益气活血降浊汤配合丁苯酞对TIA患者的疗效及机制OACSTPCD

Aim To investigate the clinical efficacy and preliminary mechanism of Yiqi Huoxue Jiangzhuo decoc-tion combined with butylphthalide in the treatment of transient ischemic attack(TIA).Methods A total of 120 pa-tients with TIA admitted to the First People's Hospital of Nanyang from January 2022 to March 2023 were selected as the re-search subjects and randomly divided into three groups with 40 cases in each group.The control group 1 was given bu-tylphthalide,the control group 2 was given Yiqi Huoxue Jiangzhuo decoction,and the observation group was given Yiqi Huoxue Jiangzhuo decoctionn combined with butylphthalide for 2 months of treatment.After 2 months of treatment,the clinical efficacy and adverse reaction rate were compared among the three groups.The ABCD2 scores,national institute of health stroke scale(NIHSS)scores,and serum biochemical indicators(soluble CD40 ligand(sCD40L),lipoprotein-asso-ciated phospholipase A2(Lp-PLA2),high-sensitive C-reactive protein(hs-CRP)),peripheral blood Kelch-like epichlo-rohydrin-related protein-1(Keap1)-nuclear factor E2-related factor 2(Nrf2)/antioxidant response element(ARE)signa-ling pathway-related protein levels(Keap1,Nrf2,ARE),and hemodynamic indicators(mean blood flow velocity(Vm),mean blood flow volume(Qm),cerebral vascular resistance(R))were compared before treatment and at 1 and 2 months after treatment in the three groups.Results The total clinical efficacy rate in observation group was significantly higher than that in control group 1 and control group 2(P＜0.05),but there was no significant difference between the two control groups(P＞0.05).Compared with before treatment,the ABCD2 scores and NIHSS scores in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P＜0.05),but there was no significant difference between the two control groups(P＞0.05).Compared with before treatment,sCD40L,Lp-PLA2,and hs-CRP in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P＜0.05).Compared with before treatment,Keap1 protein in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P＜0.05),but there was no significant difference between the two control groups(P＞0.05).Compared with before treatment,the Nrf2 protein and ARE protein in the three groups showed a significant increase trend after 1 month and 2 months of treatment,and the increase amplitude in observation group was larger than that in control group 1 and control group 2(P＜0.05),but there was no significant difference be-tween the two control groups(P＞0.05).Compared with before treatment,Qm,Vm of the three groups increased and R decreased significantly at 1 month and 2 months after treatment,and the Qm,Vm in observation group were significantly higher than that in control group 1 and control group 2,while R was significantly lower than that in control group 1 and con-trol group 2(P＜0.05).Conclusion Yiqi Huoxue Jiangzhuo decoction combined with butylphthalide is more effective than butylphthalide and Yiqi Huoxue Jiangzhuo decoction alone in treating TIA,can improve neurological function,cerebral hemodynamics,inhibit inflammatory response,and has a certain degree of safety,and its mechanism of action is related to the regulation of Keap1-Nrf2/ARE signaling pathway.