补阳还五汤治疗脑梗塞的疗效及其机制探讨

Observation and investigation on therapeutic effect and mechanism of “bu yang huan wu” decoction in treating cerebral infarction

目的：探讨补阳还五汤治疗脑缺血再灌注损伤的保护作用及其机制。方法：应用补阳还五汤治疗３６例脑梗塞患者（治疗组），并在神经功能的恢复情况及血浆内皮素（ＥＴ）、脂质过氧化物（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）和全血谷胱甘肽过氧化酶（ＧＳＨＰｘ）的含量方面分别与对照组３０例患者以及２０例正常人进行比较。结果：治疗组总有效率为８８．９％，对照组为６０．０％，２组比较有非常显著性差异（Ｐ＜０．０１）。脑梗塞患者ＥＴ和ＬＰＯ〔（分别为（１５４．６１±３２．５７）ｎｇ／Ｌ和（８．０７±０．８１）μｍｏｌ／Ｌ〕明显高于正常人组〔分别为（１０６．９１±１６．５０）ｎｇ／Ｌ和（５．４６±０．４２）μｍｏｌ／Ｌ〕，Ｐ均＜０．０１；而ＳＯＤ和ＧＳＨＰｘ〔分别为（１５９．４５±３８．３３）μｇ／Ｌ和（１５５．８４±４２．７１）Ｕ〕则明显低于正常人组〔分别为（２１０．３２±４５．２７）μｇ／Ｌ和（２１５．６７５±５３．８１）Ｕ〕，Ｐ均＜０．０１。治疗组以补阳还五汤治疗后，ＥＴ〔（１１８．５５±３０．４１）ｎｇ／Ｌ〕、ＬＰＯ〔（６．００±０．６９）μｍｏｌ／Ｌ〕均明显降低（Ｐ均＜０．０１）；而ＳＯＤ〔（１９３．７５±４１．１６）μｇ／Ｌ?

Objective:To research the protective action and its mechanism of “bu yang huan wu” decoction in treating cerebral ischemiareperfusion injury.Methods:Thirtysix cases of cerebral infarction were treated with “bu yang huan wu” decoction (treatment group),30 cases were treated with conventional therapy (control group) and 20 people of health.The improvement of neural function,level of plasma endothelin (ET),lipid peroxide (LPO),superoxide dismutase (SOD) and glutathione peroxidation (GSHPx) were examined in three groups.Results:The total effective rate was 88 9% in treatment group and 60 0% in control group respectively, P <0 01.The concentration of ET and LPO in group with cerebral infarction were(154 61±32 57)ng/L and(8 07±0 81)μmol/L respectively,which higher obviously than normal subjects (106 91±16 50)ng/L and (5 46±0 42)μmol/L respectively ,all P <0 01;while the level of SOD and GSHPx in group with cerebral infarction were (159 45±38 33)μg/L and (155 84±42 71)U respectively,which lower obviously than normal subjects (210 32±45 27)μg/L and (215 75±53 81)U respectively ,all P <0 01.It found that concentration of ET and LPO in treatment group were decreased (118 55±30 41)ng/L and (6 00±0 69)μmol/L than that of control group(all P <0 01);while SOD and GSHPx were significantly increased (193 75±41 16)μg/L and (208 14±45 67)U respectively ,but no obvious change in the control group.Conclusions:These data suggest that “bu yang huan wu” decoction can promote recovery of neural function,the mechanism might be related with clearing LPO damage to vascular endothelial cells,increasing antioxidase activity,improving the ischemia and hypoxia of brain tissue。