开窍醒神针法联合加味补阳还五汤对脑出血恢复期患者（气虚血瘀证）IL-2、MMP-9、BDNF及脑血流量的影响

doi:10.3969/j.issn.1006-5725.2025.03.019

Abstract

Abstract:

Objective To explore the application value of Kaiqiao Xingshen acupuncture combined with Buyang Huanwu decoction in the treatment of patients with cerebral hemorrhage in the recovery period （Qi deficiency and blood stasis syndrome）， and to observe its impact on inflammatory indicators and neurokines. Method A total of 166 patients with cerebral hemorrhage in the recovery period （Qi deficiency and blood stasis syndrome） treated in Hongdu Traditional Chinese Medicine Hospital from September 2021 to October 2023， were randomly divided into control group （83 cases treated with conventional western medicine）， and observation group （83 cases treated with a combination of Kaiqiao Xingshen acupuncture and Buyang Huanwu decoction）. The therapeutic effect in the two groups was compared after 8 weeks of treatment. Results After treatment， the serum levels of matrix metalloproteinase-9 （MMP-9）， endothelin-1 （ET-1）， interleukin-2 （IL-2）， homocysteine （Hcy）， and Bcl-2-associated X protein （bax） decreased in both groups， while brain-derived neurotrophic factor （BDNF） increased， and the improvement was more significant in the observation group， showing statistical significance （P < 0.05）； the average cerebral vascular flow and flow velocity in the observation group increased， while peripheral vascular resistance decreased， and the improvement in the observation group was more significant （P < 0.05）； the total symptom score of traditional Chinese medicine in the observation group decreased， while the Fuel Meyer functional score （FMA score） increased， and the improvement in the observation group was more significant （P < 0.05）； The total effective rate of the observation group was 93.98% （78/83）， which was higher than that of the control group （80.72%， 67/83）（P < 0.05）. Conclusion For patients with cerebral hemorrhage in the recovery period （Qi deficiency and blood stasis syndrome）， Kaiqiao Xingshen acupuncture and Buyang Huanwu decoction help alleviate inflammatory reactions， promote the recovery of the blood-brain barrier， improve cerebral blood flow， promote neurological function recovery， and enhance clinical efficacy.

Key words: Kaiqiao Xingshen acupuncture, Buyang Huanwu decoction, inflammatory factors, recovery period of cerebral hemorrhage, Qi deficiency and blood stasis, MMP-9, BDNF, cerebral blood flow

CLC Number:

R318.08

Tianzhong PENG,Xuedi HUANG,Xingzhen LIN,Juan YUAN,Feng ZHOU,Langhui LIU,Qi′nan ZHAN,Manhua. ZHU. Effect of Kaiqiao Xingshen acupuncture combined with Buyang Huanwu decoction on IL⁃2， MMP⁃9， BDNF， and cerebral blood flow in patients with cerebral hemorrhage during recovery period （Qi deficiency and blood stasis syndrome）[J]. The Journal of Practical Medicine, 2025, 41(3): 428-433.

Figures/Tables 6

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Tab.6

References 27

1	SUN J， SONG F H， WU J Y， et al. Sestrin2 overexpression attenuates osteoarthritis pain via induction of AMPK/PGC-1α-mediated mitochondrial biogenesis and suppression of neuroinflammation［J］. Brain Behav Immun， 2022， 102： 53-70. doi:10.1016/j.bbi.2022.02.015 doi: 10.1016/j.bbi.2022.02.015
2	HERWEH C， NORDLOHNE S， SYKORA M，et al.Climatic and Seasonal Circumstances of Hypertensive Intracerebral Hemorrhage in a Worldwide Cohort［J］. Stroke， 2020，48（12）：3384-3386.
3	GU L， SUN M， LI R，et al.Activation of RKIP Binding ASC Attenuates Neuronal Pyroptosis and Brain Injury via Caspase-1/GSDMD Signaling Pathway After Intracerebral Hemorrhage in Mice［J］.Transl Stroke Res，2022，13（6）：1037-1054. doi:10.1007/s12975-022-01009-4 doi: 10.1007/s12975-022-01009-4
4	张海沙，罗琳，原小军，等. 中老年脑微出血灶发生危险因素分析［J］. 包头医学院学报，2023，39（2）：20-25.
5	PAPALE M， NETTI G S， STALLONE G，et al.Understanding Mechanisms of RKIP Regulation to Improve the Development of New Diagnostic Tools［J］.Cancers，2022，14（20）：5070. doi:10.3390/cancers14205070 doi: 10.3390/cancers14205070
6	魏华，黄金秀，蔡海荣，等. 急性脑出血患者中医证型与炎症因子的相关性研究［J］. 中医药信息，2018，35（4）：91-94.
7	中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南（2019）［J］.中华神经科杂志，2019， 52（12）：994-1005. doi:10.3760/cma.j.issn.1006-7876.2019.12.003 doi: 10.3760/cma.j.issn.1006-7876.2019.12.003
8	郑筱萸. 中药新药临床指导原则［S］. 北京：中国医药科技出版社，2002：162-167.
9	HUANG T， JIA Z， FANG L，et al. Extracellular vesicle-derived miR-511-3p from hypoxia preconditioned adipose mesenchymal stem cells ameliorates spinal cord injury through the TRAF6/S1P axis［J］. Brain Res Bull，2022，180：73-85. doi:10.1016/j.brainresbull.2021.12.015 doi: 10.1016/j.brainresbull.2021.12.015
10	雷彪，于蓬勃，屈香，等. 脑出血早期血肿扩大的相关因素研究新进展［J］. 中国临床神经外科杂志，2023，28（6）：411-413.
11	HUA Y， HUANG Q， CHEN G， et al. Comparison of modified anterior and traditional posterior accesses for ultrasound-guided superior laryngeal nerve block in awake endotracheal intubation：Study protocol for a randomised non-inferiority clinical trial［J］.BMJ Open，2023，13（2）：e068779. doi:10.1136/bmjopen-2022-068779 doi: 10.1136/bmjopen-2022-068779
12	RAMKUMAR R， ARORA S， BHATIA N，et al. Ultrasound guided superior laryngeal nerve block as an adjuvant to generalanesthesia during endoscopic laryngeal surgery：A prospective，randomized，double-blind trial［J］. Am J Otolaryngol，2019，40（1）：30-35. doi:10.1016/j.amjoto.2018.09.004 doi: 10.1016/j.amjoto.2018.09.004
13	林晓伟，顾勇，王能，等. 熄风化瘀通络方治疗脑出血急性期风痰瘀阻型患者的疗效及其对相关炎性因子、神经因子和血脑屏障的影响［J］. 广州中医药大学学报，2022，39 （4）：756-763.
14	殷志锋，蒋宝华，许国峰，等. 补阳还五汤治疗恢复期气虚血瘀型高血压脑出血的临床疗效观察［J］. 中西医结合心脑血管病杂志，2021，19（17）：3020-3022.
15	李改，胡兵，张会敏. 瘦素、IL-18、NLRP3与高血压性脑出血严重程度、预后的关系及其在预后评估中的价值［J］. 实用医学杂志，2020，36（5）：628-633.
16	CHEN F， ZHANG S， LI B，et al. A review of invasive intracranial pressure monitoring following surgery for hypertensive cerebral hemorrhage［J］. Front Neurol，2023，14：1108722. doi:10.3389/fneur.2023.1108722 doi: 10.3389/fneur.2023.1108722
17	黄艳丽，张海垠. 局部亚低温治疗对高血压性脑出血患者血清hs-CRP及Hcy水平的影响研究［J］. 中国实验诊断学，2020，24（1）：11-14.
18	LIAO Y C， WU W C， HSIEH M H，et al. Ultrasound-guided superior laryngeal nerve block assists in anesthesia for bronchoscopic surgical procedure：A case report of anesthesia for rigid bronchoscopy［J］.Medicine （Baltimore），2020，99（27）：e20916. doi:10.1097/md.0000000000020916 doi: 10.1097/md.0000000000020916
19	毕红东，江思瑜，李宝群，等. 补阳还五汤对脑出血大鼠脑组织HIF-1α、SDF-1、CXCR-4表达的影响［J］. 中国老年学杂志，2021，41（17）：3755-3758.
20	马雪，周世辉. 脑苷肌肽联合甲氯芬酯治疗急性脑出血的疗效及对血清MMP-2/9、TSP-1/2、神经相关因子的影响［J］. 实用医学杂志，2021，37（4）：507-512.
21	吴林，张光彩，周晓晖，等. 温针灸对高血压脑出血恢复期气虚血瘀患者S100B、MMP-9、Hcy及炎性因子水平的影响［J］. 上海针灸杂志，2021，40（8）：907-912.
22	HEYBATI K， ZHOU F，ALI S，et al.Outcomes of dexmedetomidine versus propofol sedation in critically ill adults requiring mechanical ventilation： A systematic review and meta-analysis of randomised controlled trials［J］.Br J Anaesth，2022，129（4）：515-526. doi:10.1016/j.bja.2022.06.020 doi: 10.1016/j.bja.2022.06.020
23	QU W， CHENG Y， PENG W，et al. Targeting iNOS alleviates early brain injury after experimental subarachnoid hemorrhage via promoting ferroptosis of M1 microglia and reducing neuroinflammation［J］. Mol Neurobiol，2022，59（5）：3124-3139. doi:10.1007/s12035-022-02788-5 doi: 10.1007/s12035-022-02788-5
24	郭思佳. 清脑通脉汤配合针灸治疗脑出血后偏瘫的疗效及对血清S100β蛋白、NSE水平及运动功能的影响［J］. 四川中医，2022，40（2）：149-152.
25	DOS SANTOS I R C， DIAS M N C， GOMES-LEAL W. Microglial activation and adult neurogenesis after brain stroke［J］. Neural Regen Res，2022，16（3）：456-459. doi:10.4103/1673-5374.291383 doi: 10.4103/1673-5374.291383
26	吴晓光，仇志富，孟杰，等. 补阳还五汤对脑出血模型大鼠脑组织PI3K、Akt、Bcl-2、BAX蛋白表达的影响［J］. 中国组织工程研究，2020，20（40）：5933-5938．
27	阎立安，谢耀君，胡艳文，等. 针灸辅助康复训练对重症脑出血患者神经缺损功能和脑血管功能的影响［J］. 四川中医，2022，40（2）：196-199.

组别	年龄/岁	体质量/kg	脑出血病程/周	合并疾病/[例（%）]
组别	年龄/岁	体质量/kg	脑出血病程/周	高血脂	2型糖尿病	冠心病	肺气肿
对照组（n = 83）	47.26 ± 5.91	68.63 ± 5.84	6.03 ± 1.15	18（21.69）	25（30.12）	11（13.25）	6（7.23）
观察组（n = 83）	47.82 ± 6.37	68.06 ± 6.47	5.93 ± 1.39	19（22.89）	22（26.51）	13（15.66）	7（8.43）
t/χ² 值	0.587	0.596	0.505	0.454
P值	0.558	0.552	0.614	0.929

组别	MMP-9/（mg/L）		Hcy/(μmol/L)		IL-2/(pg/mL)
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n =83）	93.15 ± 16.19	74.22 ± 9.21^#	18.06 ± 4.08	12.53 ± 3.87^#	81.26 ± 9.46	65.06 ± 5.29^#
观察组（n =83）	94.18 ± 17.21	59.30 ± 6.23^#^△	18.62 ± 4.31	8.85 ± 2.67^#^△	82.43 ± 8.97	43.75 ± 4.54^#^△
t值	0.513	13.061	0.627	10.613	0.716	11.812
P值	0.480	0.000	0.367	0.000	0.286	0.000

组别	Bax/（μg/L）		ET-1/（ng/L）		BDNF/（ng/L）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 83）	17.12 ± 3.95	13.87 ± 2.96^#	78.81 ± 5.92	61.13 ± 5.95^#	3.95 ± 0.61	5.26 ± 0.57^#
观察组（n = 83）	17.38 ± 4.19	9.69 ± 1.51^#^△	79.12 ± 6.12	48.93 ± 4.17^#^△	4.14 ± 0.74	7.85 ± 0.79^#^△
t值	0.495	9.612	0.437	15.162	0.603	7.912
P值	0.473	0.000	0.556	0.000	0.394	0.000

组别	中医总症状积分		FMA评分
组别	治疗前	治疗后	治疗前	治疗后
对照组（n = 83）	14.12 ± 2.95	7.27 ± 1.36^#	39.81 ± 5.92	44.13 ± 4.95^#
观察组（n = 83）	14.68 ± 2.39	3.16 ± 0.47^#^△	40.12 ± 6.12	49.93 ± 5.17^#^△
t值	0.731	8.536	0.668	9.316
P值	0.259	0.000	0.325	0.000

组别	脑血管平均流量/（mL/s）		脑血管平均流速/（cm/s）		血管外周阻力/（kPa/s）
组别	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组（n = 83）	8.12 ± 1.35	13.87 ± 1.96^#	13.06 ± 1.85	15.13 ± 1.87^#	1 761.95 ± 185.02	1 263.26 ± 137.35^#
观察组（n = 83）	8.38 ± 1.19	16.69 ± 2.51^#^△	12.62 ± 2.03	17.53 ± 1.97^#^△	1 798.14 ± 189.17	907.81 ± 86.49^#^△
t值	0.538	9.162	0.486	7.167	0.628	16.514
P值	0.461	0.000	0.513	0.003	0.364	0.000

Effect of Kaiqiao Xingshen acupuncture combined with Buyang Huanwu decoction on IL⁃2， MMP⁃9， BDNF， and cerebral blood flow in patients with cerebral hemorrhage during recovery period （Qi deficiency and blood stasis syndrome）

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 6

References 27

Related Articles 15

Recommended Articles

Metrics

Comments

组别	显效	有效	无效	总有效率
对照组（n =83）	27（32.53）	40（48.19）	16（19.28）	67（80.72）
观察组（n =83）	36（43.37）	42（50.61）	5（6.02）	78（93.98）
χ²值				9.084
P值				0.000

[1]	Chunyan LI,Ting XIAO,Bangcui WU,Yong CHEN,Mei TIAN. PKCβ inhibitor modulates macrophage phenotype and affects kidney ischemia-reperfusion injury during transplantation [J]. The Journal of Practical Medicine, 2025, 41(1): 23-29.
[2]	Yuying HU,Jinming ZHU,Jie LIU,Yawen PAN,Qian ZHANG,Jinqiu FENG. Expression and significance of miR⁃223⁃3p in serum of pregnant women with preterm premature rupture of membranes [J]. The Journal of Practical Medicine, 2024, 40(9): 1275-1279.
[3]	Ling XIAO,Chunlei GAO,Wei GUO,Ning WANG,Xuan ZHANG,Ming. LIU. Codonopsis polysaccharide protected LPS⁃induced acute lung injury by inhibiting MAPK/NF⁃κB signaling pathway in mice [J]. The Journal of Practical Medicine, 2024, 40(7): 948-954.
[4]	Bin ZHANG,Wei HU,Rongzhen TAN,Panpan YANG,Jun HU,Zhong YUAN,Gongtao. JIANG. Effects of Yishen Huayu Xugu prescription combined with Dixumab on IL-6， β-CTX and bone mineral density in elderly patients operated for osteoporotic lumbar vertebral compression fractures [J]. The Journal of Practical Medicine, 2024, 40(19): 2766-2771.
[5]	Weifeng ZHANG,Hailong MA,Jinling. ZHANG. Effect of PCSK9 inhibitors on inflammation levels and ventricular remodeling after PCI in ST⁃elevation acute myocardial infarction [J]. The Journal of Practical Medicine, 2024, 40(15): 2142-2147.
[6]	Yinbi ZHENG,Yiming SHAO,Zhaoji LI,Shiting LI,Mingdi CHEN,Wenchi ZENG,Hongyu. DONG. Effect of dexmedetomidine on renal function in patients with septic⁃associated acute kidney injury： A cohort study [J]. The Journal of Practical Medicine, 2024, 40(10): 1423-1428.
[7]	HOU Aizhen, WANG Liping, DU Juan, XU Yuhui, ZHANG Qing.. Effect of Lichong Decoction combined with Shenghua Decoction（granules）on both adenomyosis of qi defi⁃ ciency and blood stasis type and ovarian function [J]. The Journal of Practical Medicine, 2023, 39(7): 910-913.
[8]	HUANG Tingting, WU Haike, LIAN Mengjie, YANG Xuan.. Therapeutic effect of rTMS of different frequency combined with Buyang Huanwu Decoction on motor function in stroke patients with qi deficiency and blood stasis [J]. The Journal of Practical Medicine, 2023, 39(4): 499-504.
[9]	GAO Yujiu, HU Rong, FANG Chen, LI Panpan, MENG Xiang, GUO Xingrong, FENG Ying.. ANGPTL8 knockout alleviates DEN⁃induced acute liver injury [J]. The Journal of Practical Medicine, 2023, 39(3): 278-284.
[10]	ZHANG Kaitai, DING Minggang, ZHOU Jingxiang, FANG Chongtao, ZHANG Tingting. . A clinical observation on modified Sijunzi decoction for heart failure with reduced ejection fraction of Qi deficiency and blood stasis syndrome [J]. The Journal of Practical Medicine, 2023, 39(15): 1982-1986.
[11]	XU Meng, WANG Ziwen, XIE Xu, ZHANG Linna.. Effects of different doses of dexmedetomidine on inflammatory response，immune function and brain func⁃ tion in patients with sepsis associated encephalopathy [J]. The Journal of Practical Medicine, 2022, 38(20): 2580-2584.
[12]	LUO Ping, WANG Xiaohui, XIANG Junying, LIU Zhe.. Mechanism of Helicobacter pylori metabolite adenosine in regulating secretion of inflammatory factors through A2A receptors [J]. The Journal of Practical Medicine, 2022, 38(10): 1220-1225.
[13]	XIE Hui, FENG Jun, HUANG Qiujie, WANG Junyi, YE Wen.. Effects of ulinastatin combined with Shenmai Injection on myocardial injury protection and pulmonary function in patients with severe pneumonia [J]. The Journal of Practical Medicine, 2022, 38(10): 1260-1264.
[14]	CHEN Chen, ZHANG Yanbei.. Alleviation of pulmonary vasculature injury induced by hypoxia⁃induced pulmonary hypertension via Rho kinase inhibitor combined with puerarin by inhibiting TGF⁃β1/Smads signaling pathway and inflammato⁃ ry response [J]. The Journal of Practical Medicine, 2021, 37(5): 591-595.
[15]	ZHENG Ruizhe, MAO Mintao, YANG Xitao, LIU Yumei. Protective effects of coenzyme Q10 on traumatic brain injury by inhibiting inflammatory injury and cell apoptosis [J]. The Journal of Practical Medicine, 2021, 37(4): 446-450.