Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy （antiplatelet drugs and hypolipidemic drugs） alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.

Clinical Studies on Treatment of Acute Cerebral Infarction with Xueshuantong(血栓通)Injection

Objective: To observe the effect of Xueshuantong injection (XST,血栓通注射液) with its ingredient as Notoginseng saponin, on acute cerebral infarction (ACI) and on blood coagulation and fibri-nolysis, so as to comprehensively analyse the mechanism of XST. Methods: Fifty ACI patients were randomly divided into 2 groups, and XST group (30 patients) was treated with XST, and the control group (20 patients) given low molecular dextrose, as well as low molecular heparin calcium. The course of treatment for both groups was 15 days. The changes of effective rate, score of neurologic impairment, tissue-type plasminogen activator (tPA), inhibitor of plasminogen activator (PAI), D-D dimmer, antithrombin-III (AT-III), and fibrinogen (Fbg) were all observed. Results: The total effective rate of XST group was 73.33%, that of the control group 65. 00%. After the therapy, plasma level of tPA, ratio of tPA/PAI, and AT-III content were increased obviously, while the plasma level of PAI and D-D dimmer were decreased significantly (all P<0.01) . But there was only insignificant difference between the 2 groups (P> 0.05).Conclusion: XST injection could be effective to ACI, the mechanism of which is probably related to improving the balance between plasminogen activator and its inhibitory factor, increasing the activity of fi-brinolysin, inactivating thrombin, inhibiting platelet aggregation induced by thrombin, and decreasing blood coagulation.

Effects of Xueshuantong combined with antioxidant drugs on nerve conduction function and oxidative stress in patients with diabetic peripheral neuropathy

Objective:To study the effect of Xueshuantong combined with antioxidant drugs on nerve conduction function and oxidative stress in patients with diabetic peripheral neuropathy. Methods: 138 cases of patients with diabetic peripheral neuropathy who were treated in endocrinology department of our hospital between June 2014 and October 2016 were enrolled and randomly divided into two groups. The combination group received Xueshuantong combined with antioxidant drug therapy, and the control group received antioxidant drug therapy. Before and after treatment, the nerve conduction velocity as well as serum content of oxidative stress indexes and nerve cytokines was measured.Results: 4 weeks and 8 weeks after treatment, common peroneal nerve and median nerve MNCV and SNCV as well as serum SOD, GSH-Px, HO-1, CAT, CNTF, BDNF and SDF-1 levels of both groups were significantly higher than those before treatment while serum MDA, AOPP and 8-OHdG levels were significantly lower than those before treatment, and common peroneal nerve and median nerve MNCV and SNCV as well as serum SOD, GSH-Px, HO-1, CAT, CNTF, BDNF and SDF-1 levels of combination group were significantly higher than those of control group while serum MDA, AOPP and 8-OHdG levels were significantly lower than those of control group.Conclusion:Xueshuantong combined with antioxidant drugs can improve the nerve conduction function, inhibit oxidative stress response and improve neurotrophy status in patients with diabetic peripheral neuropathy.

Clinical Effect of Laser Treatment Combined with Compound Xueshuantong Capsule in the Treatment of Diabetic Retinopathy

Objective:To determine the clinical value of compound Xueshuantong capsule in the treatment of diabetic retinopathy on the basis of laser treatment.Methods:Data were collected from 98 patients with diabetic retinopathy from February 2021 to February 2022.They were divided into two groups by drawing lots.The experimental group was treated with compound Xueshuantong capsule and laser treatment,whereas the control group was treated with laser treatment alone.Results:The absorption of exudation,resolution of retinal edema,and absorption of bleeding took longer in the control group;the incidence of visual acuity recovery to more than 0.5 and the patients’blood glucose levels were better in the experimental group,p<0.05.Conclusion:For patients with diabetic retinopathy,laser treatment combined with compound Xueshuantong capsule can effectively improve the visual function and rehabilitation efficiency of patients with diabetic retinopathy as well as stabilize their blood sugar levels.It has high clinical application value.

血栓通对阿尔茨海默症模型小鼠认知功能及神经异常兴奋性的作用及其机制研究

目的探究血栓通[主要有效成分为三七皂苷(panax notoginseng,PNS)]对阿尔茨海默症(Alzheimer’s disease,AD)模型小鼠认知功能及神经兴奋性的影响,并探讨其潜在分子机制。方法用APP/PS1小鼠作为AD研究动物模型,在小鼠淀粉样蛋白尚未检测到阶段(2月龄)开始每日以60 mg/kg对血栓通组(APP/PS1+PNS)行灌胃给药,每日1次,连续给药6个月(给药至8月龄);对照组小鼠予同等体积的0.9%氯化钠(APP/PS1+vehicle)灌胃处理,同月龄野生型小鼠予0.9%氯化钠灌胃处理作为正常对照组(WT+vehicle),每组各15只。6个月后,新物体识别实验、Morris水迷宫实验检测小鼠的认知功能;EEG脑电检测、Western blot、细胞表面生物素化试验以检测各组小鼠皮质与海马中BACE1的活性、Nav1.1α的分布、表达以及Navβ2的表达与酶解情况(Navβ2的酶解片段Navβ2 full length及Navβ2-CTF表达检测)。结果新物体识别实验显示,与对照组APP/PS1小鼠相比,血栓通用药后APP/PS1小鼠的辨别指数(discrimination index,DI)上升(P<0.05);Morris水迷宫检测结果发现,血栓通灌胃6个月后小鼠在探索实验中逃避潜伏期缩短(P<0.05),撤除平台后在目标象限停留时间增加(P<0.05)、穿梭平台次数增加(P<0.05);EEG脑电检测结果发现,血栓通给药后减少了APP/PS1小鼠棘波放电出现的频率(P<0.05)。血栓通给药后显著降低了BACE1蛋白水平的表达(P<0.05),而全长片段Navβ2的蛋白水平显著上升(P<0.05),并纠正了Nav1.1α在神经元内外的异常分布(P<0.05)。结论血栓通可以改善AD模型小鼠的学习记忆能力、纠正大脑异常兴奋性,其作用机制可能与抑制BACE1的活性从而减少Navβ2由APP/PS1诱导的过度酶解,纠正皮质、海马神经元Nav1.1α的异常表达与分布,调节神经元的兴奋性有关。

血栓通注射液联合奥拉西坦对老年缺血性脑卒中的作用

目的探讨血栓通注射液联合奥拉西坦对老年缺血性脑卒中(ischemic stroke,IS)的作用。方法选取106例老年IS患者作为研究对象,随机分为观察组和对照组,每组53例。对照组用奥拉西坦治疗,观察组在对照组治疗的基础上联合血栓通注射液治疗,比较2组的临床疗效、神经功能[用美国国立卫生研究院卒中量表评分(national institute of health stroke scale,NIHSS)评估]、运动功能(用日常生活活动能力(activities of daily living,ADL)量表评估)、颈动脉狭窄程度(颈动脉内中膜厚度和狭窄率)、血流动力学(全血黏度、血流速度和血流阻力)、神经损伤因子[神经胶质原纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)和脑源性神经生长因子(brain-derived neurotrophic factor,BDNF)]和氧化应激指标[丙二醛(malondialdehyde,MDA)和超氧化物歧化酶(superoxide dismutase,SOD)]水平。结果观察组的总有效率为98.11%,高于对照组的86.79%(P<0.05);治疗后,观察组的NIHSS评分为(10.14±1.91)分,低于对照组的(12.43±2.12)分,P<0.05;观察组的ADL评分为(64.49±8.30)分,高于对照组的(58.37±7.26)分,P<0.05;观察组颈动脉内中膜厚度和狭窄率分别为(1.27±0.11)mm、(74.84%±5.14%),低于对照组[(1.33±0.13)mm、(78.92%±5.95%)],P<0.05;观察组(高切和低切)全血黏度和血流阻力分别为(4.72±0.91)mPa·s、(10.99±2.25)mPa·s、(1.52±0.24)Pa·s·L^(-1),低于对照组[(5.86±1.17)mPa·s、(13.40±2.77)mPa·s、(1.64±0.27)Pa·s·L^(-1)],血流速度为(18.33±3.85)cm·s^(-1),高于对照组[(16.51±3.61)cm·s^(-1)],P<0.05;观察组的GFAP和NSE分别为(5.62±1.11)、(23.88±4.25)ng·mL^(-1),低于对照组[(6.57±1.30)、(27.17±4.76)ng·mL^(-1)],BDNF为(3.06±0.77)ng·mL^(-1),高于对照组[(2.38±0.52)ng·mL^(-1)],P<0.05;观察组的MDA为(3.62±0.63)μmol·L^(-1),低于对照组[(4.05±0.78)μmol·L^(-1)],SOD为(105.20±15.63)U·mL^(-1),高于对照组[(93.42±13.27)U·mL^(-1)],P<0.05。结论血栓通注射液联合奥拉西坦对老年IS患者疗效显著,可通过调节神经损伤因子和氧化应激因子水平及改善血流动力学,提高患者的神经功能和运动功能,改善颈动脉狭窄。

注射用血栓通辅助治疗急性脑梗死临床研究

目的探讨急性脑梗死患者经注射用血栓通治疗后其脑血流动力学、炎症指标及神经细胞因子的变化情况。方法根据随机数字表法分配原则将152例2020年1月—2022年8月该院收治的急性脑梗死患者分为对照组(76例)和试验组(76例)。两组均给予常规治疗,对照组在常规治疗基础上给予依达拉奉注射液进行治疗,试验组在对照组基础上给予注射用血栓通进行治疗,两组均连续治疗2周。比较两组治疗2周后的疗效,治疗前和治疗2周后的临床相关评分、脑血流动力学、炎症指标、神经细胞因子及治疗期间的安全性。结果与对照组比较,试验组治疗2周后的总有效率较高[93.42%(71/76)vs 81.58%(62/76),P<0.05)]。治疗2周后,两组美国国立卫生院卒中量表(National Institutes of Health stroke scale,NIHSS)、改良Rankin量表(improved Rankin scale,mRS)评分、动态阻力(dynamic resistance,DR)、外周阻力(peripheral resistance,Rv)及血清基质金属蛋白酶-9(matrix metalloproteinases-9,MMP-9)、同型半胱氨酸(homocysteine,Hcy)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-2(interleukin-2,IL-2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、神经元特异性烯醇化酶(neuron specific enolase,NSE)水平与治疗前比较均降低,试验组低于对照组(P<0.05);两组Barthel指数(Barthel index,BI)评分、平均血流速度(mean blood flow velocity,Vm)、平均血流量(mean blood flow,Qm)及血清神经营养因子(neurotrophic factor,NTF)、神经生长因子(nerve growth factor,NGF)、胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)水平与治疗前比较均升高,试验组高于对照组(P<0.05)。治疗期间,试验组不良反应总发生率为6.58%(5/76),与对照组(9.21%,7/76)比较,差异无统计学意义(P>0.05)。结论注射用血栓通可有效调节急性脑梗死患者炎症指标及神经细胞因子,减轻机体炎症及神经功能缺损程度,改善神经功能,并可平衡脑血流动力学,进而可促进患者生活质量的改善,提高疗效,且具有良好的安全性。

复方血栓通胶囊治疗非增殖期糖尿病视网膜病变效果的Meta分析

目的系统评价复方血栓通胶囊治疗非增殖期糖尿病视网膜病变(NPDR)的效果。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库(CBM)、Embase、PubMed和The Cochrane Library数据库(检索时间为建库至2022年4月),纳入复方血栓通胶囊治疗NPDR的随机对照研究。2位分析员独立筛选、阅读、提取文献资料并评价相关偏倚风险后,采用RevMan5.3软件进行Meta分析。结果共纳入8条文献,包括1048例患者。Meta分析结果显示,与对照组相比,试验组可显著提高患者的临床疗效[RR=1.27,95%CI(1.18,1.36),P<0.00001],减轻黄斑水肿[MD=-26.27,95%CI(-35.72,-16.83),P<0.00001],改善患者眼动脉血流动力学指标[MDPSV=1.10,95%CI(0.82,1.39),P<0.00001;MDEDV=0.73,95%CI(0.60,0.86),P<0.00001;MDRI=-0.02,95%CI(-0.03,-0.01),P<0.00001];试验组与对照组的视网膜中央动脉血流动力学指标无显著差异(P>0.05)。结论复方血栓通胶囊可显著提高NPDR患者的临床疗效、减轻黄斑水肿、改善眼动脉血流动力学指标,但对视网膜中央动脉血流动力学指标无显著改善作用。

基于网络药理学的复方血栓通胶囊治疗视网膜静脉阻塞机制研究

目的:基于网络药理学方法探究复方血栓通胶囊治疗视网膜静脉阻塞(retinal vein occlusion,RVO)的潜在作用靶点及机制。方法:利用中药系统药理学数据库与分析平台(traditional Chinese medicine systems pharmacology database and analysis platform,TCMSP)获取三七、黄芪、丹参、玄参的活性成分及相关靶点。运用GeneCards、在线孟德尔人类遗传数据库(online mendelian inheritance in man,OMIM)以及DrugBank数据库获取RVO的相关作用靶点,采用Cytoscape 3.7.2软件绘制“疾病-药物-活性成分-靶点”图,借助STRING数据库建立靶点蛋白-蛋白互作网络(protein-protein interactions,PPI),并挖掘其中潜在的蛋白质功能模块。最后通过Metascape平台进行基因本体论功能(gene ontology,GO)富集分析和京都基因与基因组百科全书(kyoto encyclopedia of genes and genomes,KEGG)富集分析。结果:筛选得到复方血栓通胶囊119个有效活性成分,有效靶点202个,RVO的疾病靶点1539个,最终获得复方血栓通胶囊治疗RVO有效靶点115个,通过PPI筛选出主要核心靶点10个,富集分析得到的有效靶点主要参与癌症相关通路,糖尿病并发症相关AGE-RAGE、流体剪切应力与动脉粥样硬化、白细胞介素17、肿瘤坏死因子、PI3K-Akt、MAPK等信号通路。结论:复方血栓通胶囊主要通过调节氧化应激、炎症因子、新血管生成、细胞凋亡等过程治疗RVO。

Protection of Salvianolate Lyophilized Injection combined with Xueshuantong Injection (Lyophilized) against focal cerebral ischemia/reperfusion injury in rats through suppression of inflammatory response

Objective： Inflammatory reactions induced by microglia in the brain play an important part in the pathogenesis of focal cerebral ischemia/reperfusion （I/R） injury, resulting in neuronal death. Salvianolate Lyophilized Injection （SLI） and Xueshuantong Injection （Lyophilized） （XST）, which have been widely used in the treatment of acutely cerebral infarction clinically in China, exhibit various biological activities. In this study, the neuroprotective properties of SLI combined with XST in a rat model of middle cerebral artery occlusion- reperfusion （MCAO/R） were investigated. Methods： In this study, male Wistar rats were subjected to 1.5h of middle cerebral artery occlusion followed by reperfusion for 24 h. The rats were randomly divided into the following six groups： normal group （NOR）, model group （MOD）, SLI group （21 mg/kg, SLI）, ）（ST group （100 mg/kg, ）（ST）, SLI combined with XST （XST 100 mg/kg ＋ SLI 21 mg/kg, 1X1S）, and Edaravone （as a positive control drug, 6 mL/kg, EDI）, once a day for 3 d. The neuronal injury, the expression of glial fibrillary acidic protein （GFAP） and ionized calcium binding adaptor molecule 1 （IBA-1）, and the changes of pro-inflammatory mediators interleukin- 6 （IL-6）, tumor necrosis factor alpha （TNF-α） and anti-inflammatory mediator interleukin-10 （IL-10） were observed. Results： 1X1S treatment significantly increased the number of neuron, compared with the MOD group, SH group and XST group. Gliosis （GFAP and IBA-1） and expression of pro-inflammatory mediators IL-6 and TNF-a were significantly reduced. Meanwhile, 1XIS significantly increased the expression of anti- inflammatory mediator IL-10 in the brains of MCAO/R rats, compared with the MOD group, SLI and XST groups. SLI and XST also remarkably down-regulated the expression of IL-6 and TNF-α compared with the MOD group. Conclusions： This study shows that SLI combined with XST （1X1S） can protect cerebral ischemia- reperfusion injury due to its anti-inflammatory property, and may provide a potential promising new therapeutic strategy for acute ischemic stroke.

Effect of Fufang Xueshuantong Capsule(复方血栓通胶囊) on A Rat Model of Retinal Vein Occlusion

Objective：To establish a retinal vein occlusion（RVO） animal model and observe the therapeutic effect of a Chinese herbal composition（Fufang Xueshuantong Capsule,复方血栓通胶囊,FXC） in ischemic retinal disease.Methods：Fifteen adult male Sprague-Dawley rats underwent laser photothrombosis to induce RVO on their right eyes and were subsequently randomized to receive FXC（the intervention group,n=7） or placebo treatment（the control group,n=8）.Fundus fluorescein angiography was performed after 2,4 and 8 weeks of treatment.Real-time reverse transcription-PCR was used to quantify the mRNA expression of vascular endothelial growth factor（VEGF） and stromal cell-derived factor-1（SDF-1）.The main outcomes were the mRNA copies of VEGF and SDF-1 and the counts of RVO signs.Results：Laser photothrombosis procedure induced typical lesions of RVO,including hemorrhage,leakage,retinal detachment,capillary non-perfusion,filling defect of retinal vessels,and lateral circulation/dilation of small vessels.The retinal lesions were associated with an increased expression of VEGF（P0.05）.No significant change of SDF-1 expression was noticed.Compared with the control group,the intervention group had numerically fewer RVO lesions at week 2（1.71±0.76 vs.3.50±1.51,t=-2.82,P0.05）.The benefit of intervention remained at weeks 4 and 8.Conclusions：A rat model of laser photothrombosis-induced RVO was established and an increase in the VEGF expression was observed in the retinal lesion.The FXC had therapeutic benefit in improving retinal lesions in the rat model of RVO.

Xueshuantong for Injection(Lyophilized,注射用血栓通)Alleviates Streptozotocin-Induced Diabetic Retinopathy in Rats

Objective To investigate the ameliorate effect and underlying mechanism of Xueshuantong for Injection(Lyophilized,注射用血栓通,XST)in streptozocin(STZ)-induced diabetic retinopathy(DR)rats.Methods Diabetes mellitus(DM)model was induced by intraperitoneal(i.p.)injection of STZ(60 mg/kg)in Sprague-Dawley rats.Diabetic rats were randomized into 3 groups(n=10)according to a random number table,including DM,XST50 and XST100 groups.XST treatment groups were daily i.p.injected with 50 or 100 mg/kg XST for 60 days,respectively.The control and DM groups were given i.p.injection with saline.Blood glucose level and body weight were recorded every week.Histological changes in the retina tissues were observed with hematoxylin-eosin staining.Apoptosis and inflammation related factors,including cleaved caspase-3,glial fifibrillary acidic protein(GFAP),tumor necrosis factor-α(TNF-α)and intercellular cell adhesion molecule-1(ICAM-1)were detected by Western blot or real-time polymerase chain reaction.Then,the levels of advanced glycation end product(AGE)and its receptor(RAGE)were investigated.Tight junctions proteins(Zonula occludens-1(ZO-1),Occludin and Claudin-5)of blood-retinal barrier were detected by Western blot.The levels of retinal fifibrosis,transforming growth factor-β1(TGF-β1)-Smad2/3 signaling pathway were evaluated at last.Results There was no signifificant difference in the body weight and blood glucose level between XST and DM groups(P>0.05).Compared with the DM group,XST treatment signifificantly increased the retinal thickness of rats(P<0.05 or P<0.01),and suppressed cleaved caspase-3 expression(P<0.01).XST increased the protein expressions of ZO-1,Occludin and Claudin-5 and decreased the mRNA expressions of matrix metalloproteinase 2(MMP-2)and MMP-9(P<0.05 or P<0.01).Moreover,XST signifificantly reduced the productions of AGE and RAGE proteins in the retina of rats(P<0.05 or P<0.01),suppressed the over-expression of TNF-α,and decreased the elevated level of ICAM-1 in retina of rats(P<0.05 or P<0.01).XST signifificantly reduced the levels ofα-smooth muscle actin(α-SMA),connective tissue growth factor(CTGF),TGF-β1 and phosphorylation of Smad2/3 protein in rats(P<0.05 or P<0.01).Conclusions XST had protective effects on DR with possible mechanisms of inhibiting the inflammation and apoptosis,up-regulating the expression of tight junction proteins,suppressing the productions of AGE and RAGE proteins,and blocking the TGF-β/Smad2/3 signaling pathway.XST treatment might play a role for the future therapeutic strategy against DR.

血栓通联合阿替普酶治疗急性脑梗死的效果及对脑血流动力学的影响

目的分析血栓通联合阿替普酶治疗急性脑梗死的效果及对脑血流动力学的影响。方法选取2015年4月至2021年10月收治的200例急性脑梗死患者为研究对象,对其进行编号,依据编号的奇偶性将其分为对照组和观察组,各100例。对照组采用阿替普酶治疗,观察组在对照组基础上联合血栓通治疗。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的全血高切黏度(HBV)、全血低切黏度(LBV)、血细胞比容(HCT)及血沉(ESR)低于对照组(P<0.05)。治疗后,观察组椎动脉(VA)和双侧大脑中动脉(MCA)的平均血流速度(Vm)及收缩期峰流速度(Vs)高于对照组,美国国立卫生研究院卒中量表(NIHSS)评分低于对照组(P<0.05)。治疗后,观察组的S-100β、内皮缩血管肽-1(ET-1)、可溶性细胞间黏附分子-1(sICAM-1)及神经元特异性烯醇化酶(NSE)水平低于对照组(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论血栓通联合阿替普酶治疗急性脑梗死的效果良好,可改善患者的脑血流动力学、血液流变学指标,提升神经功能,且安全性理想,具有重要应用价值。

复方脑肽节苷脂联合血栓通治疗缺血性脑卒中的效果

目的探讨复方脑肽节苷脂联合血栓通治疗缺血性脑卒中(IS)的效果。方法选取2023年2月至2023年10月本院收治的80例IS患者,按照抽签法分为两组。对照组采用血栓通治疗,观察组采用复方脑肽节苷脂联合血栓通治疗。比较两组的治疗效果、认知功能、日常生活能力和炎性因子。结果两组的总有效率比较无统计学差异(P>0.05)。治疗后,两组MMSE、BI评分升高,且观察组MMSE、BI评分高于对照组(P<0.05)。治疗后,两组的IL-10水平升高,TNF-α、NSE水平降低,且观察组IL-10水平高于对照组,TNF-α、NSE水平低于对照组(P<0.05)。结论复方脑肽节苷脂联合血栓通治疗可改善IS患者的认知功能及日常生活能力,抑制炎性因子。

Chemical Analysis of Xueshuantong Lyophilized Powder by LC-MS Profiling

Objective To elucidate the chemical components of Xueshuantong （XST） Lyophilized Powder and primarily disclose the chemical difference between XST and Panax notoginseng roots. Methods Liquid chromatography coupled with electrospray ionization tandem mass spectrometry （LC-ESI-MSn） was used to profile the saponins in XST and P. notoginseng. Structural elucidation was based on spectral analyses of negative and positive ESI-MS3 data, and the comparison of the retention behaviors. Results The optimized LC-MS profiling approach enabled resolution of major saponins. The negative mode ESI-MS3 fragmentation gave diagnostic information on the nature （neutral loss 162 Da for GIc, 146 Da for Rha, and 132 Da for a pentose） and sequence （priority： terminal 〉 inner） of sugars and sapogenins （m/z 475 for protopanaxatriol; re^z459 for protopanaxadiol）, while the intact glycosyl portion could be characterized by characteristic Zoα, Cnnα＋, and Cnβ＋ （n = 2 or 3） obtained in the positive mode. Ultimately, a total of 30 saponins were characterized from XST. Compared with the roots of P. notoginseng, three malonyl-ginsenosides, ginsenoside Rd, and gyponoside XVII （or its isomer） were almost undetectable, and showed potential significance for their differentiation. Conclusion The established LC-MS profiling approach is powerful for the chemical analysis of P. notoginseng and its preparations such as XST.

复方血栓通胶囊联合雷珠单抗治疗糖尿病视网膜病变的疗效及对血清hs-CRP、Ang-2水平的影响

目的:探究复方血栓通胶囊联合雷珠单抗治疗糖尿病视网膜病变(Diabetic retinopathy,DR)的疗效及对促血管生成素(Angiopoietin-2,Ang-2)以及超敏C-反应蛋白(High-sensitivity C-reactive protein,hs-CRP)水平的影响。方法:选取2019年6月至2021年12月于我院确诊120例的双眼糖尿病视网膜病变患者作为研究对象,应用随机抽样法分为观察组和对照组,各60例(120眼)。对照组采用雷珠单抗注射治疗;观察组在对照组基础上增加口服复方血栓通胶囊。比较两组患者治疗前后的hs-CRP、Ang-2水平变化、黄斑中心凹厚度(Central macular thickness,CMT)、最佳矫正视力(Best-corrected visual acuity,BCVA)以及不良反应发生率。结果:治疗6 m后,两组患者hs-CRP水平、CMT明显下降,且观察组明显低于对照组(P<0.05);两组患者Ang-2水平、视力水平明显上升,且观察组明显高于对照组(P<0.05)。治疗后,观察组视力提高占比明显高于对照组,视力下降患者占比明显少于对照组(P<0.05)。两组不良反应总发生率无明显差异(P>0.05)。结论:复方血栓通胶囊联合雷珠单抗应用于糖尿病视网膜病变患者可有效降低hs-CRP、Ang-2水平,减轻视网膜水肿,提高患者视力,改善患者视功能,大大提高患者的生活质量。

利伐沙班联合血栓通胶囊调控血栓调节蛋白表达抑制大鼠深静脉血栓形成的机制研究

目的研究利伐沙班联合血栓通胶囊对大鼠深静脉血栓的抑制作用。方法大鼠随机分为对照组、深静脉血栓模型组、利伐沙班组、血栓通胶囊组和利伐沙班联合血栓通胶囊组,每组12只。除对照组外,其余小鼠进行DVT造模。对照组和深静脉血栓模型组灌胃3 mL生理盐水;利伐沙班组灌胃2.6 mg/kg利伐沙班片;血栓通胶囊组灌胃0.45 g/kg血栓通胶囊;利伐沙班联合血栓通胶囊组灌胃2.6 mg/kg利伐沙班片和0.45 g/kg血栓通胶囊。连续给药7 d。观察凝血指标、血管内皮细胞组织、血栓质量,ELISA法和qRT-PCR检测TM、MCP-1、ICAM-1表达水平。结果与模型组、利伐沙班组和血栓通胶囊组相比,联合组APTT、PT、TT显著升高,FIB含量显著降低;血栓湿质量和干质量明显减少;TM、MCP-1、ICAM-1表达水平明显降低。内皮细胞组织切片显示联合组细胞结构损伤轻微,有极少炎症细胞附着(均P<0.05)。结论利伐沙班联合血栓通胶囊可提高血栓调节蛋白表达,抑制大鼠深静脉血栓损伤。

血栓通注射液对急性脑梗死患者脑血流动力学及血清学指标的影响

目的探讨血栓通注射液对急性脑梗死患者脑血流动力学及血清学指标的影响。方法将160例2022年1月-2022年12月伊犁州奎屯医院神经内科收治的急性脑梗死患者随机纳入对照组和试验组,各80例。经脱落或剔除后纳入120例患者进行研究,其中对照组50例、试验组70例。对照组给予西医常规治疗,试验组在对照组基础上给予血栓通注射液进行治疗,2组均治疗2周。比较2组治疗2周后的临床疗效;治疗前和治疗2周后的神经功能、自理能力、脑血流动力学、血清学指标及治疗期间的不良反应。结果试验组治疗2周后的总有效率为94.29%,高于对照组的80.00%(P<0.05);治疗2周后,2组美国国立卫生院神经功能缺损评分(National Institutes of Health Stroke Scale,NIHSS)、改良Rankin量表(Modified Rankin Scale,mRS)评分、左侧颈总动脉动态阻力(dynamic resistance,DR)、外周阻力(peripheral resistance,Rv)及血清钙结合蛋白β(calcium-binding proteinβ,S-100β)、神经元特异性烯醇化酶(neuron specific enolase,NSE)、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)、同型半胱氨酸(homocysteine,Hcy)水平与治疗前比较降低,且试验组低于对照组(P<0.05);2组日常生活活动能力(activities of daily living,ADL)评分及左侧颈总动脉平均血流速率(Vm)、平均血流量(Qm)与治疗前比较升高,且试验组高于对照组(P<0.05)。结论血栓通注射液可明显改善急性脑梗死患者脑血流动力学,调节血清学指标水平变化,进而有助于促进患者神经功能、炎症反应和自理能力的改善,提高临床疗效,且并未明显增加患者的不良反应。

川芎嗪联合血栓通治疗缺血性脑卒中的效果分析

目的分析对缺血性脑卒中患者合用川芎嗪及血栓通的治疗价值。方法76例缺血性脑卒中患者,借助随机数字表法分为对照组与观察组,均为38例。对照组患者应用川芎嗪治疗,观察组患者合用川芎嗪、血栓通治疗。对比两组患者的临床疗效及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、血流变学指标[纤维蛋白原(Fib)、血浆粘度(PV)以及血小板聚集率(PAG)]、Fugl-Meyer评分、Barthel指数。结果治疗后,两组NIHSS评分均较本组治疗前降低,且观察组NIHSS评分(8.13±1.06)分低于对照组的(12.25±1.43)分(P<0.05)。观察组治疗总有效率为97.37%,高于对照组的84.21%(P<0.05)。治疗后,观察组Fib(2.15±0.50)g/L、PV(1.16±0.26)mPa·s以及PAG(35.26±10.07)%低于对照组的(3.13±0.59)g/L、(1.32±0.29)mPa·s、(46.39±11.19)%(P<0.05)。治疗后,观察组Fugl-Meyer评分(73.69±6.17)分、Barthel指数(69.97±5.58)分均高于对照组的(62.37±5.19)、(58.76±6.72)分(P<0.05)。结论对缺血性脑卒中患者合用川芎嗪以及血栓通进行治疗有助于更好地恢复患者的神经功能,提升自理能力以及运动功能,且有助于改善血流变学指标,并提升整体疗效。

血栓通注射液联合阿替普酶治疗急性缺血性脑血管病临床疗效

目的观察血栓通注射液联合阿替普酶治疗急性缺血性脑血管病临床效果及对血清肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)的影响。方法纳入医院2018年3月—2021年5月期间90例急性缺血性脑血管病患者,采用随机数字表法分为观察组和对照组各45例。对照组予以阿替普酶治疗,观察组联合血栓通注射液治疗,两组用药疗程均为2周。比较两组临床疗效,治疗前、治疗2周后神经功能缺损(NIHSS)与生活能力[Barthel指数(BI)]量表评分、血液流变学、血清生化指标(TNF-α、IL-1β)水平变化。结果治疗2周后,观察组治疗总有效率高于对照组(P<0.05);两组NIHSS评分、血液流变学指标及血清TNF-α、IL-1β均较治疗前降低,且观察组低于对照组,BI评分均较治疗前升高,且观察组高于对照组(P<0.05)。结论血栓通注射液联合阿替普酶治疗急性缺血性脑血管病疗效确切,可改善血液流变学指标,抑制炎症反应,减轻神经功能损伤。