Clinical Study And Proteomic Analysis On Treatment Of Ischemic Stroke Rehabilitation (Yang Deficiency) By Modified Sini Decoction Therapy

Objective: To observe the clinical efficacy of Modified Sini Decoction in the treatment of patients with Ischemic Stroke Rehabilitation(Yang Deficiency),and testing the plasma through proteomic analysis,in order to provide the basis for the application of Modified Sini Decoction in the Ischemic Stroke Rehabilitation(Yang Deficiency)in the future,and increase the treatment of ischemic stroke in the recovery period.Methods: 60 patients with ischemic stroke recovery(Yang deficiency)in the inpatient department and outpatient of First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine(TCM)from March 2020 to January 2021 were included.Random number table method w as used to randomly divide the treatment group and control group,with 30 cases in each group.The control group received conventional basic medical treatment for ischemic stroke.The treatment group was supple mented with modified Sini Decoction on the basis of the control group.Both groups were treated for 4 weeks for 1 courses of treatment.After the treatment course,the clinical efficacy,cognitive function,TCM syn drome score,Fugl-Meyer(FMA)motor function score and daily living activity score(ADL)of the two groups were compared,and safety anal ysis was carried out according to the relevant monitoring indexes durin g medication.At the same time,5 cases in the treatment group and 5cases in the control group were randomly selected and measure the ch anges of plasma regulatory proteins through Data independent acquisitio nwas(DIA)technology in the laboratory.Results:(1)Comparison of clinical efficacy : The total effective rate of the treatment group was 83.3%,and that of the control group was 73.3%.The difference between the two groups was statistically significant(P < 0.05),indicating that the total effective rate of the treatment group was better than that of the control group;(2)Comparison of TCM symptom scores: Before treatment,there was no significant difference in TCM syndrome score between the two groups(P > 0.05).After treatment,the TCM symptom scores of the two groups decreased,and the data of the treatment group decreased more significantly(P < 0.05).The improvement of TCM symptom scores of the treatment group was better than that of the control group;(3)Comparison of short-form Fugl-Meyer(FMA)motor function scores: Before treatment,there was no significant difference in the Fugl Meyer(FMA)motor function score between the two groups(P > 0.05);after treatment,the FMA score of the two groups was improved,the improvement of the treatment group was more obvious(P < 0.05),and the improvement FMA score of the treatment group was better than that of the control group;(4)Comparison of living activity score(ADL):After treatment,ADL scores in both groups were improved(P <0.05).Compared with the control group,the treatment group was better than the control group(P < 0.05);(5)Clinical adverse reactions: No serious adverse events occurred during the treatment with modified Sini Decoction,and the treatment with a good safety profile.(6)Proteomic analysis through DIA:A total of 9 differentially expressed proteins were screened from the two groups.It contains four up-regulated proteins(LV545,POSTIN,C1 RL,FHR4)and five down regulated proteins(PXDC2,CD44,FA7,MF2L2,HV316).And their functions were mainly related to neuroprotection and inhibition of inflammatory factor expression.Pathway analysis indicated that these proteins were significantly associated with tight junction,pentose phosphate pathway,methane metabolism,axon guidance and biosynthesis of amino acids.The results showed that Modified Sini Decoction participated in a series of anti-inflammatory,antioxidant and neuroprotective processes.Conclusions: Modified Sini Decoction can significantly improve the TCM syndrome score of ischemic stroke patients with Yang deficiency syndrome,improve motor function and activities of daily living.The mechanism may be related to anti-inflammatory,anti-oxidation and neuroprotective effects by regulating multiple proteins such as POSTIN,CD44 and FA7 and participating in tight junction and pentose phosphate pathway.It has definite clinical efficacy,good safety and no obvious toxic and side effects.