excitability toxic action induced by ischemia-reperfusion.5 future prospectsOn the basis of this study,we may enlarge sample volume and expand the scope to discuss thoroughly the distribution and evolution regularity of syndrome in patients with cerebral infarction before and after revascularization treatment,which may provide methods and ideas for the treatment of the complications after revascularization in patients with cerebral infarction.Then,we may carry out randomized controlled studies on the prevention and cure Using xiongqi compositionfor complications related with revascularization in patients with cerebral infarction,and carry out beneficial exploration on the prevention and cure for complications after revascularization in patients with Cerebral infarction using Chinese medicine.