益气活血对急性缺血性中风气虚血瘀证血管内皮细胞功能的影响

Effect of the Method of Reinforcing Qi and Activating Blood on the Functions of Vascular Endothelial Cells in Acute Ischemic Stroke with Qi—deficiency and Blood—stasis Syndrome

为研究以益气活血法拟定的脑栓康处方治疗急性缺血性中风（脑血栓形成）气虚血瘀证的作用，将符合条件的６６例患者随机分为试验组３４例和安慰剂组３２例，以双盲法进行临床观察和检测血管内皮细胞功能的相关指标，另设１７例正常对照组进行比较。结果：治疗前试验组和安慰剂组的ｔＰＡ、６＿ｋｅｔｏ＿ＰＧＦ１α、ＡＴⅢ、ＮＯ、ＣＧＲＰ含量（或活性）均低于正常对照组水平（Ｐ＜０．０１），ＰＡＩ、ＴＸＢ２、ＥＴ含量（或活性）均高于正常对照组水平（Ｐ＜０．０１）。经４周治疗后，自身前后比较：两组ｔＰＡ、６＿ｋｅｔｏ＿ＰＧＦ１α、ＮＯ、ＡＴⅢ、ＣＧＲＰ含量（或活性）均升高（Ｐ＜０．００１），ＰＡＩ、ＴＸＢ２、ＥＴ含量（或活性）均降低（Ｐ＜０．００１）。两组治疗前后差值组间比较：试验组ＰＡＩ、ＴＸＢ２、ＥＴ含量（或活性）降低，ｔＰＡ、ＡＴⅢ、ＣＧＲＰ含量（或活性）升高，和安慰剂组比较，差异无显著意义（Ｐ＞０．０５），试验组６＿ｋｅｔｏ＿ＰＧＦ１α、ＮＯ含量升高比安慰剂组高（Ｐ＜０．０１）。治疗后与正常对照组比较：两组的ＰＡＩ、ＴＸＢ２、ＥＴ含量（或活性）降低及ｔＰＡ、ＡＴⅢ含量（或活性）升高已接近正常对照组水平（Ｐ＞０．０５）；ＮＯ、ＣＧ?

おhis is a report on the functional change of vascular endothelial cell (VEC) in acute ischemic stroke with qi-deficiency and blood_stasis syndrome and effects of the formula with the function of replenishing qi and promoting blood circulation. A design of randomized double_blinded controlled trial was adopted in this study. Sixty_six cases were divided into two groups. Group 1(n=34) was treated with Naoshuangkang,a formula with the function of replenishing qi and promoting blood circulation; and group 2 (n=32) received placebo. Furthermore, a normal control group (n=17) was conducted for comparing with the patient groups. The results showed that:①Before treatment, the blood concentrations of active substances (tPA, NO, 6_keto_PGF1α, CGRP and AT Ⅲ),secreted by VEC in patient groups, were significantly lower than those in normal control group(P<0.01)while the concentrations of PAI, TXB2 and ET were notably higher(P<0.01) in patient groups. ②At the end of the four_week treatment, the levels of PAI,TXB2 and ET decreased significantly, near the level of normal control group (P>0.05),while the level of tPA and AT Ⅲ increased significantly, both close to normal control group (P>0.05).However, the concentrations of NO and 6_keto_PGF1α in the treatment groups were still lower than those in normal control group (P<0.01),and the concentrations of NO and 6_keto_PGF1α in group 1 were remarkably higher than those in group 2 (P<0.01). The results described above demonstrated that the development of acute ischemic stroke with qi_deficiency and blood_stasis syndrome had close relationship with functional changes of VEC, the increased vasoconstriction active substances and decreaseded vasodilatation active substances. The latter may be the predominant change during this course. Drugs with the function of replenishing qi and promoting blood circulation may effectively enhance VEC to secrete more NO and PGI2.