苦碟子注射液对急性脑梗死患者血清神经递质的影响
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摘要
目的观察急性脑梗死患者入院后第1、3、5、14天血清中神经递质的含量变化,研究苦碟子注射液的治疗作用。方法发病时间≤48 h的急性脑梗死患者,随机分为基础治疗组(20例),基础治疗+苦碟子注射液组(20例),共40例。采集患者入院后第1、3、5、14天血清,超高效液相四级杆飞行时间质谱法(UPLC-Q-TOF-MS)检测血清谷氨酸(Glu)、5-羟色胺(5-HT)浓度。结果随着治疗时间的延长,苦碟子注射液可明显降低患者血清5-HT及Glu浓度,且与基础治疗组相对应时间点比较,苦碟子注射液组第3、14天血清5-HT浓度及第5、14天血清Glu浓度明显低于基础治疗组(P<0.05),且治疗14 d后,苦碟子注射液组较基础治疗组血清Glu浓度显著降低(P<0.05)。结论苦碟子注射液可较早地降低急性脑梗死患者血清Glu、5-HT浓度。
Objective To observe changes of serum neurotransmitters in patients with acute cerebral infarction on the 1 st,3 rd,5 thand 14 thdays after admission,and to study the therapeutic effects of the Kudiezi( KDZ) injection. Methods Forty patients with acute cerebral infarction within 48 hours were recruited and randomly divided into routine treatment group( n = 20),routine treatment + KDZ injection group( n = 20). Patient serum samples were collected on the1 st,3 rd,5 th,and 14 thdays to measure concentration of glutamate( Glu) and 5-hydroxytryptamine( 5-HT) by using UPLC-Q-TOF-MS. Results Kudiezi injection could significantly decrease the concentration of 5-HT and Glu over time. Concentrations of Glu at day 5 and 14 and 5-HT in KDZ treatment group at day 3 and 14 were significantly lower than those in the routine treatment group at the same time( P < 0. 05); and after 14 days of treatment,the concentration of Glu decreased significantly in the KDZ treatment group( P < 0. 05). Conclusion Kudiezi injection can significantly reduce the serum concentrations of Glu and 5-HT in acute cerebral infarction patientsat early time.
Objective To observe changes of serum neurotransmitters in patients with acute cerebral infarction on the 1 st,3 rd,5 thand 14 thdays after admission,and to study the therapeutic effects of the Kudiezi( KDZ) injection. Methods Forty patients with acute cerebral infarction within 48 hours were recruited and randomly divided into routine treatment group( n = 20),routine treatment + KDZ injection group( n = 20). Patient serum samples were collected on the1 st,3 rd,5 th,and 14 thdays to measure concentration of glutamate( Glu) and 5-hydroxytryptamine( 5-HT) by using UPLC-Q-TOF-MS. Results Kudiezi injection could significantly decrease the concentration of 5-HT and Glu over time. Concentrations of Glu at day 5 and 14 and 5-HT in KDZ treatment group at day 3 and 14 were significantly lower than those in the routine treatment group at the same time( P < 0. 05); and after 14 days of treatment,the concentration of Glu decreased significantly in the KDZ treatment group( P < 0. 05). Conclusion Kudiezi injection can significantly reduce the serum concentrations of Glu and 5-HT in acute cerebral infarction patientsat early time.
引文
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[13]刘思燚,张秀平,尚展鹏,等.UHPLC-LTQ-Orbitrap鉴定苦碟子注射液化学成分及其在大鼠血浆中的移行成分[J].中国中药杂志,2016,41(12):2235-2244.Liu SY,Zhang XP,Shang ZP,et al.Rapid characterization of chemical constituents and rats metabolites of Kudiezi injection by UHPLC-LTQ-Orbitrap[J].China Journal of Chinese Materia Medica,2016,41(12):2235-2244.
[14]马思萌,刘睿,任晓亮,等.HPLC-DAD同时测定苦碟子注射液中7种黄酮类成分含量[J].中国实验方剂学杂志,2014,20(7):63-66.Ma SM,Liu R,Ren XL,et al.Simultaneous Determination of Seven Flavonoids Constitutes in Kudiezi Injection by RP-HPLC-DAD[J].Chinese Journal of Experimental Traditional Medical Formulae,2014,20(7):63-66.
[15]毛建生.苦碟子注射液对心脑血管疾病的药理作用及临床应用[J].中华老年心脑血管病杂志,2007,9(8):572-573.Mao JS.The pharmacological effect and clinical application of Kudiezi injection on cardiovascular and cerebrovascular diseases[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2007,9(8):572-573.
[16]蒋亚斌,陈克家.碟脉灵注射液治疗急性脑梗死的系统评价[J].中国组织工程研究,2006,10(27):100-101.Jiang YB,Chen KJ.The systematic evaluation of the treatment of acute ischemic stroke by Die Mailing injection[J].Chinese Journal of Tissue Engineering Research,2006,10(27):100-101.
[17]郭国志.苦碟子注射液在急性脑梗死患者治疗中的应用研究[J].吉林医学,2016,37(9):2264-2265.Guo GZ.Application of Kudiezi Injection in the Treatment of Patients with Acute Ischemic Stroke[J].Jilin Medical Journal,2016,37(9):2264-2265.
[18]尹彩萍,倪桂莲,朱玲.苦碟子注射液治疗老年急性脑梗死的临床疗效及对血液流变学的影响[J].浙江中医杂志,2015,50(4):267-268.Yin CP,Ni GL,Zhu L.The clinical curative effect and effect on hemorheology of senile patients with acute ischemic stroke[J].Zhejiang Journal of Traditional Chinese Medicine,2015,50(4):267-268.
[19]陈春光,贾洪丽,吕首旭,等.苦碟子注射液对大鼠急性脑缺血-再灌注损伤的保护作用[J].中国临床药理学杂志,2012,28(3):196-199.Chen CG,Jia HL,Lyu SX,et al.Protective effect of Kudiezi on acute cerebral ischemic reperfusion injury in rats[J].The Chinese Journal of Clinical Pharmacology,2012,28(3):196-199.
[20]梁晓,张允岭,王新祥,等.清热活血组分对急性脑梗死火毒证大鼠NF-κB炎症信号通路调控作用研究[J].北京中医药大学学报,2015,38(6):377-382.Liang X,Zhang YL,Wang XX,et al.Effects of heatclearing and blood-activating combination on acute cerebral ischemia of heat toxin pattern in rats via NF-κB signaling pathway[J].Journal of Beijing University of Traditional Chinese Medicine,2015,38(6):377-382.
[21]Liu XM,Zhang XY,Wang FL,et al.Improvement in cerebral ischemia-reperfusion injury through the TLR4/NF-κB pathway after Kudiezi injection in rats[J].Life Sciences,2017,191(15):132-140.
[2]解登梅,刘晓晴,李敏,等.缺血性脑卒中与神经递质的关系[J].中外医学研究,2011,9(15):154-157.Xie DM,Liu XQ,LI M,et al.The relationship between ischemic stroke and neurotransmitter[J].Chinese and Foreign Medical Research,2011,9(15):154-157.
[3]王巍巍,胡晶,王晶,等.苦碟子注射液配合常规西药治疗急性脑梗死的系统评价[J].中华中医药杂志,2014,29(4):1105-1108.Wang WW,Hu J,Wang J,et al.Systematic review of Kudieziinjection cooperate with conventional western medicine for acute cerebral infarction[J].China Journal of Traditional Chinese Medical and Pharmacy,2014,29(4):1105-1108.
[4]中华医学会神经病学分会脑血管病学组急性缺血脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国临床医生杂志,2011,43(3):67-73.Guideline drafting committee for the diagnosis and treatment of acute ischemic stroke,Neurology Branch of China Medical Society.Guidelines for diagnosis and treatment of acute ischemic stroke in China 2010[J].Chinese Journal for Clinicians,2011,43(3):67-73.
[5]Fonarow GC,Smith EE,Saver JL,et al.Timeliness of tissue-type plasminogen activatortherapy in acute ischemic stroke:patient characteristics,hospital factors,and outcomes associatedwith door-to-needle times within 60 minutes[J].Circulation,2011,123(7):750-758.
[6]Zhang F,Wu Y,Jia J,et al.Pre-ischemic treadmill training induces tolerance to brain ischemia:involvement of glutamate and ERK1/2[J].Molecules,2010,15(8):5246
[7]汪昌树,顾统元,黎明.急性脑卒中患者血浆5-羟色胺等物质改变的临床意义[J].卒中与神经疾病,1999,6(3):176-177.Wang CS,Gu TY,Li M.The clinical significance of plasma5-hydroxytryptamine in acute ischemic stroke patients[J].Stroke and Nervous Disease,1999,6(3):176-177.
[8]王展,石玉芝,王安心,等.缺血性卒中急性期血浆神经递质水平的病例对照研究[J].中国卒中杂志,2014,9(7):578-582.Wang Z,Shi YZ,Wang AX,et al.Plasma neurotransmitter levels in patients with acute ischemic stroke:Acase-controlstudy[J].Chinese Journal of Stroke,2014,9(7):578-582.
[9]De Jong JSG,Dekker LRC.Platelets and cardiac arrhythmia[J].Frontiers in Physiology,2010,1(1):166-169.
[10]Heistad DD,Mark AL,MARCUS ML,et al.Dietary treatment of atherosclerosis abolishes hyperresponsiveness to serotonin:implications for vasospasm[J].Circulation Research,1987,61(3):346-351.
[11]党连生,徐燕,王晓霞,等.谷氨酸与缺血性脑卒中早期进展关系的研究[J].中华老年心脑血管病杂志,2013,15(1):57-59.Dang LS,Xu Y,Wang XX,et al.Relation between glutamate level and early progression of ischemic cerebral stroke[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2013,15(1):57-59.
[12]杜杰.黄芪总苷和人参皂苷降低缺血性脑卒中患者脑脊液中谷氨酸、磷酸化Tau[J].东南大学学报(医学版),2017,36(5):828-832.Du J.A comparative study of the effect of total saponins of Astragalus and Panax ginseng saponins on the improvement of cognitive impairment in elderly patients with ischemic stroke[J].Journal of Southeast University(Medical Science Edition),2017,36(5):828-832.
[13]刘思燚,张秀平,尚展鹏,等.UHPLC-LTQ-Orbitrap鉴定苦碟子注射液化学成分及其在大鼠血浆中的移行成分[J].中国中药杂志,2016,41(12):2235-2244.Liu SY,Zhang XP,Shang ZP,et al.Rapid characterization of chemical constituents and rats metabolites of Kudiezi injection by UHPLC-LTQ-Orbitrap[J].China Journal of Chinese Materia Medica,2016,41(12):2235-2244.
[14]马思萌,刘睿,任晓亮,等.HPLC-DAD同时测定苦碟子注射液中7种黄酮类成分含量[J].中国实验方剂学杂志,2014,20(7):63-66.Ma SM,Liu R,Ren XL,et al.Simultaneous Determination of Seven Flavonoids Constitutes in Kudiezi Injection by RP-HPLC-DAD[J].Chinese Journal of Experimental Traditional Medical Formulae,2014,20(7):63-66.
[15]毛建生.苦碟子注射液对心脑血管疾病的药理作用及临床应用[J].中华老年心脑血管病杂志,2007,9(8):572-573.Mao JS.The pharmacological effect and clinical application of Kudiezi injection on cardiovascular and cerebrovascular diseases[J].Chinese Journal of Geriatric Heart Brain and Vessel Diseases,2007,9(8):572-573.
[16]蒋亚斌,陈克家.碟脉灵注射液治疗急性脑梗死的系统评价[J].中国组织工程研究,2006,10(27):100-101.Jiang YB,Chen KJ.The systematic evaluation of the treatment of acute ischemic stroke by Die Mailing injection[J].Chinese Journal of Tissue Engineering Research,2006,10(27):100-101.
[17]郭国志.苦碟子注射液在急性脑梗死患者治疗中的应用研究[J].吉林医学,2016,37(9):2264-2265.Guo GZ.Application of Kudiezi Injection in the Treatment of Patients with Acute Ischemic Stroke[J].Jilin Medical Journal,2016,37(9):2264-2265.
[18]尹彩萍,倪桂莲,朱玲.苦碟子注射液治疗老年急性脑梗死的临床疗效及对血液流变学的影响[J].浙江中医杂志,2015,50(4):267-268.Yin CP,Ni GL,Zhu L.The clinical curative effect and effect on hemorheology of senile patients with acute ischemic stroke[J].Zhejiang Journal of Traditional Chinese Medicine,2015,50(4):267-268.
[19]陈春光,贾洪丽,吕首旭,等.苦碟子注射液对大鼠急性脑缺血-再灌注损伤的保护作用[J].中国临床药理学杂志,2012,28(3):196-199.Chen CG,Jia HL,Lyu SX,et al.Protective effect of Kudiezi on acute cerebral ischemic reperfusion injury in rats[J].The Chinese Journal of Clinical Pharmacology,2012,28(3):196-199.
[20]梁晓,张允岭,王新祥,等.清热活血组分对急性脑梗死火毒证大鼠NF-κB炎症信号通路调控作用研究[J].北京中医药大学学报,2015,38(6):377-382.Liang X,Zhang YL,Wang XX,et al.Effects of heatclearing and blood-activating combination on acute cerebral ischemia of heat toxin pattern in rats via NF-κB signaling pathway[J].Journal of Beijing University of Traditional Chinese Medicine,2015,38(6):377-382.
[21]Liu XM,Zhang XY,Wang FL,et al.Improvement in cerebral ischemia-reperfusion injury through the TLR4/NF-κB pathway after Kudiezi injection in rats[J].Life Sciences,2017,191(15):132-140.