| Objective: To observe the clinical efficacy of Zhongfeng Qixue Decoction in the treatment of acute ischemic stroke,to study the changes of PGC-1α and VASH1 expression in patients with acute ischemic stroke after the treatment of Zhongfeng Qixue Decoction,and to explore the mechanism of Zhongfeng Qixue Decoction in the treatment of acute ischemic stroke.Methods:1.Clinical study: A total of 60 patients with acute ischemic stroke treated in the Department of Neurology of Liuzhou traditional Chinese Medicine Hospital from January 2022 to January 2023 were randomly divided into observation group(n=30)and control group(n=30).The observation group was treated with Zhongfeng Qixue Decoction for 14 days.To explore the clinical effect and mechanism by observing and comparing the changes of NIHSS score,m RS score,TCM syndrome scores and serum PGC-1α and VASH1 levels before and after treatment.2.Animal experiment:50 healthy SD rats,weighing 250-300 g,were randomly divided into 5 groups: sham operation group,model group,high,middle and low dose groups of Zhongfeng Qixue Decoction,with 10 rats in each group.The model group and the high,middle and low dose groups of Zhongfeng Qixue Decoction were used to establish the animal model of cerebral ischemia,while the rats in the sham operation group only underwent cervical skin incision,separation of blood vessels,nerves,thread and other operations.The degree of neurological deficit in each group was observed by modified neurological deficit score after operation,and the rats in the high,middle and low dose groups were given intragastric administration at different doses on the first day after operation.On the 7th day after operation,the brain tissues of all rats were taken,and the cerebral infarction area of MCAO rats in each group was measured by TTC staining,and the protein expression of PGC-1 α and VASH1 in the cerebral infarction area of each group was detected by Westernblot method.Results:1.Clinical study: The patients who completed this study were 29 cases in the observation group and 29 cases in the control group.(1)Baseline data: Before treatment,there was no significant difference in age,sex and stroke risk factors between the two groups(P>0.05).(2)NIHSS score: Before treatment,there was no significant difference in NIHSS score between the two groups(P>0.05).After treatment,the NIHSS score of the two groups decreased compared with that before treatment(P<0.05),and the score of the observation group decreased significantly than that of the control group,and the difference was statistically significant(P<0.05).(3)m RS score: Before treatment,there was no significant difference in m RS score between the two groups(P>0.05).After treatment,the m RS score of the two groups decreased compared with that before treatmentt(P<0.05),and the score of the observation group decreased significantly than that of the control group,and the difference was statistically significantt(P<0.05).(4)TCM syndrome scores: Before treatment,there was no significant difference in TCM syndrome scores between the two groups(P>0.05).After treatment,the scores of the two groups decreased(P<0.05),and the decrease of TCM syndrome scores in the observation group was greater than that in the control group(P<0.05).(5)Serum detection: Before treatment,there was no significant difference in serum PGC-1α and VASH1 levels between the two groups(P>0.05).After treatment(P<0.05),the serum level of PGC-1α in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The serum level of VASH1 in the two groups decreased after treatment(P<0.05),and the decrease in the observation group was significantly higher than that in the control group(P<0.05).2.Animal experiments:One rat died after operation in the model group and the high dose group,and two rats died in the low dose group.(1)Zea-longa score of rats: On the first day after operation,there was no significant difference in Zea-longa score between model group and Zhongfeng Qixue Decoction group(P>0.05).On the 7th day after operation,the Zea-longa score in the model group and Zhongfeng Qixue Decoction group was significantly lower than that on the first day after operation(P<0.05),indicating that the ischemic symptoms of rats were improved,and the Zea-longa score in the high and middle dose groups of Zhongfeng Qixue Decoction was significantly lower than that in the model group(P<0.05).It shows that the high and middle dose groups of Zhongfeng Qixue Decoction are superior to the model group in improving the neurological function of rats.(2)TTC staining results:Formation of infarct-free focus in sham-operated rats;Compared with the model group,the infarct area was smaller in the high,middle and low dose groups of Zhongfeng Qixue Decoction(P<0.05,P<0.01),and the ischemia was relatively mild.Compared with the high dose group of Zhongfeng Qixue Decoction,the infarct area of middle and low dose groups was larger,but the difference was not statistically significant.The results showed that all the groups of Zhongfeng Qixue Decoction had therapeutic effect,and there was no significant difference among the groups.(3)Westrnblot test results:1)The expression of PGC-1α: Compared with the sham operation group,the expression level of PGC-1α in model group and Zhongfeng Qixue Decoction group was significantly higher than that in sham operation group(P<0.05,P<0.01).Compared with the model group,the expression level of PGC-1α in the brain tissue of rats in the middle dose group of Zhongfeng Qixue Decoction increased significantly(P<0.05),which suggested that Zhongfeng Qixue Decoction could up-regulate the expression level of PGC-1α in the brain tissue of MCAO rats.2)The expression of VASH1: Compared with the sham operation group,the expression level of VASH1 in the model group and Zhongfeng Qixue Decoction group was significantly higher than that in the sham operation group(P<0.05,P<0.01).Compared with the model group,the expression of VASH1 in the brain tissue of rats in the middle dose of Zhongfeng Qixue Decoction group decreased,and the difference was statistically significant(P<0.05).The results showed that the expression of VASH1 in the brain tissue of rats increased after focal ischemia.Zhongfeng Qixue Decoction could inhibit the expression of VASH1 and inhibit its anti-angiogenesis at the middle dose level.Conclusion:1.Zhongfeng Qixue Decoction can improve the NHISS score,m RS score and TCM syndrome score of acute ischemic stroke patients with Zhongfeng Qixue Decoction,and can improve the symptoms of limb movement disorder,hemiplegia,dysphasia and so on.2.Zhongfeng Qixue Decoction may promote angiogenesis by up-regulating PGC-1α and inhibit its anti-angiogenesis by inhibiting the expression of VASH1,so as to achieve therapeutic angiogenesis.3.Zhongfeng Qixue Decoction can improve the score of neurological deficit,reduce the area of cerebral infarction and improve the disturbance of limb activity in rats. |
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