摘要
目的基于核转录因子(NF-κB)信号通路探究复方丹参滴丸联合丁苯酞对急性脑梗死(ACI)患者炎性反应的影响。方法选取2020年7月至2022年5月平顶山市第一人民医院收治的ACI患者118例,按随机数表法分为观察组和对照组各59例。对照组患者予以丁苯酞注射液治疗,观察组患者在对照组治疗的基础上联合复方丹参滴丸治疗,均连续治疗两周。治疗两周后,比较两组患者的疗效,以及治疗前、治疗一周后、两周后的美国国立研究院卒中量表(NIHSS)、简易智能状态量表(MMSE)、Barthel指数(BI)评分、脑神经因子[神经生长因子(NGF)及神经营养因子(NTF)]、NF-κB信号通路相关蛋白、mRNA和NF-κB信号通路相关因子[白细胞介素(IL)-1β、IL-6、IL-8、肿瘤坏死因子(TNF)-α]水平,同时比较两组患者治疗期间的不良反应发生情况。结果观察组患者的临床治疗总有效率为94.92%,明显高于对照组的81.36%,差异有统计学意义(P<0.05);治疗一周和两周后,两组患者的NIHSS评分均呈下降趋势,且观察组明显低于对照组,MMSE及BI评分呈升高趋势,且观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗一周和两周后,两组患者的NGF、NTF均呈升高趋势,且观察组明显高于对照组,差异均有统计学意义(P<0.05);治疗一周后、两周后,两组患者的NF-κB p50蛋白、NF-κB p50 mRNA、NF-κB p65蛋白、NF-κB p65 mRNA均呈下降趋势,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗一周后、两周后,两组患者的NF-κB信号通路相关因子IL-1β、IL-6、IL-8、TNF-α均呈下降趋势,且观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗期间,观察组患者不良反应总发生率为11.86%,略高于对照组的8.47%,但差异无统计学意义(P>0.05)。结论复方丹参滴丸联合丁苯酞可通过调控NF-κB信号通路,抑制炎性反应,加速神经功能缺损恢复,临床应用效果显著且安全性较高。
Objective To explore the influence of compound Danshen(Salvia miltiorrhiza)dripping pills combined with butylphthalide on inflammatory response in patients with acute cerebral infarction(ACI)based on nuclear transcription factor(NF-κB)signaling pathway.Methods A total of 118 ACI patients admitted to the First People's Hospital of Pingdingshan City from July 2020 to May 2022 were selected and randomly divided into an observation group and a control group,with 59 patients in each group.Patients in the control group were treated with butylphthalide injection,while those in the observation group were treated with compound Salvia miltiorrhiza dripping pills in addition to the treatment in the control group.Both groups of patients were treated continuously for 2 weeks.After treatment,the efficacy was compared between the two groups,as well as the National Institutes of Health Stroke Scale(NIHSS),Mini-mental State Examination(MMSE),Barthel Index(BI)scores,brain nerve factors[nerve growth factor(NGF)and neurotrophic factor(NTF)],NF-κB signaling pathway-related proteins,mRNA,and NF-κB signaling pathway-related factors[interleukin(IL)-1β,IL-6,IL-8,tumor necrosis factor(TNF)-α]levels before treatment,after 1 week of treatment,and after 2 weeks of treatment.At the same time,the adverse reactions during treatment were also compared between the two groups.Results The total effective rate of clinical treatment in the observation group was 94.92%,significantly higher than 81.36% in the control group(P<0.05).After 1 and 2 weeks of treatment,the NIHSS scores of both groups of patients showed a downward trend,and the scores in the observation group were significantly lower than those in the control group;the MMSE and BI scores showed an upward trend,and the scores in the observation group were significantly higher than those in the control group;the differences were statistically significant(P<0.05).After 1 and 2 weeks of treatment,the NGF and NTF of both groups of patients showed an increasing trend,and the levels in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).After 1 week and 2 weeks of treatment,the levels of NF-κB p50 protein,NF-κB p50 mRNA,NF-κB p65 protein,NF-κB p65 mRNA of both groups of patients showed a decreasing trend,and the levels in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).After 1 week and 2 weeks of treatment,the levels of NF-κB signal pathway-related factors(IL-1β,IL-6,IL-8,TNF-α)of both groups of patients showed a downward trend,and the levels in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).During the treatment period,the total incidence of adverse reactions in the observation group was 11.86%,slightly higher than 8.47% in the control group(P>0.05).Conclusion Compound Salvia miltiorrhiza dripping pill combined with butylphthalide can inhibit inflammatory response and accelerate the recovery of neurological function defects by regulating NF-κB signaling pathway,with significant clinical application effect and high safety.
作者
郭恩会
刘凯
闫向格
张豪杰
赵志华
GUO En-hui;LIU Kai;YAN Xiang-ge;ZHANG Hao-jie;ZHAO Zhi-hua(The Third Ward of the Department of Neurology,the First People's Hospital of Pingdingshan City,Pingdingshan 467000,Henan,CHINA;Department of Neurorehabilitation,China Rehabilitation Research Center(Beijing Boai Hospital),Beijing 100068,CHINA)
出处
《海南医学》
CAS
2024年第3期314-319,共6页
Hainan Medical Journal
基金
河南省科技攻关项目(编号:222102211237)。
关键词
急性脑梗死
复方丹参滴丸
丁苯酞
核转录因子信号通路
炎性反应
Acute cerebral infarction
Compound Salvia miltiorrhiza dropping pills
Butylphthalide
Nuclear transcription factor signaling pathway
Inflammatory response
