| Objective: By observing the therapeutic effect of Tongqiao Huoxue Decoction on acute ischemic stroke,and the effect of Tongqiao Huoxue Decoction on the changes of Th1 and Th2 related cytokines,from the perspective of Th1/Th2 immune balance,understand Tongqiao Huoxue Decoction in the prevention and treatment of acute ischemic stroke.The mechanism of action of cerebral apoplexy provides a research basis for the impact of traditional Chinese medicine on immunity in the prevention and treatment of acute ischemic stroke.Methods:1.Clinical study: 60 patients with acute ischemic stroke who met the research criteria of this clinical trial were selected from the neurology ward of Liuzhou Traditional Chinese Medicine Hospital(Liuzhou Zhuang Medical Hospital),and divided into a control group of 30 by random number method.cases and30 cases in the Tongqiao Huoxue Decoction group.The patients in the control group were treated with general routine treatment,and the patients in the Tongqiao Huoxue Decoction group were given the traditional Chinese medicine decoction Tongqiao Huoxue Decoction in addition to the ordinary routine treatment.The treatment course of the patients in both groups was 14 days.On the 1st day before treatment and 14 days after treatment,the NIHSS score and m RS score of the two groups of patients were respectively measured,and serum samples were collected,and flow cytometry was used to detect the secretion of Th1 and Th2 cells in the serum of the two groups of subjects respectively.The number of related cytokines IFN-γ,IL-4,IL-10.2.Animal experiment: Taking healthy male SD rats as the research object,Zea-Longa suture was selected to block the right middle cerebral artery of the rats,and the rat MCAO model was made.Scores were used to confirm the modeling effect.After excluding non-compliant rats,MCAO rats were randomly divided into 4 groups: model group and Tongqiao Huoxue Decoction high-dose,middle-dose,and low-dose groups,with 10 rats in each group.Only.Another 10 rats were selected as the sham operation group.The treatment method was the same as that of MCAO,but only the blood vessels were separated,and no ligation and suture placement were performed.After the completion of the grouping,the treatment can be started.The rats in the high,middle and low dose groups were treated with Tongqiao Huoxue Decoction at doses of 0.72ml/100 g,0.36ml/100 g,0.18ml/100 g and distilled water at volumes of 0.28ml/100 g,0.64ml/100 g,and 0.82ml/100 g,1 time/d,the rats in the sham operation group and the model group were given1ml/100 g volume of distilled water for gavage.The course of treatment for the rats in each group was 14 d,and the degree of Longa neurological deficit was used to score the rats after 24 h and 14 d.The rats were sacrificed after the last injection and scored,and brain tissue samples were collected.The brain tissue was sliced and then stained with TTC.Image Pro-plus6.0 software was used to calculate the volume percentage of cerebral infarction in each group of rats.In addition,RT-PCR method was used.The expression levels of Th1 and Th2-related cytokines IFN-γ m RNA,TNF-α m RNA,IL-6 m RNA and IL-10 m RNA in the brain tissue of rats in each group were detected respectively.Results:1.Clinical experiment: In the clinical efficacy,the NIHSS score and m RS score of the control group and the Tongqiao Huoxue Decoction group before treatment had no statistical significance(P>0.05).Compared with the control group,the m RS score decreased,with significant statistical significance(P<0.01).Compared with the control group,the NIHSS score and m RS score of the Tongqiao Huoxue Decoction group decreased more significantly.In terms of cytokine expression,before treatment,there was no significant difference in the expression of IFN-γ,IL-4,IL-10 and other factors secreted by serum Th1 and Th2 cells between the control group and the Tongqiao Huoxue Decoction group(P>0.05).After treatment,among Th1 related factors,the levels of IFN-γ inflammatory factors in both groups showed a downward trend after treatment(P<0.05),while the Tongqiao Huoxuetang group decreased more significantly(P<0.01).In the control group,the level of IL-4 inflammatory factor did not change after treatment,and there was no statistical significance(P>0.05).The IL-10 levels of Th2 cell-related factors in the serum of the two groups showed an upward trend(P<0.05),and the increase was more obvious in the Tongqiao Huoxue Decoction group(P<0.01).Before treatment,there was no statistical difference in the ratio of IFN-γ/IL-4 between the two groups(P>0.05).The decrease in Tongqiao Huoxue Decoction group was more significant(P<0.01).2.The results of animal studies suggest:(1)Neurological deficit: 24 h and 14 d after modeling,the rats in the five groups were scored for Longa neurological deficit respectively.Compared with the sham operation group,the model group had significant statistical significance(P<0.01).Compared with the model group,there was no significant difference in the scores of the three treatment groups with Tongqiao Huoxue Decoction at 24 hours,and there was no statistical significance(P>0.05).After 14 days,the scores of the three groups of Tongqiao Huoxue Decoction were statistically significant compared with the model group(P<0.05),while the scores of the rats in the high-dose group were statistically significant(P<0.01),indicating that the treatment of Tong Qiao Huoxue Decoction was statistically significant(P<0.01).It can improve the neurological deficit of MCAO rats.(2)Percentage change of cerebral infarction volume: After the slices of the rats in each group were stained with TTC reagent,obvious pale infarct lesions were seen in the tissue slices of the MCAO model rats in the coronal area of the brain,while the sham-operated rats had obvious pale infarct lesions.Sections showed no infarct lesions.Compared with the sham-operated group,the percentage of infarct volume in the brain slices of the rats in the model group was significantly different(P<0.01).The percentage of infarct volume was decreased and there was a statistical difference(P<0.05),and the cerebral infarction area in the high-dose Tongqiao Huoxue decoction group was more significantly reduced,with a significant difference(P<0.01).(3)Changes in the m RNA levels of Th1 and Th2 related inflammatory factors in each group: Compared with the sham operation group,Th1 and Th2-related inflammatory factors IFN-γ m RNA,TNF-α m RNA,IL-6 m RNA,and IL-10 m RNA in the brain tissue of the model group rats The expression levels were increased(P<0.05).Compared with the model group,the IL-10 m RNA in the brain tissue of the rats in each dose group of Tongqiao Huoxue Decoction showed an upward trend(P<0.05),and the increase of IL-10 m RNA in the high dose group of Tongqiao Huoxue Decoction was more significant(P<0.01);IFN-γ m RNA,TNF-α m RNA and IL-6 m RNA were down-regulated to varying degrees(P<0.05),and the factor levels were down-regulated more significantly in the high-dose group,with a statistically significant difference(P<0.01).Conclusion(s):1.Clinical studies and animal experiments have shown that Tongqiao Huoxue Decoction can significantly reduce the NIHSS score and m RS score of patients with acute ischemic stroke,improve the patient’s limb dysfunction,and improve the clinical efficacy;and can significantly reduce the MCAO model rats.The area of cerebral infarction has the effect of improving neurological deficit in rats.2.In terms of Th1 and Th2 related cell inflammatory factors,Tongqiao Huoxue Decoction can reduce the expression of Th1 cell-related pro-inflammatory factor IFN-γ in serum,and promote the expression of Th2cell-related anti-inflammatory factors IL-4 and IL-10.Adjust the ratio of IFN-γ/IL-4 and reduce the immune inflammatory response in the brain;in animal studies,Tongqiao Huoxue Decoction can effectively inhibit Th1 and Th2 cell-related inflammatory factors IFN-γ m RNA,TNF-α m RNA,IL-6m RNA in MCAO rats expression,and increased the expression of Th2-related anti-inflammatory factor IL-10 m RNA level.3.Tongqiao Huoxue Decoction may have the ability to regulate Th1/Th2 immune balance by interfering with the secretion of Th1 and Th2 related cytokines,making it tend to balance,reducing the occurrence of inflammatory reactions,and transferring to Th2 to promote brain nerve function after stroke recovery. |
PDF Full Text Request