| There is inflammatory response and changes of matrix metalloproteinase activity in atherosclerosis and ischemic stroke. Smoking is a risk factor of cerebrovascular disease, literature shows that smoking leads to atherosclerotic and cardiovascular and cerebrovascular diseases through inflammatory response, effect of promoting thrombosis, changes of matrix metalloproteinase activity and so on. Thus, there is some correlation between smoking and the prognosis of stroke. The fifteenth project-research shows that integrated TCM therapy hit the stroke disease and do good effect. The clinical trail of paper will study the influence of the integrated TCM therapy on outcome assessments indexes. Yi Naokang capsule is an effective effective prescriptions in the treatment of ischemic stroke resulting from above-mentioned therapeutic theory. The animal experiment of paper will investigate the influence of Yi Naokang capsual on inflammatory reaction about rats with atherosclerotic ischemic stroke.The clinical trailObjectiveThe influence of the integrated TCM therapy on outcome assessments indexes about smoking patients with ischemic stroke.MethodThe cases were from patients in fifteenth project-research, selecting the smoking and non-smoking patients to investigate the influence of integrated TCM therapy(A plan) and simple western medicine program(B plan) on outcome assessments indexes for ischemic stroke, Namely three measuring scale levels about the disease(NIH, BI, MRS, SS-QOLand SS-TCM). Result1. For smoking patients with ischemic stroke:There is no statistical difference about score NIH in patients treated with A and B plan respectively on 7,14 and 21 days after entering the group. The statistical P are(0.623,0.314,0.199).There is no statistical difference about score BI and MRS in patients treated with A and B plan respectively on 21,60 and 90 days after entering the group. The statistical P are(0.092,0.128,0.157). There is no statistical difference about score SS-QOL in patients treated with A and B plan respectively on 14,21,60 and 90 days after entering the group. The statistical P are(0.587,0.639,0.783,0.437). There is no statistical difference about score SS-QOL in patients treated with A and B plan respectively on 14,21,60 and 90 days after entering the group. The statistical P are (0.587,0.639,0.783,0.437). There is no statistical difference about score of SSTCM affecting life in patients treated with A and B plan respectively on 7,14,21,60 and 90 days after entering the group. The statistical P are (0.268,0.595,0.902,0.378,0.176).2. For non-smoking patients with ischemic stroke:There is no statistical difference about score NIH in patients treated with A and B plan respectively on 7,14 and 21 days after entering the group. The statistical P are(0.933,0.315,0.109). There is no statistical difference about score BI in patients treated with A and B plan respectively on 21,60 and 90 days after entering the group. The statistical P are(0.915,0.505,0.091). There is no statistical difference about score MRS in patients treated with A and B plan respectively on 21 and 60 days after entering the group. The statistical P are(0.433,0.285). But there is statistical difference on the 90th day (P=0.033). There is no statistical difference about score SS-QOL in patients treated with A and B plan respectively on 14,21,60 and 90 days after entering the group. The statistical P are(0.914,0.648,0.388,0.283). There is no statistical difference about score of SSTCM affecting life in patients treated with A and B plan respectively on 7,14,21 and 60 days after entering the group. The statistical P are(0.693,0.061,0.106,0.060).But there is statistical difference on the 90th day(P=0.005).Conclusion1.For smoking patients with ischemic stroke:In the current observation period, the integrated TCM therapy and simple western medicine program have equivalent effects on outcome assessments indexes for patients. But with the time longer, compared with simple western medicine program, the integrated TCM therapy has the increasingly significant trend of improving the efficacy.2. For non-smoking patients with ischemic stroke:In the current observation period, for improving the 90th score MRS and score of SSTCM affecting life, the integrated TCM therapy make better than simple western medicine program. But there are no differences of other outcome assessments indexes between A and B plans. With the time longer, compared with simple western medicine program, the integrated TCM therapy still has the increasingly significant trend of improving the efficacy.3. According to the general characteristics of patients and the selection and time of evaluation about outcome assessments indexes, compared with simple western medicine program, the advantages of the integrated TCM therapy are that there is better efficacy for non-smoking ischemic stroke patients with heart disease, diabetes and other chronic underlying diseases, relatively older.The clinical effect shows more apparent in some scales with longer follow-up time.ObjectiveTo investigate the influence of Yi Naokang capsule on content of MMP-9, TIMP-1 and expression of ICAM-1 in brain tissue and the level of serum ICAM-1 about rats with atherosclerotic ischemic stroke.Method115 rats were divided into 6 groups randomly:normal group, arterioscl-erosis group, ischemic stroke group, preventive medication group, Yi Nao kang group and Lipitor group. Duplicating atherosclerotic ischemic stroke model, and the rats were administered by intragastric injection using preventive and therapeutic usage. Preventive medication group was irrigated the stomach once a day before and after modeling, Yi Naokang group and Lipitor group were irrigated the stomach once a day for seven days. At the last day of irrigating the stomach, observing the changes of experiment items(the activity of MMP-9 , TIMP-1 and the expression of ICAM-1 in brain tissue,the content of serum ICAM-1, and brain watercontent), investigating the influence of Yi Naokang capsule on forging index. Result1.Cmpared with normal group, the content of serum ICAM-1 was improved significantly(P<0.01)in arteriosclerosis group and the expression of ICAM-1 in aorta was more obviously.2. Compared with arteriosclerosis group,the content of serum ICAM-1 was improved significantly(P<0.01)in ischemic stroke group and the exp-ression of ICAM-1 in brain tissue was more obviously.3.The content of serum ICAM-1 was improved significantly(P<0.01)and the expression of ICAM-1 in brain tissue was obviously one week after ischemic stroke. One week at the end of treatment, compared with ischemic stroke group , the content of serum ICAM-1 was decreased significantly (P<0.01) in preventive medication group,Yi Naokang group and Lipitor group, and the expression of ICAM-1 in brain tissue was decline, but there is no statistical difference in the content of serum ICAM-lamong preven- tive medication group,Yi Naokang group and Lipitorgroup(P>0.05). Compared with ischemic stroke group one week before treatment, there is no statis- tical difference in the content of serum ICAM-lamong ischemic stroke group, preventive medication group, Yi Naokang group and Lipitor group (P>0.05).4. The comparison of the activity of MMP-9 in brain tissue for each gr-oup:One week after treatment of stroke, compared with normal group, the act-ivity of MMP-9 in brain tissue was improved significantly(P<0.01)in pre-ventive medication group,Yi Naokang group and Lipitor group.At the end of treatment, compared with ischemic stroke group, the activity of MMP-9 in brain tissue decreased obviously(P<0.01)in preventive medication group, Yi Naokang group and Lipitor group,but there is no statistical difference(P>0.05)among preventive medication group, Yi Naokang group and Lipitor group.5. The comparison of the activity of TIMP-1 in brain tissue for each group: One week after treatment of stroke, compared with normal group, the activity of TIMP-1 in brain tissue was improved significantly(P<0.01)in preventive medication group, Yi Naokang group and Lipitor group, but there is no statis-tical difference(P>0.05)in ischemic stroke group.At the end of treatment, compared with ischemic stroke group, the activity of TIMP-1 in brain tissue increased obviously(P<0.01)in preventive medication group, Yi Naokang group and Lipitor group, but there is no statistical difference(P>0.05)among pre-ventive medication group, Yi Naokang group and Lipitor group. 6. One week after treatment of stroke, compared with ischemic stroke group, the brain water content decreased obviously (P<0.01)in preventive medication group, Yi Nao kang group and Lipitor group,but there is no statis-tical difference(P>0.05)among preventive medication group, Yi Naokang group and Lipitor group.Conclusion1. Inflammatory responce exists between artherosclerosis and ischemic stroke.2. Yi Nao kang capsule can reduce the content of serum ICAM-1 and Expression of ICAM-1 in brain tissue in rats with atherosclerotic ischemic stroke effectively.3. Yi Nao kang capsule can reduce the activity of MMP-9 but enhance the activity of TIMP-1 in brain tissue in rats with atherosclerotic ischemic stroke effectively.4. Yi Nao kang capsule can reduce brain water content in rats with Atherosclerotic ischemic stroke.5.The possible mechanism of depressing inflammatory responce and cerebral edema by Yi Naokang capsule was that it can reduce the content of serum ICAM-1, the expression of ICAM-1 in brain tissue,the activity of MMP-9 in brain tissue and improve the activity of TIMP-1.
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