The effects of Xingnao Jieyu capsules on post-stroke depression are similar to those of fluoxetine

The Xingnao Jieyu capsule has been shown to effectively relieve neurologic impairments and les- sen depression. It remains poorly understood whether this capsule can be used to treat post-stroke depression. Thus, in the present study, we established a rat model of post-stroke depression using left middle cerebral artery occlusions in combination of chronic unpredictable stress and solitary housing during development. Experimental rats received intragastric perfusion with 0.82, 0.41, and 0.20 g/kg Xingnao Jieyu capsules separately dissolved in 2 mL distilled water. Fluoxetine served as a positive control. The treatment was conducted over 28 days. Sugar water consumption test, open-field test, real-time fluorescent quantitative PCR and immunohistochemical staining results demonstrated that intragastric perfusion with various doses of Xingnao Jieyu capsules increased sugar water consumption, voluntary behaviors and synaptotagmin mRNA and protein expression in rats with post-stroke depression. These therapeutic effects were similar to those of fluoxetine. These results indicate that Xingnao Jieyu capsules upregulate synaptotagmin expression in hip pocampi of rats with post-stroke depression, and exert antidepressant effects.

Xingnao Kaiqiao needling method for acute ischemic stroke： a meta-analysis of safety and efficacy

OBJECTIVE： To evaluate the effectiveness and safety of the Xingnao Kaiqiao needling method for treating acute ischemic stroke.DATA SOURCES： We retrieved relevant randomized controlled trials involving Xingnao Kaiqiao acupuncture for treatment of acute ischemic stroke. The China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and Pub Med were searched from June 2006 to March 2016.DATA SELECTION： We analyzed randomized and semi-randomized clinical controlled trials that compared Xingnao Kaiqiao acupuncture with various control treatments, such as conventional drugs or other acupuncture therapies, for treatment of acute ischemic stroke. The quality of articles was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions（Version 5.1）, and the study was carried out using Cochrane system assessment methods. Rev Man 5.2 was used for the meta-analysis of the included studies.OUTCOME MEASURES： The mortality rate, disability rate, activities of daily living（Barthel Index）, and clinical efficacy were observed.RESULTS： Twelve studies met the inclusion criteria for this review. The meta-analysis showed that between Xingnao Kaiqiao acupuncture and the control treatment, Xingnao Kaiqiao acupuncture reduced the disability rate [risk ratio（RR） = 0.51, 95% confidence interval（CI） = 0.27-0.98, z = 2.03, P 〈 0.05], elevated the activities of daily living（weighted mean difference = 12.23, 95% CI： 3.66-20.08, z = 2.80, P 〈 0.005）, and had greater clinical efficacy（RR = 1.61, 95% CI： 1.23-2.09, z = 3.53, P 〈 0.0004）. However, there was no significant difference in mortality rate（RR = 0.61, 95% CI： 0.15-2.45, z = 0.70, P 〉 0.05）. CONCLUSION： The Xingnao Kaiqiao needling method is effective and safe for acute ischemic stroke. However, there was selective bias in this study, and the likelihood of measurement bias is high. Thus, more high-quality randomized controlled trials are needed to provide reliable evidence of the efficacy and safety of Xingnao Kaiqiao acupuncture in the treatment of acute ischemic stroke.

Systematic review of long-term Xingnao Kaiqiao needling efficacy in ischemic stroke treatment

OBJeCTIve：To systematically evaluate the long-term effect and safety ofXingnao Kaiqiao nee-dling method in ischemic stroke treatment. DATA ReTRIevAL： We retrieved relevant random and semi-random controlled trials that used theXingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014. SeLeCTION CRITeRIA： Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers’ Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies. MAIN OUTCOMe MeASUReS： Mortality rate, recurrence rate, and disability rate were observed. ReSULTS：Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no sig-niifcant differences in mortality reduction （risk ratio （RR） = 0.58, 95% conifdence interval （CI）： 0.17–1.93,Z = 0.89,P = 0.37） or recurrence rate （RR = 0.55, 95%CI： 0.18–1.70,Z = 1.04,P = 0.30） of ischemic stroke patients between theXingnao Kaiqiao needling and control treatment groups. However, theXingnao Kaiqiao needling method had a tendency towards higher efifcacy in mor-tality reduction and recurrence rates. TheXingnao Kaiqiao needling method was signiifcantly better than that of the control treatment in reducing disability rate （RR = 0.51, 95%CI： 0.27–0.98, Z = 2.03,P 〈 0.05）. CONCLUSION：TheXingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect ofXingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions aboutXingnao Kaiqiao needling.

Clinical effects of Xingnao Kaiqiao acupuncture on neurological impairment following cerebral infarction

BACKGROUND： Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect. OBJECTIVE： Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN： Controlled observation. SETTING： Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces. PARTICIPANTS： A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria： in accordance with ＂main points of diagnosis on different cerebrovascular disease＂ secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospital＇s ethics committee. METHODS： ① Experiment grouping： All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course： Group Ⅰ （onset within 7 hours）, group Ⅱ （onset from 7 hours to 3 days）, group Ⅲ （onset within 4-7 days）, and group IV （onset within 21-180 days）. On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ① The principal acupoints were Neiguan, Renzhong, and Sanyinfiao. ② The auxiliary acupoints were Jiquan, Chize, and Weizhong. ③Acupuncture manipulations： initially, Neiguan （PC6, bilateral） was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for l minute. Subsequently, Renzhong （GV26） was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao （SP6, affected limb） was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, l cun from the quondam Jiquan （HT1） acupoint; the armpit hair was avoided. Jiquan （affected limb） was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize （LU5） was selected when the patient flexed the elbow at 120°. Chize was vertically needled at l cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong （BL40） was selected when the patient＇s leg was raised straight in a supine position. Weizhong was vertically needled at 0.5 1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the post＇s specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation： To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21（range of 0 45; decreasing score indicates functional improvement）.To evaluate clinical curative effect by clinical effective power： Basic recovery： equal to or more than 81%; significant improvement： 56% to 81% （including 56%）; Improvement： between 36% to 56% （including 36%）; Slight Improvement： 11% to 36% （including 11%）; No change： less than 11%; Aggravation （including death）： negative value. Total effective rate was computed at the same time. MAIN OUTCOME MEASURES： The total effective rate and amelioration of neurological impairment of the patients after treatment. RESULTS： All 120 patients with cerebral infarction were included in the final analysis, without deletion. ① Comparison of the total effective rate： the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ and group IV was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects （x^2 = 36.351 7, P 〈 0.01）. ② Amelioration of neurological impairment： A decreased neurological impairment score was observed in group Ⅰ on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group Ⅳ and the remaining three groups were significant （P 〈 0.05）. CONCLUSION： Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.

Influence of Xingnao Jieyu capsule on hippocampal and frontal lobe neuronal growth in a rat model of post-stroke depression

The present study established a rat model of post-stroke depression using incomplete ischemia induced by unilateral carotid artery ligation in combination with solitary raising and subcutaneous injection of a small dose of reserpine. After intragastric perfusion with 45 mg/100 g, 15 mg/100 g, and 7.5 mg/100 g of Xingnao Jieyu for 7, 14 and 21 days, neuronal morphology in the frontal lobe and hippocampus was improved, depression state and voluntary behaviors were also effectively improved in rats with post-stroke depression. Moreover, the effects of Xingnao Jieyu at a dose of 45 and 15 mg/100 g were similar to the traditional antidepressant Prozac.

Yizhi Xingnao prescription improves the cognitive function of patients after a transient ischemic attack

Patients with mild cognitive impairment after a transient ischemic attack were included in this study. They were treated with Yizhi Xingnao prescription, ergoloid mesylates or aspirin for 60 days. Evaluation using the Montreal Cognitive Assessment Scale showed that cognitive function was significantly improved in all patients, especially after the combined treatment of Yizhi Xingnao and aspirin. The scores from the Montreal Cognitive Assessment Scale were improved overall and the effective treatment rate was as high as 79%, which was higher than patients treated with a combination of ergoloid mesylates and aspirin, or aspirin alone. Our experimental findings indicate that YizhiXingnao prescription can improve mild cognitive impairment after a transient ischemic attack, and that it is more effective than ergoloid mesylates.

Exploring the mechanism of Xingnao Kaiqiao acupuncture method for ischemicstroke based on EEG dynamic changes: a study protocol of an exploratory,prospective,interventional trial

Background: The Xingnao Kaiqiao acupuncture method, founded by Academician ShiXuemin, has outstanding efficacy in the treatment of ischemic stroke and has been widelyused at home and abroad. However, after half a century of animal experiments and clinicalstudies, clearly and intuitively revealing its therapeutic mechanism is still a great challengefor researchers. Therefore, this experiment is based on the combination of medicine andengineering to study the immediate effects of the acupuncture method in treating patientsby recording the electroencephalography (EEG) activities of subjects during the acupunctureprocess and to further reveal the therapeutic mechanism at the brain level. Methods: Thistrial is an exploratory, prospective, single-arm interventional study involving a total ofpatients with ischemic stroke. Physicians will record EEG data from patients duringacupuncture as the primary outcome indicator. After pre-processing the EEG data,researchers will use various methods to analyze the immediate effects of acupuncture toobtain brain effectiveness. Deep learning will then be used to identify acupoint stimuli andreceive correspondence between the acupuncture effect and the brain’s internal state.National Institutes of Health Stroke Scale score before and after the acupuncture process willbe used as the secondary outcome indicator. Conclusion: This is the first study protocol toapply dynamic changes in EEG to explore a range of mechanisms of action of acupuncture inthe treatment of ischemic stroke. We propose a method to analyze EEG signals ofacupuncture patients. The deep learning model will be applied for supervised training toobtain the compelling relationship between the acupuncture method and internal brainstates, providing a new prospect for the digitization of traditional Chinese medicine.

Meta-analysis of the clinical efficacy of Xingnao Kaiqiao acupuncture combined therapy in the treatment of infantile cerebral palsy

Objective:To evaluate the clinical efficacy of Xingnao Kaiqiao acupuncture combined therapy in treating infantile cerebral palsy by meta-analysis.Methods:CNKI,VIP,Wanfang knowledge service platform,CBM,PubMed,Embase and Cochrane library databases were searched.The retrieval time period was pushed back to the establishment of the database in March 2021.Through layers of screening and quality evaluation of the included literature,the data were analyzed with Revman 5.4.Results:9 articles were included,a total of 748 cases.The results of meta-analysis showed that compared with other therapies(control group),Xingnao Kaiqiao acupuncture combined therapy(treatment group)could improve the total clinical effective rate(or=3.32,95%CI[2.14,5.13],P<0.00001),improve the ability of language acceptance(MD=1.13,95%CI[0.92,1.34],P<0.00001),and improve the ability of language expression(MD=1.28,95%CI[1.03,1.54],P<0.00001),improve gmfm88 score(MD=23.13,95%CI[18.75,27.51],P<0.00001),improve dysarthria score(MD=0.33,95%CI[0.26,0.41],P<0.00001),improve MCA of cerebral ultrasound blood flow examination(MD=13.12,95%CI[9.22,17.01],P<0.00001),and ACA of cerebral ultrasound blood flow examination(MD=9.45,95%CI[6.28,12.62],P<0.00001).Conclusion:Compared with other therapies,Xingnao Kaiqiao acupuncture combined therapy in the treatment of infantile cerebral palsy can improve the total clinical efficiency,and has obvious advantages in improving language function,gross motor function,dysarthria,MCA and ACA of cerebral ultrasonic blood flow examination,but it still needs more and higher quality literature to prove it.

Evaluation of the Curative Effect of "Xingnao Kaiqiao" Acupuncture Based on Brunnstrom Staging on Upper Limb and Hand Motor Function in the Recovery Period after Stroke

Objective: To observe the effects of Xingnao Kaiqiao acupuncture(醒脑开窍针) on the motor function of upper limb and hand in the recovery period after stroke. Methods: Seventy-six cases of hemiplegia patients with ischemic stroke were divided into the treatment group and the control group(n=38 in each). Based on the Brunnstrom's stage of Xingnao Kaiqiao acupuncture combined with rehabilitation training was used in the treatment group, and the control group was given rehabilitation training. FuglMeyer Assessment of the upper extremity(FMA-UE), Action Research Arm Test(ARAT) and Simple Test for Evaluating hand Function(STEF) were adopted separately to compare scores before treatment and 8 weeks after treatment. Results: The difference was not statistically significant in the two groups of patients for comparison of FMA-UE, ARAT and STEF scores before treatment(P>0.05). The difference was statistically significant in the two groups of score comparison of FMA-UE, ARAT and STEF after treatment(P<0.05). Conclusion: The Xingnao Kaiqiao acupuncture has its unique advantages in improving recovery of motor function of upper limb and hand in recovery period after stroke.

Expert Consensus on the Clinical Application of Tianma Xingnao Capsule in the Treatment of Vascular Cognitive Impairment and Neuropathic Headache

The prescription of Tianma Xingnao Capsule is composed of Gastrodiae Rhizoma,Pheretima,Acori Tatarinowii Rhizoma,Polygalae Radix,Rehmanniae Radix Praeparata,and Cistanches Herba.It has effects of nourishing liver and kidney,dredging collaterals and relieving pain.More than 20 years of clinical application and evidence-based medical research have shown that Tianma Xingnao Capsule has a significant therapeutic effect on vascular cognitive impairment and neuropathic headache.In order to further guide the proper clinical use of this prescription,the consensus expert group conducted a comprehensive analysis of the prescription of Tianma Xingnao Capsule.Combining the existing evidence-based medicine evidence and the experience of clinical experts,this consensus report standardized the usage,dosage,duration and safety of Tianma Xingnao Capsule in the treatment of vascular cognitive impairment and neuropathic headache.It is expected to provide a theoretical basis for clinically reasonable and safe use of Tianma Xingnao Capsule.

“醒脑开窍”针刺法对老年卒中相关性肺炎发病影响的巢式病例对照研究

[目的]探讨真实环境下“醒脑开窍”针刺法对老年急性脑梗死(ACI)患者卒中相关性肺炎(SAP)发生率的影响。[方法]在ACI队列研究基础上,采用巢式病例对照研究方法,经倾向性匹配评分(PSM)均衡混杂因素,匹配因素包括美国国立卫生研究院卒中量表(NIHSS)以及吞咽困难,设置卡钳值为0.01,按照1∶4的比例进行匹配。随后利用Logistic回归分析针灸对老年SAP的发病影响,分析中医证型对SAP的发病影响及针灸对不同证型ACI患者SAP的发病影响。[结果]研究最终选取病例组48例、对照组155例患者进入研究,使用“醒脑开窍”针刺法后老年SAP发病风险降低76%(P<0.001)。多因素Logistic回归分析发现,在60~69、70~79、≥80岁年龄段中,“醒脑开窍”针刺法均是影响SAP发生的显著因素;“醒脑开窍”针刺法可以显著降低阴虚风动证ACI患者SAP的发病率[OR=0.12,95%CI(0.05,0.25),P<0.0001]。此外,无论ACI患者是否发生昏迷[基于格拉斯哥昏迷评分法(GCS)评分定义],“醒脑开窍”针刺法均可以减少SAP的发生。[结论]“醒脑开窍”针刺法可以降低ACI患者SAP的发生率,尤其是对阴虚风动证患者更为明显,预防效果尚需要进一步前瞻性研究加以证实。

醒脑开窍针法联合VR技术干预卒中后非痴呆型血管性认知障碍的临床观察

目的:观察醒脑开窍针法联合VR技术干预卒中后非痴呆型血管性认知障碍(VCIND)的临床疗效。方法:采用随机数字表法将2021年10月至2022年9月江西省南昌市洪都中医院住院治疗的首发脑卒中后VCIND患者78例分为三组,各26例。对照组实施常规认知训练,醒脑开窍针法组实施醒脑开窍针法针刺治疗,醒脑开窍针法+VR技术组是在醒脑开窍针法组基础上联合VR技术康复训练,三组均进行为期4周的康复训练。比较三组康复训练前后认知功能、日常生活能力状况。结果:康复训练4周后,三组认知功能MoCA评分、MMSE评分均提高,且醒脑开窍针法+VR技术组高于醒脑开窍针法组、对照组(P<0.05);三组日常生活能力MBI评分均提高,且醒脑开窍针法+VR技术组高于醒脑开窍针法组、对照组(P<0.05)。结论:醒脑开窍针法联合VR技术干预可改善卒中后VCIND患者认知障碍,提高患者认知能力及日常生活能力。

醒脑通督针刺联合推拿治疗小儿脑瘫的效果

目的:观察醒脑通督针刺联合推拿治疗小儿脑瘫的效果。方法:选取2022年2月至2023年2月该院收治的70例脑瘫患儿进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各35例。对照组采用中医推拿治疗,研究组在对照组基础上联合醒脑通督针刺疗法。比较两组临床疗效,治疗前后日常生活能力[儿童生活质量量表脑瘫模块(PedsQL-CP)]评分、运动功能[粗大运动功能评估量表(GMFM)]评分、脑血流动力学指标[大脑前动脉(ACA)、基底动脉(BA)血流速度]水平及改良Ashworth痉挛量表分级。结果:研究组治疗总有效率为94.29%(33/35),高于对照组的77.14%(27/35),差异有统计学意义(P<0.05);治疗后,研究组PedsQL-CP、GMFM评分及ACA、BA血流速度均高于对照组,改良Ashworth痉挛量表分级低于对照组,差异有统计学意义(P<0.05)。结论:醒脑通督针刺联合推拿治疗小儿脑瘫效果显著,能够提高患儿运动功能和日常生活能力,改善脑血流动力学指标水平,减轻肢体痉挛程度,效果优于单用推拿治疗。

基于脑-肠相通理论观察醒脑调神针刺法治疗腹泻型肠易激综合征临床研究

目的:基于脑-肠相通理论观察醒脑调神针刺法治疗腹泻型肠易激综合征(IBS-D)的临床疗效。方法:选取110例脾肾阳虚证IBS-D患者,按随机数字表法分为对照组和观察组各55例。对照组给予常规西药治疗,观察组在对照组基础上给予醒脑调神针刺法治疗。比较2组临床疗效、肠易激综合征症状严重程度量表(IBS-SSS)评分、胃肠激素指标[生长抑素(SS)、血管活性肠肽(YIP)]、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)]、肠道菌群变化、肠易激综合征生活质量量表(IBS-QOL)评分、不良反应总发生率。结果:观察组总有效率为96.36%,高于对照组74.55%(P<0.05)。治疗后,2组生活干扰度、排便满意度、腹胀程度、腹痛天数、腹痛程度评分及总分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗后,2组血清SS、VIP、IL-6、TNF-α、IL-8水平较治疗前降低(P<0.05),且观察组血清SS、VIP、IL-6、TNF-α、IL-8水平低于对照组(P<0.05)。治疗后,2组肠球菌、肠杆菌门丰度较治疗前降低,乳酸杆菌、双歧杆菌门丰度较治疗前升高(P<0.05);且观察组肠球菌、肠杆菌门丰度均低于对照组,乳酸杆菌、双歧杆菌门丰度均高于对照组(P<0.05)。治疗后,2组IBS-QOL评分较治疗前升高(P<0.05),且观察组IBS-QOL评分高于对照组(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:醒脑调神针刺法可有效调节IBS-D患者肠道菌群及胃肠激素分泌,缓解腹痛等腹部不适症状,减轻炎症反应,提高生活质量,安全可靠。

基于PGC-1α通路探索珍龙醒脑胶囊对大鼠脑缺血再灌注损伤的保护机制

目的:基于过氧化物酶体增殖物激活受体-γ共激活因子-1α(PGC-1α)通路探索珍龙醒脑胶囊对大鼠脑缺血再灌注损伤的保护机制。方法:SD大鼠随机分为假手术组(Sham)组、模型组(I/R)组、珍龙醒脑低、中、高剂量组(ZLXNl、ZLXNm、ZLXNh)组。每组12只。除Sham外采用改良的Longa 法复制缺血性脑损伤大鼠模型,造模后除I/R外,3组大鼠分别灌胃给予珍龙醒脑50、100及200mg/(kg·d),I/R组和Sham组同步给予0.9%氯化钠溶液,疗程1周。造模后第6,12,24h进行神经功能缺陷评分;治疗干预1周后采用ELISA法检测海马组织中超氧化物歧化酶(SOD)、丙二醛、谷胱甘肽过氧化物酶、肿瘤坏死因子-α、白细胞介素-6含量,Western blot 检测核转录因子κB(NF-κB)、PGC-1α、核呼吸因子-1(NRF1)、线粒体转录因子 A(TFAM)的mRNA表达。结果:与I/R组比较,ZLXNm、ZLXNh组各时间点神经功能缺陷评分明显降低,差异具有统计学意义(P<0.05);珍龙醒脑胶囊各剂量组的 白细胞介素-6、肿瘤坏死因子-α和丙二醛水平显著降低,而谷胱甘肽过氧化物酶显著升高,差异有统计学意义(P< 0.05)。ZLXNl组SOD活性与I/R组比较,差异无统计学意义(P>0.05),ZLXNm、ZLXNh组SOD显著升高,差异有统计学意义(P<0.05)。珍龙醒脑各剂量组海马组织PGC-1α和 TFAMmRNA 表达显著升高(P<0.05),NF-κB蛋白表达在ZLXNm、ZLXNh组显著降低(P<0.05),NRF1蛋白表达在ZLXNm、ZLXNh组显著升高(P<0.05)。结论:珍龙醒脑胶囊可以促进脑缺血再灌注损伤大鼠的神经功能恢复,并抑制氧化应激和炎性反应从而发挥神经保护作用。其机制可能与 NF-κB表达的下调和 PGC-1α 信号通路激活有关。

杞黄醒脑颗粒质量标准

建立杞黄醒脑颗粒的质量标准,为其质量控制提供依据.采用薄层色谱法(TLC)对杞黄醒脑颗粒中枸杞子、淫羊藿、丹参、仙茅、当归、何首乌进行鉴别,采用高效液相色谱法(HPLC)测定制剂中二苯乙烯苷的含量.色谱柱Waters Bridge C 18柱(4.6×250 mm,5μL),流动相为甲醇-水(体积比36∶64),检测波长320 nm,流速1.0 mL/min,柱温30℃.结果表明枸杞子、淫羊藿、丹参、仙茅、当归、何首乌的TLC图谱主斑点清晰,分离度好,阴性对照无干扰;二苯乙烯苷在0.1956~2.9340μg(R 2=0.9995,n=6)内线性关系良好,精密度、重复性、稳定性的RSD均小于2.0%,加样回收率为96.38%~100.19%,RSD为1.48%.该质量标准项目设置合理,操作便捷、准确,可用于杞黄醒脑颗粒的质量控制.

基于生物信息学探讨中风醒脑液对脑出血后神经系统及免疫系统的影响

目的探讨中风醒脑液(Zhongfeng Xingnao Liquid)对脑出血(intracerebral hemorrhage,ICH)后神经系统及免疫系统的影响。方法从中医药系统药理数据库和分析平台(Traditional Chinese Medicine Databaseand AnalysisPlatform,TCMSP)获取中风醒脑液有效活性成分;并通过TCMSP、SwissTargetPrediction数据库获取有效活性成分作用靶点;通过药物靶标在线数据库(Therapeutic Target Database,TTD)、人类在线孟德尔遗传数据库(Online Mendelian Inheritance in Man,OMIM)、DisGeNET、GeneCards和Drugbank数据库筛选脑出血相关靶点;通过京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)筛选神经系统和免疫系统相关靶点;运用STRING平台分别对“中风醒脑液-脑出血-免疫系统”,“中风醒脑液-脑出血-神经系统”交集靶点进行蛋白互作分析和筛选信号通路,运用MCC法筛选中风醒脑液影响脑出血后神经系统和免疫系统的核心靶点;利用Cytoscape 3.9.0软件构建“药物-成分-核心靶点-通路”网络,计算网络度值(Degree),筛选出中风醒脑液关键活性成分,运用Autodock Vina软件对活性成分与核心靶点进行分子对接。利用胶原酶Ⅶ型诱导大鼠脑出血疾病模型进行实验验证。结果预测得出中风醒脑液主要活性成分31种;中风醒脑液对脑出血后神经系统潜在作用靶点33个,对免疫系统潜在作用靶点68个;槲皮素、洋川芎醌和β-谷甾醇等是中风醒脑液影响脑出血后神经系统和免疫系统的主要活性成分,预测得出肿瘤蛋白P53(TP53)、丝裂原活化蛋白激酶1(MAPK1)、胱天蛋白酶3(CASP3)等是中风醒脑液影响脑出血后神经系统的核心靶点,肿瘤坏死因子(TNF)、白细胞介素6(IL-6)、基质金属蛋白酶9(MMP9)等是中风醒脑液影响脑出血后免疫系统的核心靶点;分子对接结果显示MMP9、信号转导及转录激活蛋白3(STAT3)和白细胞介素1β(IL-1β)等蛋白受体与槲皮素,洋川芎醌,β-谷甾醇及人参皂苷Rh2等主要活性成分具有较好的亲和力。动物实验验证结果表明,中风醒脑液高剂量组能改善脑出血大鼠神经缺损症状及血肿周边组织病理结构,有效减少脑出血后CASP3、IL-1β、IL-6、TNF、PRKCA、PRKCD、RELA、TP53和MAPK1mRNA的相对表达,上调NFKBIA、AKT1mRNA的相对表达(P<0.05,P<0.01,P<0.001)。结论中风醒脑液可能通过调控TNF、IL-6、TP53、MAPK1及CASP3等表达来影响脑出血后神经系统和免疫系统,发挥治疗作用。

通督调神法针刺联合石冰醒脑颗粒对血管性痴呆大鼠肠道菌群微生物的影响

目的探讨通督调神法针刺联合石冰醒脑颗粒对血管性痴呆大鼠肠道菌群的影响及其可能的作用机制。方法将80只大鼠随机分为假手术组、模型组、通督调神法针刺组、石冰醒脑颗粒组、通督调神法针刺联合石冰醒脑颗粒组,每组10只。采用改良双侧颈总动脉永久结扎法制备血管性痴呆模型。石冰醒脑颗粒组采用石冰醒脑颗粒溶解液灌胃,通督调神法针刺组采用通督调神针刺治疗,通督调神法针刺联合石冰醒脑颗粒组采用石冰醒脑颗粒溶解液联合通督调神法针刺治疗。采用Morris水迷宫实验评价各组大鼠认知和记忆功能变化,16S rRNA测序技术分析肠道菌群结构变化。Western blot法检测caspase-3、Bax和Bcl-2蛋白表达水平。结果与假手术组比较,模型组大鼠平均逃避潜伏期显著延长(P<0.05),caspase-3和Bax蛋白表达水平显著升高(P<0.05),Bcl-2蛋白表达水平显著降低(P<0.05);肠道中罗姆布茨菌等有益菌相对丰度显著降低(P<0.05)。与模型组比较,通督调神法针刺组、石冰醒脑颗粒组、通督调神法针刺联合石冰醒脑颗粒组大鼠平均逃避潜伏期显著缩短(P<0.05);caspase-3、Bax蛋白表达水平均显著降低(P<0.05)、Bcl-2蛋白表达水平均显著升高(P<0.05),肠道中密螺旋菌等有害菌相对丰度降低(P<0.05)。结论通督调神法针刺联合石冰醒脑颗粒可改善血管性痴呆大鼠认知功能障碍,其作用可能是通过调节海马caspase-3、Bax和Bcl-2蛋白表达,进一步影响肠道菌群而实现的。

醒脑解郁方灌胃对大鼠卒中后抑郁的治疗作用及机制

目的 观察醒脑解郁方对大鼠卒中后抑郁(PSD)的治疗作用,并探讨其作用机制与下丘脑—垂体—肾上腺(HPA)轴的关系。方法 取雄性SD大鼠60只,随机分为正常对照组、PSD组、氟西汀组、醒脑解郁方低剂量组、醒脑解郁方高剂量组,每组各12只。正常对照组正常饲养不做干预,其余4组采用大脑中动脉栓塞联合慢性不可预知温和刺激(CUMS)制备PSD模型。CUMS期间氟西汀组给予氟西汀溶液0.2 mg/100 g灌胃,醒脑解郁方低剂量组和高剂量组分别给予1.05、2.10 g/mL醒脑解郁方灌胃,正常对照组、PSD组给予1 mL/100 g生理盐水灌胃。根据大鼠体质量、强迫游泳实验、糖水消耗实验和旷场实验评估抑郁状态;处死大鼠,取脑组织,采用HE染色法观察海马组织病理形态;采用ELISA法检测血清HPA轴相关激素促肾上腺皮质激素(ACTH)、皮质醇(CORT);Western blotting法检测HPA轴相关激素海马糖皮质激素受体(GR)、下丘脑促肾上腺皮质激素释放激素(CRH)蛋白。结果 与正常对照组比较,PSD组体质量降低、强迫游泳测试时间缩短、糖水消耗量减少、水平及垂直运动得分降低,海马组织神经元数量缺失明显,呈现炎性改变,血清ACTH、CORT水平升高,海马组织GR蛋白表达水平降低,下丘脑组织CRH蛋白表达水平升高(P均<0.01)。与PSD组比较,氟西汀组和醒脑解郁方低、高剂量组体质量增加、强迫游泳时间延长、糖水消耗量增多、水平及垂直运动得分增加,海马组织神经元受损程度较轻,水肿现象减少,细胞存活率提高,细胞排列紧密;血清ACTH、CORT水平降低,海马组织GR蛋白表达水平升高,下丘脑组织CRH蛋白表达水平降低(P均<0.01)。结论 醒脑解郁方能够改善PSD大鼠的抑郁样行为,其机制可能是通过抑制HPA轴过度激活从而减轻海马神经元损伤发挥作用。

四渎穴凤凰展翅手法结合醒脑开窍针刺法治疗中风后手指拘挛的临床研究

目的:观察针刺“四渎穴”凤凰展翅手法结合醒脑开窍针刺法治疗中风后手指拘挛的临床疗效。方法:选择60例中风后手指拘挛的患者,按照随机数表法分为对照组和治疗组,每组各30例,其中对照组仅给予醒脑开窍针法进行治疗,而治疗组则在对照组的基础上加用“四渎穴”凤凰展翅手法进行治疗,两组均治疗两个疗程。治疗结束后根据改良的Ashworth(MAS)痉挛评分量表、简化的Fugl-Meyer运动功能量表分别对两组患者进行手指肌张力评价和手指运动功能评价,并应用改良的Ashworth(MAS)痉挛量表进行临床疗效评价。结果:治疗组总有效率96%(29/30),明显高于对照组总有效率90%(27/30),差异具有统计学意义(P<0.01);两组患者治疗后MAS评分、Fugl-Meyer评分与治疗前比较,差异具有统计学意义(P<0.05或P<0.01),且治疗组显著优于对照组,差异具有统计学意义(P<0.01)。结论:四渎穴凤凰展翅手法结合醒脑开窍针刺法治疗中风后手指拘挛的临床疗效确切,可明显降低患者手指肌张力并改善患者手指运动功能。