Research On Distribution About Fushi Syndrome At Onset Of Ischemic Stroke And Mechanism Of Tongfu To Treat Stroke By Openning Xuanfu

1.Background and ObjectiveIn modern aging society,stroke is a normal disease characterized with high morbidity mutilation and recurrence rate.lt is reportedthere are 150,000,000 persons with stoke,including 5,000,000 dead and 5,000,000 with disability. As 55-80%is ischemic,it is important to prevent and cure ischemic stroke. As an acute and severe disease,it is important to study the distribution of syndromes of stroke.Fushi is a common syndrome to sroke.However,there is few description about Fushi syndrome or its distribution.At preseat,it is focused on the efficiency of Tongfu treatment,and it si not very clear in other aspect,such as,the distribution of Fushi syndrome,the relationship between Tongfu treatment and Xuanfu,the mechanism of Tongfu to Treat Stroke by protecting nervous system.Aiming at resolve the questions above,the reseach is helpful to provide evidence for Tongfu treatment. 2.Methods2.1 Review of ArticalsCondition and problems of researches on syndrome of ischemic stroke was presented by review of revelant articals,rhe mechanism of Tongfu to treat stroke and correlation between Tongfu treatment and Xuanfu were summarized by anylasis of related articals.The experiment desigh was improved by review of articals about relationship between matrix metalloproteinases-9 (MMP-9),blood brain barrer(BBB)and ischemic cerebral edema.Preparations for advanced research had been completed through review of articals.2.2 Clinical Research:Distribution about Fushi Syndrome at Onset of Ischemic StrokeAs a retrospective research,503 ischemic stroke cases,within 1week and without systematic treatment,were brought into the research.The same questionaire were used in all cases,including stroke syndromes value,description of Fushi syndrome,information of demography and diagnosis,medicine about Tongfu treatment,according to the patients' case file about complaint,physical sign,appearance of tongue and pulse,and image,lnformation about syndrome were received by two doctors at the same time.lf they had different diagnosis,they would consult their tutor.Database were developed by SPSS 13.0 with all data.Ratio were computed and compared by chi-square test,α=0.05.2.3 Experimental research:Mechanism of Tongfu to Treat Stroke by Openning XuanfuRat model of focal cerebral ischemia-reperfusion was established by middle cerebral artery occlusion(MCAO)with a nylo monofilament suture which was then extracted after 2 hous.Rats were divided into three groups:normal control group,sham-operated group,modle group and TFXSJN group.Intragastric administration with TFXSJN or water had been performed twice from the day before operation in different groups.Nervous difficiency scores,water content of brain tissue,Infarct volume,EB content of brain tissue,number of MMP-9 positive cells were observed in different groups in 1d,3d,7d. Pathological sections and sections with immunohistochemistry had been done to show histological change and distribution of positive cells.Database were developed by SPSS 13.0 with all data.Mean were computed and compared multiply by One-Way ANOVA or t test,α=0.05.3.Result3.1 Clinical ResultExcess syndrome,such as Wind syndrome,Phlegm-dampness syndrome,Heat-fire syndrome,Blood-stasis syndrome,was common at onset of ischemic stroke.Deficiency syndrome was rare.Compared with other syndrome,wind syndrome had the highest frequency76.14%Combination of two or three kinds of syndrome appeared frequently(totally 78.73%).They were usually in form of combination of Wind syndrome and Phlegm-dampness syndrome or Heat-fire syndrome or Blood-stasis syndrome,such as Fengyu(11.93%,combination of Wind syndrome and Blood-stasis syndrome),Fengtan(10.47%,combination of Wind syndrome and Phlegm-dampness syndrome),Fenghuo(9.34%,combination of Wind syndrome and Heat-fire syndrome),Fengtanyu(10.54%,combination of Wind syndrome, Phlegm-dampness syndrome and Blood-stasis syndrome),Fenghuoyu(9.94%, combination of Wind syndrome,Heat-fire syndrome and Blood-stasis syndrome).Distribution of Fushi syndrome at onset of stroke:Fushi syndrome could appear in combination with any kind of the six which were Wind syndrome,Phlegm-dampness syndrome,Heat-fire syndrome,Blood-stasis syndrome,Yin deficiency and Qi deficiency.Compared with other syndrome,Heat-fire syndrome had the highest frequency73.68%(P＜0.05).Fushi syndrome usually appeared in form of Fenghuo(14.11%),Fenghuotan(18.26%),Fengtan(12.03%), Fengtanyu(11.2%).They were totally 55.6%.Fushi syndrome appeared more frequently in combination with Viscera syndrome(75.6%)than Meridian syndrome(45.45%)(P＜0.05).And Fushi syndrome appeared more frequently in combination with LACI than TACI or PACI(p＜0.05). 3.2 Experimental resultCompared with sham operation group,the water content of brain tissue of ischemia-reperfusion rats increased in 1d(P＜0.05).Compared with 1d group,it reached peak in 3d(P=0.034),and decreased in 7d(P=0.001).EB content of brain tissue had the similar change.Compared with sham operation group,the number of MMP-9 positive cells of ischemia-reperfusion rats increased in ischemic side in 1d(P=0.000),and it reached peak in 3d,then decreased in 7d.The number of MMP-9 positive cells were more in ischemic side than in the other side(P=0.000).The nervous difficiency scores of TFXSJN group were less than model group in 1d,3d,7d(P＜0.05).Compared with model group,the water content and EB content of brain tissue of TFXSJN group decreased in 3d(P=0.000,0.022).So was the number of MMP-9 positive cells of TFXSJN group in 7d(P=0.026).It was concluded that TFXSJN possibly decreased the permeability of BBB and cerebral edema by shutdowning MMP-9 expression to protect the brain and reduce the nervous difficiency scores.4.Conclusions(1)Excess syndrome,such as Wind syndrome,Phlegm-dampness syndrome,Heat-fire syndrome,Blood-stasis syndrome,was common at onset of ischemic stroke.Deficiency syndrome was rare.Compared with other syndrome,wind syndrome had the highest frequency.Combination of two or three kinds of syndrome appeared frequently.They were usually in form of combination of Wind syndrome and Phlegm-dampness syndrome or Heat-fire syndrome or Blood-stasis syndrome,such as Fengyu,Fengtan,Fenghuo,Fengtanyu,Fenghuoyu.(2)Distribution of Fushi syndrome at onset of stroke:Fushi syndrome was common in ischemic stroke beginning.It could appear in combination with any kind of the six which were Wind syndrome,Phlegm-dampness syndrome,Heat-fire syndrome,.Blood-stasis syndrome,Yin deficiency and Qi deficiency.Compared with other syndrome,Heat-fire syndrome had the highest frequency.Fushi syndrome usually appeared in form of Fenghuo,Fenghuotan,Fengtan,Fengtanyu. Fushi syndrome appeared more frequently in combination with Viscera syndromethan Meridian syndrome,and LACI than TACI or PACI.It was concluded that Fushi syndrome usually appeared in severe casese and that Fushi syndrome maybe resulted in or aggravated the throw-off of Xuanfu.(3)In ischemia-reperfusion rat group,there was tight correlation between water content of brain tissue,EB content of brain tissue and number of MMP-9 positive cells.They had the similar change with time,that is,they increased in 1d andreached peak in 3d,then decreased in 7d.(4)TFXSJN could reduce the nervous difficiency scores,water content ofbrain and infarct volume.It was concluded that TFXSJN possibly decreased the permeability of BBB and cerebral edema by shutdowning MMP-9 expression to protect the brain.Tongfu treatment was efficient in protection of the brain.