通络逐瘀汤对脑缺血/再灌注损伤的临床研究

目的观察通络逐瘀汤对脑缺血/再灌注损伤的保护作用,并对其机制作初步探讨。方法对大鼠大脑中动脉缺血2h/再灌注22h模型采用不同方案治疗,比较其神经病学评分、脑梗死范围及抗脑缺血/再灌注损伤的效果;放射免疫法检测患侧皮质内皮素（ET）、血栓素B2（TXB2）、6-酮-前列腺素F1α（6-keto-PGF1α）含量的变化。结果大鼠脑缺血2h/再灌注22h后,假手术组大鼠神经病学评分均为0分,无脑梗死;尼莫地平组和通络逐瘀汤30、60mg/kg组神经病学评分和脑梗死范围均小于生理盐水组,差异有统计学意义（P〈0.05）。生理盐水组ET及TXB2含量高于假手术组,6-Keto-PGF1α活性低于假手术组,差异均有统计学意义（P〈0.05）;尼莫地平组和通络逐瘀汤30、60mg/kg组ET及TXB2含量低于生理盐水组,6-Keto-PGF1α活性高于生理盐水组,差异均有统计学意义（P〈0.05）。结论通络逐瘀汤对脑缺血/再灌注损伤有保护作用,其作用机制与抑制ET、TXB2含量,提高6-keto-PGF1α活性,维持TXB2/6-keto-PGF1α动态平衡有关。

Protective effects of Tongluozhuyu soup in the treatment of cerebral ischemia /reperfusion injury

Objective To observe the protective effects of Tongluozhuyu soup on cerebral ischemia /reperfusion injury,and its mechanism were discussed preliminary.Methods With different treatment on the rat model of middle cerebral artery ischemia 2h/reperfusion 22h,compare the effects of which on the neurological scale,cerebral infract size and antagonizing cerebral ischemia /reperfusion injury;The content changes of endothelin（ET）,thromboxane B2 （TXB2） and 6-keto-prostaglandin F1α （6-ketoPGF1α） were measured with radioimmunoassay .Results After rat cerebral artery ischemia 2h / reperfusion 22h ,the neurological scale of the sham operation group was zero,without cerebral infarction .The neurological scale and cerebral infract size of the nimodipine gronp and Tongluozhuyu soup of 30、60mg/kg group were respectively less than those of the normal saline group,and the differences were statistically significant （P0.05）.The contents of ET,TXB2 of the normal saline group were higher than those of the sham operation group,but the the activity of 6-ketoPGF1α of which was lower than that of the sham operation group, and the differences were statistically significant （P0.05）.The contents of ET、TXB2 of the nimodipine gronp and Tongluozhuyu soup of 30、60mg/kg group were lower than those of the normal saline group,and the activity of 6-ketoPGF1α of which was higher than that of the normal saline group,and the differences were statistically significant （P0.05）.Conclusion Tongluozhuyu soup may protect cerebral ischemia/reperfusion injury,and the mechanism might be related with inhibiting the concents of ET、TXB2,increasing the avtivity of 6-keto-PGF1α and maintaining the dynamic equilibrium of TXB2/6-ketoPGF1α.