Experimental Study And Clinical Observation On The Effect Of Diosgenin On Post-stroke Cognitive Impairment

Objective:To observe the correlation between phlegm turbid type and the nerve function defect after ischemic stroke,to investigate the cognitive damage caused by stoke and probe the efficacy of diosgenin on the neurologic impairment through animal experiment,and to provide theoretical support for the post-stroke cognitive impairment（PSCI）.Method:Seventy patients with phlegm turbid type of PSCI were randomized into control group and treatment group,thirty-five patients in each group.2 in control group and 3 in another group were refused in the experimental process for some reason,a total of sixty-five cases.Basic information of all patients was collected,such as age,gender,and education level,followed by MMSE,Mo CA and ADL tests during the treatment.The difference of neurological defect between two groups was analyzed and compared by SPSS 23.0.Furthermore,forty male Wistar rats were divided into five groups:control group（sham operation）,model group（middle cerebral artery occlusion）,high-dose of diosgenin group(40mg·Kg^-1),low-dose of diosgenin group(20mg·Kg^-1),and Butylphthalide group(40mg·Kg^-1)after adaption,with eight in each group.Referring to Zea Longa method,the middle cerebral artery occlusion（MCAO）model was established successfully.Morris water maze was used to observe the learning and memory ability of rats;HE staining were used to observe the pathological changes of brain tissues;The expression of m RNA and protein of synaptophysin（SYP）,postsynaptic density protein（PSD-95）and brain-derived neurotrophic factor（BDNF）in brain were detected by RT-PCR and western blotting.Result:The clinical results showed that there was no statistical difference in age,gender,degree of educational,and scores of MMSE,Mo CA and ADL between two groups before treatment（P>0.05）.Compared with control group,the scores of MMSE,Mo CA and ADL were higher obviously in treatment group（P<0.05）.The results indicated that learning and memory ability was damaged post-MCAO as is illustrated in Morris water maze.And diosgenin could shorten the latency time and increase times of getting across the terrace.The pathological changes of neurons were probed by H&E staining in each group.Compared with treatment before,the levels of m RNA and protein of SYP,PSD-95 and BDNF were declined significantly（P<0.01）.the expression of m RNA and protein of these genes were improved markedly after treatment of diosgenin（P<0.01）.Besides,the high dosage of diosgenin had a greater advantage.Conclusion:the patients with phlegm turbid type had a neurological deficit after ischemia stoke.The situations of patients were improved in both groups after two courses.The way in treatment group was obviously better than that of the control group.Meanwhile,the experimental data suggested that diosgenin could improve learning and memory ability of rats post-MCAO and upregulate the levels of m RNA and protein of SYP,PSD-95 and BDNF in rats brain tissues.