| objectiveIn this study,we investigated the clinical efficacy of Banxia Baizhu Tianma decoction on vestibular vertigo from both clinical and basic research aspects and the effectiveness of GAS,the main active ingredient in Tianma,on the recovery of damaged vestibular hair cells through Notch signaling can better guide clinical diagnosis and medication use.Methods1.Clinical study:Treatment of vestibular vertigo with retention of phlegmatic dampness using Banxia Baizhu Tianma decoction October 2020 through January 2023,patients with vestibular vertigo with retention of phlegmatic dampness attending the Provincial Hospital of Shandong First Medical University,age,gender,duration of residual dizziness,past history(history of dizziness or vertigo-like diseases),and history of underlying diseases divided into treatment and control groups according to a randomised method.The control group received oral treatment with betahistine mesylate tablets,while the treatment group received oral treatment with Banxia Baizhu Tianma decoction.The efficacy of the traditional chinese medicine symptoms was observed,the scores were assigned according to the clinical symptom scale of vertigo,and statistical analysis was performed.2.Basic Experimental Research:Gastrodin protects against aminoglycoside-induced vestibular injury by inhibiting the Notch signaling pathway.Three groups of C57 mice aged 7-8 weeks each were created: the control group,the gentamicin group,and the gentamicin + gastrodin group.The gentamicin group received an intraperitoneal injection of gentamicin(400 mg/kg),while the control group received an intraperitoneal injection of0.9% saline(0.6 m L/100g).The mice in the gentamicin + gastrodin group were given gastrodin(300 mg/kg)intraperitoneally first,followed by gentamicin(400 mg/kg)1 hour later.All the above operations were performed continuously for 14 days.Vestibular damage in mice was evaluated by observing the contact righting reflex,swimming test,and air righting test.Immunofluorescence was used to detect vestibular hair cell damage and the expression of three Notch pathway-related proteins(Notch1,Jagged1,and Hes1).Western blot and Real-time PCR were used to detect the expression of the three proteins and m RNA of the Notch pathway so as to investigate the restoration of vestibular function by Notch pathway inhibition with gastrodin.Results:1.Clinical study:Complete medical records were obtained in 110 cases,55 cases in the treatment group and 55 cases in the control group.The degree of vertigo disorder scale score and traditional chinese medicine symptom scale score were significantly improved in the treatment group and the control group compared with those before treatment.The degree of improvement in the treatment group was significantly higher than that in the control group,and the difference was statistically significant(ρ<0.05).In this treatment,no significant adverse reactions were observed in the treatment and control groups.2.Basic Experimental Research:(1)The results of animal behaviour evaluation showed that mice in the gentamicin group had higher scores in the contact righting reflex,swimming test,and air righting test than the control group(ρ<0.05),and the scores in the gentamicin + gastrodin group were lower than those in the gentamicin group(ρ<0.05).(2)The immunofluorescence results showed that the stereocilia and hair cells were significantly reduced in the gentamicin group compared with the control group,while the stereocilia were significantly increased in the gentamicin + gastrodin group compared with the gentamicin group;the expression of Notch1,Jagged1,and Hes1 was significantly enhanced in the gentamicin group compared with the control group(ρ<0.05),while it was significantly reduced in the gentamicin + gastrodin group compared with the expression was significantly weaker in the gentamicin + gastrodin group compared to the gentamicin group(ρ<0.05).(3)Western blot results showed that the expression of Notch1,Jagged1,and Hes1 was significantly enhanced in the gentamicin group compared with the control group(ρ<0.05),and the expression of Notch1,Jagged1,and Hes1 was significantly decreased in the gentamicin+ gastrodin group(ρ<0.05).Cleaved Caspase-3 protein expression was significantly higher in the gentamicin group compared with the control group(ρ<0.05),while anti-apoptotic factor Bcl-2 protein expression was significantly lower than that in the control group(ρ<0.05);compared with the gentamicin group,pro-apoptotic factor Bax and Cleaved Caspase-3 protein expression was significantly lower in the gentamicin +gastrodin group(ρ<0.05),while anti-apoptotic factor Bcl-2 protein expression was significantly higher in the gentamicin + gastrodin group(P<0.05).Bcl-2 protein expression was significantly higher(ρ<0.05).(4)Real-time PCR results showed that the m RNA expression of Notch1,Hes1 and Jagged1 was increased in the gentamicin group compared with the control group(ρ<0.05)and decreased in the gentamicin + gastrodin group compared with the gentamicin group(ρ<0.05).Conclusion:The treatment of vestibular vertigo with the retention of phlegmatic dampness in Banxia Baizhu Tianma decoction can better reduce dizziness and other symptoms in patients compared with traditional western medicine,enable patients to return to normal life more quickly,and reduce the recurrence of vestibular vertigo.No significant adverse effects were observed in either group during the treatment,and the treatment plan has a high safety level.After vestibular injury,the Notch signaling pathway was significantly activated,and after the application of asparagine,the expression of Notch pathway-related proteins was reduced,and vestibular injury in mice was alleviated.Therefore,gastrodin could protect against aminoglycoside-induced vestibular injury by inhibiting the Notch signaling pathway. |
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