化浊解毒活血通络方联合通督调神针刺法治疗急性脑梗死疗效及NLRP3信号通路研究

Study on the Efficacy of Huazhuo Jiedu Huoxue Tongluo Formula Combined with Tongdu Tiaoshen Acupuncture in the Treatment of Acute Cerebral Infarction and Its Effect on NLRP3 Signaling Pathway

目的观察化浊解毒活血通络方联合通督调神针刺法治疗急性脑梗死(ACI)的疗效,以及对患者神经功能和NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎性小体信号通路的影响。方法80例ACI患者采用随机数字表法分为两组,对照组采用化浊解毒活血通络方治疗,观察组采用化浊解毒活血通络方联合通督调神针刺治疗。观察两组疗效、神经功能、残疾程度、NLRP3炎性小体信号通路相关分子mRNA表达、炎症因子和氧化应激的差异。结果观察组治疗总有效率高于对照组(P<0.05)。两组治疗后中医证候积分、美国国立卫生院脑卒中量表(NIHSS)、改良RANKIN量表(mRS)评分,外周血单核细胞NLRP3 mRNA、凋亡相关点样蛋白(ASC)mRNA、半胱氨酸蛋白酶-1(Caspase-1)mRNA表达,血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、丙二醛(MDA)水平较治疗前降低(P<0.05),超氧化物歧化酶(SOD)水平较治疗前增高(P<0.05)。观察组治疗后中医证候积分、NIHSS、mRS评分,外周血单核细胞NLRP3 m RNA、ASC mRNA、Caspase-1 mRNA表达,血清TNF-α、IL-6、MDA水平低于对照组(P<0.05),SOD水平高于对照组(P<0.05)。结论化浊解毒活血通络方联合通督调神针刺法可更有效抑制NLRP3炎性小体信号通路,缓解炎症反应和氧化应激,改善神经功能,减轻残疾程度,提高临床疗效。

Objective:To investigate the efficacy of Huazhuo Jiedu Huoxue Tongluo Formula combined with Tongdu Tiaoshen Acupuncture in the treatment of acute cerebral infarction(ACI),and its effect on neurological function and the inflammasome signaling pathway of NOD-like receptor thermoprotein domain-related protein 3(NLRP3)in ACI patients.Methods:A total of 80 patients with ACI admitted to our hospital were enrolled and divided into two groups by random number table.The control group was treated with Huazhuo Jiedu Huoxue Ton⁃gluo Formula,and the observation group was treated with Huazhuo Jiedu Huoxue Tongluo Formula combined with Tongdu Tiaoshen Acupuncture.The differences in efficacy,neurological function,degree of disability,mRNA expres⁃sion of molecules related to NLRP3 inflammasome signaling pathway,inflammatory factors and oxidative stress be⁃tween the two groups were observed.Results:The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the scores of TCM syndrome scores,the National Institutes of Health Stroke Scale(NIHSS)and modified RANKIN scale(mRS score)scores,the expression of NL⁃RP3 mRNA,apoptosis-related spot protein(ASC)mRNA,cysteine protease-1(Caspase-1)mRNA in peripheral blood mononuclear cells,serum tumor necrosis factor-α(TNF-α),interleukin(IL)-6,the level of malondialdehyde(MDA)decreased compared with those before treatment(P<0.05),and the level of superoxide dismutase(SOD)increased compared with that before treatment(P<0.05).After treatment,the TCM syndrome score,NIHSS and mRS scores,the expression of NLRP3 mRNA,ASC mRNA and Caspase-1 mRNA in peripheral blood mononuclear cells,the serum levels of TNF-α,IL-6 and MDA were lower in the observation groups than those in the control group(P<0.05),and the levels of SOD were higher than those in the control group(P<0.05).Conclusion:Hua⁃zhuo Jiedu Huoxue Tongluo Formula combined with Tongdu Tiaoshen Acupuncture can more effectively inhibit the NLRP3 inflammasome signaling pathway,alleviate inflammation and oxidative stress,improve neurological func⁃tion,reduce disability,and improve clinical efficacy.