| Study 1 Correlation between acute brain infarction and Wind-phlegm obstruction syndromeObjectiveIn the acute stage of cerebral infarction,cerebral microcirculation disorder and inflammatory response are important mechanisms of brain injury.By studying the distribution of Chinese medicine certificate and condition,the severity of the Wind-phlegm obstruction syndrome of cerebral infarction and the corresponding relationship between Chinese medicine certificate and syndrome,the correlation between the sputum resistance Chinese medicine certificate integral and the index of cerebrocyclic disorders and the inflammatory factors.To investigate the inflammation associated with sputum evidence and the material basis of microcirculation disorders in patients with acute stage of cerebral infarction.MethodsFrom April 2016 to March 2019,200 patients were admitted to the Department of Brain Disease Department in Traditional Chinese Medicine Hospital of Guangzhou,affiliated to the University of Guangzhou Traditional Chinese Medicine,and 200 patients were admitted to the department of brain disease,which met the diagnostic criteria for stroke and acute ischemic cerebrovascular disease in Western medicine.1,respectively,the statistics of the medical certificate,which wind certificate,hot certificate,sputum certificate,blood stasis,qi deficiency,Yang hyperactivity caused by Yin deficiency.each certificate meet the condition of more than 7 scores,this certificate is established.2,according to the TCM syndrome integral,included in the same subject stroke certificate and sputum certificate waiting points increased by 7 scores,the syndrome of wind and sputum diagnosis is established.According to the scores,the severity of the sputum firescoad card is layered,divided into light,medium and heavy three degrees,of which 14-28 scores is mild,29-44 scores is divided into moderate,45 scores or more is heavy.3,analysis of the subject’s Wind-phlegm obstruction syndrome waiting integral and nerve function defect(NIHSS)score correlation;4.Collect serum in patients with acute stroke in the Wind-phlegm obstruction syndrome,and determine the content of TXB2,6-K-PGF1 alpha,TNF-alpha,IL-6 and MMP-9.5,the Wind-phlegm obstruction syndrome integral and TXB2,6-K-PGF1 alpha,TNF-alpha,IL-6 and MMP-9 multilinear regression analysis.Results1.The frequency of each Chinese medicine certificate in 200 cases of acute stroke from more to less was:Blood Stasis with 143 times(71.5%),wind certificate 124 times(62%),sputum card 101 times(50.5%),gas false certificate 65 times(32.5%),hot certificate 49 times(24.5%),Yang hyperactivity caused by Yin deficiency 42 times(21%).2.The average TCM syndrome integral score of 24.15±3.70 for patients with mild Wind-phlegm obstruction syndrome;The average TCM syndrome integral score of patients with moderate Wind-phlegm obstruction syndrome was 36.22±4.11;The average TCM syndrome integral score was 49.57±4.12 for patients with severe Wind-phlegm obstruction syndrome.The certificate waiting points increase with the deepening of Wind-phlegm obstruction syndrome.3.The Wind-phlegm obstruction syndrome scords is positively related to NIHSS(P<0.05),with a Pearson correlation coefficient of 0.989.4.The severity with Wind-phlegm obstruction syndrome of patients in acute stroke patients were correlated with 6-K-PGF1α and TNF-α in multiple linear correlations,with linear regression coefficients of-0.065 and 0.719,and constant terms of 0.861.Conclusion1.The Wind-phlegm obstruction syndrome and the blood stasis certificate are the most common types of acute stroke disease.2.The scores of Wind-phlegm obstruction syndrome reflects the severity of brain injury in acute stroke.3.There was a multiple linear correlation between the scores of Wind-phlegm obstruction syndrome and 6-K-PGF1α and TNF-α in acute stroke patients That is,the lower the 6-K-PGF1α content,the higher the TNF-α content,the more serious the Wind-phlegm obstruction syndrome was.4.The severity of brain injury in patients with acute stroke was positively correlated with microcirculation disorders and inflammatory responses to the brain.Study2 Study on the intervention of acute cerebral infarction microcirculationdisorder and inflammatory response of eliminating phlegm and freeing channelsdecoctionObjectiveIn this study,eliminating phlegm and freeing channels decoction was used to treat acute cerebral infarction,to observe its effects on neurological deficit score,daily living activity ability,microcirculation disorder and inflammatory response indicators,and to explore the mechanism of eliminating phlegm and freeing channels decoction in the treatment of acute cerebral infarction.MethodsFrom April 2016 to March 2019,90 patients were admitted to the Department of Brain Disease in the TCM hospital of Guangzhou,affiliated to the Guangzhou university of traditional Chinese medicine,and met the diagnostic criteria for stroke and acute ischemic cerebrovascular disease in Western medicine.Patients were grouped in random numerical tables in the order of admission.The first group was control group:Treated with Injection of Sanqi Panax Notoginseng and normal Western medicine treatment.The second group was the treatment group:on the basis of the control group,eliminating phlegm and freeing channels decoction was used.Before and after the 14th day of treatment,the data of Neurofunctional impairment scores(NIHSS),TCM syndrome integral scores,daily activity ability scores(based on Barthel index score)were collected,and collected intravenous blood to test TXB2,6-K-PGF1α,TNF-α,IL-6 and MMP-9.Statistical treatment group and control group before and after treatment NISS score,Chinese medicine certificate scores,Barthel score,Serum concentration of TXB2,6-K-PGF1α,TNF-α,IL-6,MMP-9.The date of each group was compared before and after treatment,Comparisons were made before and after treatment inter-group.The effect of eliminating phlegm and freeing channels decoction on acute cerebral infarction and its effect on microcirculation disorders and inflammatory responses was studied.Results1.There was no significant difference in NIHSS scores between the two groups before treatment(P>0.05).There was a significant difference in NIHSS scores before and after treatment in the treatment group(P<0.05).The NIHSS scores of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in NIHSS scores between the treatment group and the control group(P<0.05).There were significant differences in NIHSS scores between the two groups before and after treatment(P<0.05).2.There was no significant difference in TCM scores between the two groups before treatment(P>0.05).There was a significant difference in TCM scores before and after treatment in the treatment group(P<0.05).The TCM scores of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in TCM scores between the treatment group and the control group(P<0.05).There were significant differences in TCM scores between the two groups before and after treatment(P<0.05).3.There was no significant difference in the wind syndrome integral between the two groups before treatment(P>0.05).There was a significant difference in the wind syndrome integral before and after treatment in the treatment group(P<0.05).The the wind syndrome integral of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the wind syndrome integral between the treatment group and the control group(P<0.05).There were significant differences in the wind syndrome integral between the two groups before and after treatment(P<0.05).4.There was no significant difference in the Phlegm syndrome integral between the two groups before treatment(P>0.05).There was a significant difference in the Phlegm syndrome integral before and after treatment in the treatment group(P<0.05).The the Phlegm syndrome integral of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Phlegm syndrome integral between the treatment group and the control group(P<0.05).There were significant differences in the Phlegm syndrome integral between the two groups before and after treatment(P<0.05).5.There was no significant difference in the Daily life activity rating between the two groups before treatment(P>0.05).There was a significant difference in the Daily life activity rating before and after treatment in the treatment group(P<0.05).The the Daily life activity rating of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Daily life activity rating between the treatment group and the control group(P<0.05).There were significant differences in the Daily life activity rating between the two groups before and after treatment(P<0.05).6.The therapeutic effect of neurological defect score in the two groups was compared.In the treatment group,2 cases were cured,18 cases were significantly effective,16 cases were effective,and 0 cases were ineffective,with a total effective rate of 100%.In the control group,0 cases were cured,11 cases were significantly effective,12 cases were effective,and 13 cases were ineffective,with a total effective rate of 63.89%.Mann-Whitney U test showed that there was a significant difference in the total effective rate between the two groups(Mann-Whitney U=371.000,P=0.001<0.05).Chi-square test showed that there was a significant difference in the total effective rate between the two groups(X2=17.261,P=0.001<0.05).7.The curative effect of TCM syndrome integral in the two groups was compared.The total effective rate was 83.33%in the treatment group,1 case was cured,6 cases were significantly effective,23 cases were effective,and 6 cases were not effective,and the total effective rate was 22.22%in the control group,0 cases were cured,1 case was significantly effective,7 cases were effective,and 28 cases were not effective.Mann-Whitney U test showed that there was a significant difference in the total effective rate between the two groups(Mann-Whitney U=238.500.000,P=0.000<0.05).Chi-square test showed that there was a significant difference in the total effective rate between the two groups(X2=27.340,P=0.000<0.05).8.There was no significant difference in the Serum TXB2 concentration between the two groups before treatment(P>0.05).There was a significant difference in the Serum TXB2 concentration before and after treatment in the treatment group(P<0.05).The the Serum TXB2 concentration of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Serum TXB2 concentration between the treatment group and the control group(P<0.05).There were significant differences in the Serum TXB2 concentration between the two groups before and after treatment(P<0.05).9.There was no significant difference in the Serum 6-K-PGF1α concentration between the two groups before treatment(P>0.05).There was a significant difference in the Serum 6-K-PGF1α concentration before and after treatment in the treatment group(P<0.05).The the Serum 6-K-PGF1α concentration of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Serum 6-K-PGF1α concentration between the treatment group and the control group(P<0.05).There were significant differences in the Serum 6-K-PGF1α concentration between the two groups before and after treatment(P<0.05).10.There was no significant difference in the Serum TNF-aconcentration between the two groups before treatment(P>0.05).There was a significant difference in the Serum TNF-aconcentration before and after treatment in the treatment group(P<0.05).The the Serum TNF-aconcentration of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Serum TNF-aconcentration between the treatment group and the control group(P<0.05).There were significant differences in the Serum TNF-aconcentration between the two groups before and after treatment(P<0.05).11.There was no significant difference in the Serum IL-6 concentration between the two groups before treatment(P>0.05).There was a significant difference in the Serum IL-6 concentration before and after treatment in the treatment group(P<0.05).The the Serum IL-6 concentration of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Serum IL-6 concentration between the treatment group and the control group(P<0.05).There were significant differences in the Serum IL-6 concentration between the two groups before and after treatment(P<0.05).12.There was no significant difference in the Serum MMP-9 concentration between the two groups before treatment(P>0.05).There was a significant difference in the Serum MMP-9 concentration before and after treatment in the treatment group(P<0.05).The the Serum MMP-9 concentration of the control group were significantly different before and after treatment(P<0.05).After treatment,there was a significant difference in the Serum MMP-9 concentration between the treatment group and the control group(P<0.05).There were significant differences in the Serum MMP-9 concentration between the two groups before and after treatment(P<0.05).Conclusion1.Eliminating phlegm and freeing channels decoction can improve nerve function defect,reduce wind-phlegm obstruction syndrome integral and reduce brain injury.2.Eliminating phlegm and freeing channels decoction reduces the expression of TXB2,TNF-α,IL-6 and MMP9 by up-regulating the expression of 6-k-PGF1α,and down-regulating the expression of TXB2,TNF-α,IL-6 and MMP9,so as to reduce the disturbance of brain microcirculation,control inflammation,reduce brain injury and protect brain tissue. |
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