从“风痰瘀论”治疗中风与细胞自噬作用相关机制研究

Study on Mechanism of Treatment of Stroke and Autophagy from Theory of Wind Phlegm and Blood Stasis

目的研究"风痰瘀"理论指导下采用三虫半夏白术天麻汤治疗风痰瘀阻证中风与细胞自噬作用的相关机制。方法选取2018年8月—2020年8月神经内科收入的162例中风患者展开研究,按照信封原则划分为研究组81例和对照组81例,对照组采用常规西医疗法,研究组在对照组基础上加用三虫半夏白术天麻汤治疗,1周为1个疗程,观察并比较治疗前后两组疗效、神经功能缺损评分、血清炎症因子水平及自噬相关蛋白表达水平。结果治疗2个疗程后,研究组治疗总有效率90.12%(73/81)显著高于对照组75.13%(61/81)(P<0.05),差异有统计学意义;研究组NIHSS评分、CRP水平、IL-6水平及TNF-α水平均比对照组低,研究组血清中自噬相关蛋白LC3-Ⅱ、Beclin-l表达水平均高于对照组(P<0.05),差异有统计学意义。结论"风痰瘀"理论指导下采用三虫半夏白术天麻汤治疗风痰瘀阻证缺血性中风疗效显著,改善神经损伤,可能与降低炎症因子水平,调控细胞自噬相关通路作用相关。

Objective To study the mechanism of using Sanchong Banxia Baizhu Tianma Decoction(三虫半夏白术天麻汤)to treat wind-phlegm-blood stasis syndrome of apoplexy and autophagy under the guidance of"wind,phlegm and blood stasis"theory.Methods A study was conducted on 162 stroke patients with neurology from August 2018 to August 2020.According to the envelope principle,they were divided into a study group of 81 cases and a control group of 81 cases.The control group was treated with conventional western medicine,and the study group was based on the control group.The above treatment was treated with Sanchong Banxia Baizhu Tianma Decoction,and 1 week was a course of treatment.The efficacy,neurological deficit score,serum inflammatory factor level and autophagy-related protein expression level of the two groups were observed and compared before and after treatment.Results After two courses of treatment,the total effective rate(90.12%,73/81)in the study group was significantly higher than 75.13%in the control group(P<0.05).The study group’s NIHSS score,levels of CRP,IL-6 and TNF-αwere lower than those of the control group.The expression levels of autophagy-related proteins LC3-Ⅱand Beclin-l in the study group were significantly higher than those of the control group(P<0.05).Conclusion The use of Sanchong Banxia Baizhu Tianma Decoction under the guidance of the theory of"wind,phlegm and blood stasis"is effective in treating ischemic stroke with wind-phlegm-blood stasis syndrome and improves nerve damage,which may be related to the reduction of inflammatory factors and the regulation of autophagy-related pathways.