Clinical And Metabolomic Study On Tongnao Decoction In Treating Acute Ischemic Stroke With Phlegm And Blood Stasis Blocking Collaterals Syndrome

ExperimentI Observation of the Clinical Effect of Tongnao Decoction on Acute Ischemic Stroke with Symptom of Phlegm and Blood StasisObjective:To explore the clinical effect of Tongnao Decoction in the treatment of acute ischemic stroke patients with phlegm and blood stasis syndrome.Method:Forty acute ischemic stroke(AIS)patients with phlegm and blood stasis syndrome were included and randomly divided into treatment group and control group.Patients in the control group were treated with basic treatment,while the treatment group was treated with addtional Tongnao Yin on the basis of conventional treatment for 10 days.The scores of National Institutes of Health Stroke Scale(NIHSS),Modified Rankin Scale(mRS)and TCM symptom were observed on the first and tenth day.Result:After ten-days'treatment,the scores of NIHSS,MRS and TCM symptom score of the two groups were significantly improved than before treatment(P<0.05).On the 10th day of treatment,significant differences were observed between the two groups(P<0.05).The NIHSS score?MRS score and TCM symptom score of the treatment group were significantly lower than those of the control group.Conclusion:The effect of basic treatment combined with Tongnao decoction in treating AIS patients with phlegm and blood stasis syndrome is better than basic treatment alone.Tongnao decoction can improve the neurological deficit symptoms,living ability and clinical symptoms of traditional Chinese medicine in AIS patients.Experiment ? Metabonomic Study on the Treatment of Acute Ischemic Stroke with Tongnao DecoctionObjective:1.By means of metabolomics technology,we compared the blood metabolites of AIS with symptom of phlegm and blood stasis with that of healthy control group and to analyze the molecular function of related abnormal metabolites to explore the possible role of these metabolites in the pathogenesis of AIS.2.To compare the blood metabolites before and after Tongnao decoction treatment of AIS and to explore the mechanism of Tongnao decoction in treating AIS by further analyzing these different metabolites.Method:A metabolomic profiling of serum between AIS with symptom of phlegm and blood stasis,healthy control group,treatment group and control group were conducted through LC-MS approaches;and the differential metabolites were identified by multivariate statistical methods.Result:1.Multivariate statistical analysis showed that there were 15 different metabolites between AIS with symptom of phlegm and blood stasis and healthy control group.Compared with the healthy group,the serum levels of choline,creatinine,pyroglutamic acid,ureidosuccinic acid,phosphorylcholine,L-acetylcarnitine,L-kynurenine,i soleucylproline,succinylcamitine,heptadecanoic acid,sphingosine,arachidic acid and LysoPC(20:3(8Z,11Z,14Z))were significantly elevated and L-tyrosine,nervonic acid were significantly decreased in the AIS patients group.2.Compared with treatment before,the serum levels of campesterol were increased and N-undecanoylglycine;succinylcarnitine,linoleyl carnitine and elaidic carnitine were decreased after basic treatment in control group.3.Compared with treatment before,the serum levels of nervous acid were increased and choline,uric acid,L-acetylcarnitine,isoleucylproline,N-undecanoylglycine,phytosphingosine,elaidic carnitine and LysoPC(20:3(8Z,11Z,14Z))were decreased after Tongnao decoction treatment in treatment group.Conclusion:1.The serum metabonomics suggested that amino acid metabolism,energy metabolism as well as lipid metabolism were closely related to AIS with symptom of phlegm and blood stasis,which was helpful to reveal the pathophysiopogical mechanism of AIS.2.Tongnao decoction can improve the neurological defects by regulating a mino acid metabolism,energy metabolism,lipid metabolism and uric acid metabolism.