Clinical Observation On The Effect Of Perfusing Triple Burner Method On Ischemic Stroke Patients And The Influence Of Gut Microbiota

ObjectiveTo observe the clinical efficacy of Tongsheng prescription combined with conventional western medicine in treating patients with acute ischemic stroke(IS)and to explore the effect of Tong Sheng prescription on gut microbiota and its potential mechanism,so as to further explore the therapeutic effect of perfusing triple burner method on acute IS.MethodsUnder the principle of randomized controlled study,72 patients who were treated in our hospital from February 2021 to March 2022 were chosen,and these patients were diagnosed as acute IS.These patients were divided into Xuantong group and control group by random number table.Both groups were 36 cases and the treatment course of both groups was one week.The treatment of control group was conventional western medicine,such as regulating lipid and stabilizing plaque,inhibiting platelet aggregation.On the basis of control group,Tongsheng prescription was added to the treatment of Xuantong group.Observation on the changes of TCM syndrome score,NIHSS score and modified Barthel index before and after treatment in two groups,.Analyzed by 16 Sr DNA sequencing,the changes of the diversity and structure of gut microbiota in the two groups were observed before and after treatment.Aim to observe the clinical effect of perfusing triple burner method on acute IS patients and its gut microbiota,so as to further explore the potential mechanism of perfusing triple burner method.Results1.In the clinical research of this study,63 patients were eventually inclueded which including 32 cases in Xuantong group and 31 cases in control group.During the treatment,1 cases fell off in Xuantong group and 2 cases in the control group,3 cases in both two group were rejected.In the research of the gut microbiota of this study,55 patients were eventually inclueded which including 28 cases in Xuantong group and 27 cases in control group.During the research,4 cases fell off in both of Xuantong group and the control group.2.Between the control group and Xuantong group,there is no significant difference in age,gender,smoking and alcohol history,past history.3.Treatment effect: Before the treatment,the NIHSS score,TCM syndrome score and modified Barthel index were comparable,so that there was no significant difference in those scale between two groups(P>0.05).After one week of treatment,the NIHSS score,the modified Barthel index score and the TCM syndrome score in both two groups decreased importantly compared with before treatment(P<0.05),which Xuantong group reduced more outstanding(P<0.05).4.Therapeutic efficacy:The effective rate of the Xuantong group was 93.8%,apparently higher than the control group,which was 71.0%(P<0.05).5.Gut microbiota:Before treatment,the Alpha and Beta diversity was is no obvious difference between two groups.In the analysis of the structure of gut microbiota,the results show that the dominant phylum and dominant genus of gut microbiota in two groups are roughly the same.After one week of treatment,it was no statistically significant difference in Alpha diversity analysis between two groups(P>0.05),but the Beta diversity analysis showed a statistically apparently difference in two groups(P<0.05).At phylum level,the relative abundance of Proteobacteria descended in Xuantong group.And the relative abundance of Proteobacteria ascended in control group at phylum level after treatment,while the relative abundance of Firmicutes decline.At genus level,the relative abundance of Enterococcus ascended in Xuantong group after treatment,while the relative abundance of Escherichia-Shigella descended.And the relative abundance of Escherichia-Shigella ascended in control group at genus level after treatment,while the relative abundance of Bifidobacterium decline.Analysing the biomaker between two groups basing on LEf Se after treatment,the result show that the Enterococcus was enriched in Xuantong group,while the Proteobacteria and Escherichia-Shigella were enriched in control group.6.Safety analysis:During the treatment,2 patients in Xuantong group had a fever due to pneumonia after diagnosis.In the control group,3 patients had a fever,which 2patients were diagnosed as pneumonia and 1 patient was diagnosed as urinary tract infection.After analysis by a chief physician,5 patients were considered not related to taking drugs,which were not belong to the adverse drug events.Those 5 cases were rejected because them had to use the antibiotic.Two patients in Xuantong group with symptoms,such as stool rot,which were likely happen after taking traditional Chinese medicine,so it was not belong to the adverse drug events.The other patients in both of two groups had no adverse events occurred during the treatment.7.Except for 1 case in Xuantong group had used the probiotics,the other patients are taking medicine with good compliance.Conclusion1.Tongsheng prescription combined with conventional western medicine in treating patients with acute ischemic stroke had better therapeutic efficacy in promote the MBI index score and declining TCM syndrome score and the NIHSS score compared with the conventional western medicine.2.Tongsheng prescription also can effectively regulate gut microbiota.Rising the probiotics such as Enterococcus and declining the harmful bacteria such as Proteobacteria,Escherichia-Shigella may be the mechanism of Tongsheng prescription treatment of acute ischemic stroke.