中药补阳还五汤熏蒸治疗脑梗死机制的研究

王有科+覃兴乐+唐汉庆+农峰+蓝娇娜+黄岑汉

【摘要】目的探讨中药补阳还五汤熏蒸对脑梗死治疗作用的分子机制。

方法选择41例脑梗死患者，在中药补阳还五汤熏蒸治疗前后分别采集血清进行双抗体夹心酶联免疫吸附法（ELISA）检测，比较治疗前后患者血清血管内皮生长因子（VEGF）和脑源性神经营养因子（BDNF）的表达水平，分析VEGF、BDNF表达水平之间的线性关系。

结果治疗前后患者血清VEGF、BDNF表达水平差异有统计学意义（P<0.01），治疗后血清VEGF、BDNF表达水平显著高于治疗前。血清VEGF、BDNF表达水平相关不显著（P>0.05）。

结论中药补阳还五汤熏蒸治疗可显著升高脑梗死患者血清VEGF、BDNF表达水平，提示其可能对脑梗死具有较好的治疗作用。

【关键词】中药熏蒸；补阳还五汤；脑梗死

中图分类号：R743.33文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.007

【Abstract】ObjectiveTo explore the molecular mechanism of treatment effect of Buyang Huanwu Decoction on cerebral infarction.

Methods41 patients with cerebral infarction were selected，and double antibody sandwich enzymelinked immunosorbant assay（ELISA） was used to detect serums which were respectively collected before and after treatment.In addition，expression levels of vascular endothelial growth factor（VEGF） and brain derived neurotrophic factor（BDNF） were compared before and after treatment，and linear relationship between the expression levels of the VEGF and BDNF was analyzed.

ResultsBefore and after treatment，difference of the expression levels of VEGF and BDNF was statistically significant（P<0.01），and after treatment，the expression levels of them were significantly higher than those before treatment.There was no significant correlation between the expression levels of serum VEGF and BDNF（P>0.05）.

ConclusionTraditional Chinese medicine Buyang Huanwu Decoction can significantly increase the expression levels of serum VEGF and BDNF in patients with cerebral infarction，which suggests that it may have a better therapeutic effect on cerebral infarction.

【Key words】traditional Chinese medicine fumigation；Buyang Huanwu Decoction；cerebral infarction

腦卒中主要分出血性和缺血性。我国现有脑卒中患者约700万例，其中缺血性脑卒中（即脑梗死）占比最高，约为80%[1]，仅脑卒中治疗费用即约400亿元/年[2]。国内外对脑梗死进行了大量的研究，但治疗上仍未获得重大突破，目前仍没有确切的治疗方法来减轻神经损伤，多年来唯一被美国FDA 批准用于脑卒中的药物只有组织纤溶酶原激活剂（tPA）[3]。从我国传统中药材或复方中筛选多靶点药物是一个较好的研究方向，对于传统医药资源保护和攻克脑卒中均具有重要意义[4]。在使用西药的基础上联合口服或鼻饲中药补阳还五汤，能显著促进脑梗死患者的神经功能恢复[5]。近年来，采用中药熏蒸治疗脑卒中取得了良好的效果，但研究主要是对其疗效做局部机理的探讨，认识停留在宏观甚至仅仅限于推理。……