| ObjectiveTo observe the efficacy of Nao-qing nasal spray microemulsion on patients with acute ischemic stroke,and its effect on serum matrix metalloproteinase-9(MMP-9)and aquaporin-4(AQP-4),and to evaluate its effect on subjects’ blood rheology,neurological deficits,TCM symptoms,daily living ability and prognosis,so as to provide new ideas for the prevention and treatment of acute ischemic stroke by combining TCM and Integrated Chinese and Western medicine.MethodsThis study was a prospective randomized controlled study.Ninety patients who were hospitalized in the neurology department of the Affiliated Hospital of Traditional Chinese Medicine of Guangzhou Medical University for acute ischemic stroke from January 2022 to February 2023 were selected and randomly grouped into 30 patients each in the high-dose group,low-dose group and control group.On the basis of conventional Western medical treatment,the high-dose group and low-dose group were respectively treated with 3 snaps/2 snaps of nasal spray each time,while the control group was given 3 snaps of blank microemulsion each time,all 3 times a day for 10 days.The baseline information such as gender,age,for the three groups were compared at the beginning,and the serum concentrations of MMP-9 and AQP-4 and blood rheology levels of the subjects in the three groups were compared before and after the treatment.Results1.In terms of general information,there was no significant difference in baseline information with regards to gender and age among the three groups of patients before the treatment,hence the data of the three groups were comparable(P > 0.05)2.After treatment on the three groups,the total effective rate was 93.33% for the high-dose group,83.33% for the low-dose group,and 60.00% for the control group,with significant differences among the three groups(P < 0.05).The difference between the high-dose group and the low-dose group was statistically significant compared to the control group(P < 0.05),and there was no difference between the high-dose group and the low-dose group(P > 0.05).3.After treatment,the expression of MMP-9 and AQP-4 was inhibited in both the high-dose group and the low-dose group,as compared to the conditions before treatment(P < 0.05),and there was no trend of improvement in MMP-9 and AQP-4 expression in the control group as compared to the conditions before treatment(P > 0.05).After treatment,the expression of MMP-9 in the high-dose group was significant when compared to the low-dose group(P < 0.05),while there was no significant difference in AQP-4 expression(P > 0.05),and the concentrations of MMP-9 and AQP-4 reduced in both the high-dose group and the low-dose group after treatment,as compared to the control group during the same period(P < 0.05).4.In terms of blood rheology,whole blood high cut viscosity(200/S),whole blood medium cut viscosity(50/S),whole blood low cut viscosity(1/S)and plasma viscosity of patients in the high-dose group and the low-dose group decreased significantly after treatment(P < 0.05),while there was no difference before and after the treatment in the control group(P > 0.05),and the results of high-dose group and the low-dose group were both significantly different from that of the control group after treatment(P < 0.05),while there was no significant difference between the high-dose group and the low-dose group(P < 0.05).5.In terms of NIHSS scores,the NIHSS scores of all the three groups decreased as compared to the conditions before treatment(P < 0.05),and when compared with the control group in the same period,the NIHSS scores of the high-dose group and the lowdose group decreased significantly after the treatment(P < 0.05),and the difference between the NIHSS scores for the high-dose group and the low-dose group after treatment was not significant(P > 0.05).6.In terms of TCM symptom scores,all the three groups showed a decrease in TCM symptom scores as compared to the pre-treatment period(P < 0.05),the high-dose group and the low-dose group showed a significant decrease in TCM symptom scores after treatment compared with the control group(P < 0.05),and the difference in TCM symptom scores after high and low dose treatment was not significant(P > 0.05).7.In terms of BI scores,the relative independence accounted for 56.67% in the high-dose group,53.33% in the low-dose group,and 26.67% in the control group,and the relative independence ratio was better in both the high-dose group and the low-dose group than in the control group(P < 0.05),and there was no significant difference between the high-dose group and the low-dose group(P > 0.05).8.In terms of the mRS score,63.33% of patients with mRS score ≤ 2 in the high dose group,60.00% in the low dose group and 33.33% in the control group,the proportion of good prognosis was better in both the high-dose group and the low-dose group than in the control group(P < 0.05),and there was no significant difference in the comparison between the high-dose group and the low-dose group(P > 0.05).9.In terms of safety,during the treatment period,no adverse events were observed in the three groups of patients,and the incidence rate was 0.After treatment,ALT,AST,BUN,and Cr in the three groups had no significant difference compared with those before treatment(P > 0.05).Compared with the control group,there was no significant difference after treatment in the high-dose and low-dose groups(P > 0.05),and there was no significant difference between the high-dose and low-dose groups(P > 0.05).ConclusionAs compared to conventional western medicine treatment alone,the addition of Nao-qing nasal spray microemulsion in the treatment of patients with acute ischemic stroke has a good curative effect,can reduce the symptoms of neurological deficits,promote the recovery of patients’ living ability and quality,and significantly reduce the concentration of serum MMP-9 and AQP-4 in patients with acute ischemic stroke,thus protecting the Blood Brain Barrier,and can improve the hemorheology of patients,and has good safety,which is worth promoting in clinical practices. |
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