脉管复康胶囊通过调节内质网应激-自噬对缺血性脑卒中后遗症患者神经功能的影响

The effect of Maiguan Fukang capsule on neurological function in patients with ischemic stroke sequelae by regulating endoplasmic reticulum stress- autophagy

关键词:  脉管复康胶囊  缺血性卒中后遗症  内质网应激  自噬  神经功能

Key words:  Maiguan Fukang Capsules  ischemic stroke sequelae  endoplasmic reticulum stress  autophagy  neurological function

摘要:

[目的] 探究脉管复康对缺血性卒中后遗症患者的神经恢复的促进作用以及对内质网应激-自噬的调节作用。[方法] 2019年2月—2023年2月邢台市中心医院收治的124例缺血性卒中后遗症患者被随机分为观察组和对照组，每组62例。对照组进行基础治疗，观察组采用基础治疗联合脉管复康胶囊口服。治疗8周后评价神经功能、中医证候积分、临床疗效、血流流变学指标、炎症因子以及内质网应激-自噬相关基因mRNA和蛋白的表达。[结果] 治疗后观察组美国国立卫生研究院卒中量表（NIHSS）显著低于对照组，Fugl-Meyer评分和Barthel指数（BI）显著高于对照组（P＜0.05），中医证候积分和总有效率显著高于对照组（P＜0.05）。治疗后观察组全血黏度、纤维蛋白原、脑血管外周阻力显著低于对照组，中动脉和基底动脉平均血流速度显著高于对照组（P＜0.05）。治疗后观察组白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）均显著低于对照组（P＜0.05）。治疗后观察组蛋白激酶样内质网激酶（PERK）、α亚基的真核起始因子（eif2 α）、内质网分子伴侣糖调节蛋白78（GRP78） mRNA以及p-PERK 蛋白、p-Eif2α蛋白、GRP78蛋白表达显著低于对照组，Beclin1、LC3 Ⅱ、Bax的mRNA和蛋白表达均显著低于对照组，Bcl-2 mRNA和蛋白表达均显著高于对照组（P＜0.05）。[结论] 脉管复康胶囊能通过改善脑动脉血液循环、降低血液黏稠度、减轻炎症反应来改善缺血性卒中后遗症患者的神经功能，并抑制内质网应激-自噬信号通路mRNA和蛋白的表达。

Abstract:

[Objective] To investigate the promoting effect of Maiguan Fukang capsule on neurological recovery and its regulatory effect on endoplasmic reticulum stress-autophagy in patients with ischemic stroke sequelae.[Methods] From February 2019 to February 2023,124 patients with ischemic stroke sequelae admitted to our hospital were randomly divided into an observation group and a control group,with 62 cases in each group. The control group received basic treatment,while the observation group received basic treatment combined with oral administration of Maiguan Fukang capsules. After 8 weeks of treatment,neurological function,traditional Chinese medicine syndrome score,clinical efficacy,hemorheological indicators,inflammatory factors,and the mRNA and protein expression of endoplasmic reticulum stress-autophagy related genes were evaluated.[Results] After treatment,the NIHSS score of the observation group was significantly lower than that of the control group,while the Fugl-Meyer score and BI index were significantly higher(P<0.05). The TCM syndrome score and total effective rate were significantly higher than those of the control group(P<0.05). After treatment,the whole blood viscosity,fibrinogen,and peripheral cerebrovascular resistance in the observation group were significantly lower,while the mean blood flow velocity in the middle and basilar arteries was significantly higher(P<0.05). The levels of IL-6,hs-CRP,and TNF-α in the observation group were significantly lower than those in the control group(P<0.05). After treatment,the mRNA levels of protein kinase R-like endoplasmic reticulum kinase(PERK),the α subunit of eukaryotic initiation factor 2(eif2α),glucose-regulated protein 78(GRP78),as well as the protein expression of p-PERK,p-eif2α,and GRP78 in the observation group were significantly lower than those in the control group. The mRNA and protein expressions of Beclin1,LC3 Ⅱ,and Bax were significantly lower,while the mRNA and protein expressions of Bcl-2 were significantly higher(P<0.05).[Conclusion] Maiguan Fukang capsule can improve neurological function in patients with ischemic stroke sequelae by improving cerebral arterial circulation,reducing blood viscosity,and alleviating inflammatory responses,and it inhibits the mRNA and protein expression of the endoplasmic reticulum stress-autophagy signaling pathway.