| Objective: To observe the clinical efficacy of Jiawei Sini Decoction on patients with Yang deficiency syndrome in the recovery period of Ischemic stroke(IS),and to preliminarily reveal the therapeutic mechanism of this prescription with the help of mass spectrometry detection.Methods:(1)A total of 60 patients with Yang deficiency syndrome in the convalescence stage of ischemic stroke treated or hospitalized in our hospital from March 2020 to January 2021 were collected and randomly divided into two groups with 30 patients in each group by random number table method.The control group received conventional basic treatment and conventional rehabilitation treatment.On the basis of the control group,the treatment group was additionalized with Jiawei Sini Decoction.The treatment course of both groups was 4 weeks.After the course of treatment,clinical efficacy,NIHSS score,TCM syndrome score and MRS score were compared between the two groups,and safety analysis was conducted according to adverse reactions and related monitoring indicators during medication.(2)Ten patients were randomly selected from the control group and the treatment group,respectively,and 5ml of venous blood anticoagulated by heparin sodium was extracted on an empty stomach in the early morning of the 28 th day of treatment,for plasma mass spectrometry detection.Then,according to the test results,the data were analyzed to obtain the results of PCA,OPLS-DA,significantly different endogenous metabolite analysis and pathway analysis.Results:(1)The therapeutic effect of Jiawei Sini Decoction on the treatment of Yang deficiency syndrome in the convalescent period of ischemic stroke is mainly evaluated as follows:(1)Clinical Comparison:The total effective rate of the treatment group was83.3%.The total effective rate of the control group was 73.3%,and there was a significant difference between the two groups(P<0.05),indicating that the total effective rate of the treatment group was better than the control group.(2)NIHSS Score:After treatment,NIHSS scores in 2 groups were improved compared with those before treatment(P<0.05),and the improvement effect in the treatment group was significantly better than that in the control group(P<0.05).(3)Comparison of TCM Syndrome Scores:After treatment,TCM syndrome scores in both groups decreased compared with before(P<0.05),but the treatment group was significantly better than the control group(P<0.05).(4)MRS Score:After treatment,the MRS score of treatment group was significantly lower than that of control group(P<0.05).(5)Clinical Adverse Reaction:No serious adverse events were observed during the treatment with the modified Sini prescription,and the patient was well tolerated.(2)The changes of endogenous compounds of Jiawei Sini Decoction in the treatment of Yang deficiency syndrome in the convalescence period of ischemic stroke were detected by mass spectrometry and the metabolic pathways involved were analyzed and discovered:Jiawei Sini Decoction can cause the expression changes of 22 endogenous compounds in patients with Yang deficiency syndrome during the recovery period of ischemic stroke.Among them,8 endogenous compounds were significantly different.The expression levels of glycine,glutamic acid,fumaric acid,1N-acetyl-5-hydroxytryptamine,cycloleucine,2-glucan-β-glucoside and n-dodecanol were significantly decreased after administration of Jiawei Sini Decoction,while the expression level of(2R)-2-amino-3-phosphonate propionate 1 was significantly increased.Conclusion: Combined with Western medicine treatment,Jiawei Sini Decoction can effectively improve the clinical efficacy,NIHSS score,TCM syndrome score and MRS score in the treatment of Yang deficiency syndrome in the convalescence period of ischemic stroke.The mechanism of action may be related to the regulation of glutamate and other amino acids and energy metabolism,and the correction of metabolic disorder in patients. |
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