杨洋, 阮甦, 梁晖, 陈巧兰, 严年文, 黄燕苹. 基于BDNF通路探讨化痰通络汤治疗卒中后认知功能障碍的研究[J]. 南京中医药大学学报, 2024, 40(9): 979-984. DOI: 10.14148/j.issn.1672-0482.2024.0979
引用本文: 杨洋, 阮甦, 梁晖, 陈巧兰, 严年文, 黄燕苹. 基于BDNF通路探讨化痰通络汤治疗卒中后认知功能障碍的研究[J]. 南京中医药大学学报, 2024, 40(9): 979-984. DOI: 10.14148/j.issn.1672-0482.2024.0979
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YANG Yang, RUAN Su, LIANG Hui, CHEN Qiaolan, YAN Nianwen, HUANG Yanping. Clinical Study of Huatan Tongluo Decoction in the Treatment of Post-Stroke Cognitive Impairment Based on BDNF Pathway[J]. Journal of Nanjing University of traditional Chinese Medicine, 2024, 40(9): 979-984. DOI: 10.14148/j.issn.1672-0482.2024.0979
Citation: YANG Yang, RUAN Su, LIANG Hui, CHEN Qiaolan, YAN Nianwen, HUANG Yanping. Clinical Study of Huatan Tongluo Decoction in the Treatment of Post-Stroke Cognitive Impairment Based on BDNF Pathway[J]. Journal of Nanjing University of traditional Chinese Medicine, 2024, 40(9): 979-984. DOI: 10.14148/j.issn.1672-0482.2024.0979
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基于BDNF通路探讨化痰通络汤治疗卒中后认知功能障碍的研究

Clinical Study of Huatan Tongluo Decoction in the Treatment of Post-Stroke Cognitive Impairment Based on BDNF Pathway

    摘要
  • 摘要:
    目的 观察化痰通络汤治疗卒中后认知功能障碍(PSCI)痰瘀阻络证的临床疗效及其对患者血清脑源性神经营养因子(BDNF)通路相关因子的影响。
    方法 收集符合纳入标准的患者60例，随机分为对照组和治疗组各30例。对照组予基础治疗和尼莫地平治疗，治疗组在对照组治疗基础上加服化痰通络汤，2组疗程均为4周。治疗前后比较2组简易精神状态评价量表(MMSE)、中医证候积分及血清BDNF、核转录因子κB(NF-κB)、B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关X蛋白(Bax)水平变化，治疗后评估2组患者中医临床疗效，治疗期间观察2组患者不良反应发生情况。
    结果 治疗后，2组患者MMSE评分显著增加，中医证候积分总积分明显降低(P＜0.01)，治疗组优于对照组(P＜0.01)；2组患者血清BDNF、NF-κB、Bcl-2水平明显升高(P＜0.05，P＜0.01)，Bax水平明显下降(P＜0.01)，治疗组优于对照组(P＜0.01)。
    结论 化痰通络汤能够改善痰瘀阻络型PSCI患者临床症状，安全有效，其疗效机制可能与调控BDNF通路，抑制神经细胞凋亡有关。

     

    Abstract:
    OBJECTIVE To observe the clinical efficacy of Huatan Tongluo Decoction in the treatment of post-stroke cognitive impairment (PSCI) with phlegm stasis obstructing collaterals syndrome, and its influence on the serum brain-derived neurotrophic factor (BDNF) pathway-related factors.
    METHODS Sixty patients who met the inclusion criteria were collected and randomly divided into a control group and a treatment group with 30 patients each. The control group was given basic treatment and nimodipine, while the treatment group was given Huatan Tongluo Decoction on the basis of the treatment in the control group. The treatment course for both groups was 4 weeks. Changes in Mini-Mental State Examination (MMSE), TCM syndrome scores and serum levels of BDNF, nuclear transcription factor κB(NF-κB), B lymphocyte tumor-2 (Bcl-2) and Bcl-2-associated X protein (Bax) were compared between the two groups before and after treatment. The TCM clinical efficacy in the two groups of patients was evaluated after treatment, and the occurrence of adverse reactions was observed during treatment.
    RESULTS After treatment, the MMSE scores of the patients in the two groups increased significantly, the total TCM syndrome scores decreased significantly (P < 0.01), and the treatment group was better than the control group (P < 0.01); the serum BDNF, NF-κB, and Bcl-2 levels of the two groups of patients were significantly increased (P < 0.05, P < 0.01), and the Bax level was significantly decreased (P < 0.01). The treatment group was better than the control group (P < 0.01).
    CONCLUSION Huatan Tongluo Decoction can improve the clinical symptoms of PSCI patients with phlegm stasis obstructing collaterals, and is safe and effective. Its therapeutic mechanism may be related to regulating the BDNF pathway to protect nerve cells and inhibit nerve cell apoptosis.

     

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