[1]张亚,赵见文,刘杰,等.竺黄醒脑胶囊治疗浊瘀毒损型轻度血管性认知障碍患者的临床疗效及对铁死亡标记物水平的影响[J].卒中与神经疾病杂志,2025,32(02):136-145.[doi:10.3969/j.issn.1007-0478.2025.02.006]
　Zhang Ya,Zhao Jianwen,Liu Jie,et al.Clinical efficacy of Zhuhuang Xingnao Capsule in treating patients with mild vascular cognitive impairment of turbid-stasis and toxin-injury type and its impact on levels of ferroptosis markers[J].Stroke and Nervous Diseases,2025,32(02):136-145.[doi:10.3969/j.issn.1007-0478.2025.02.006]
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竺黄醒脑胶囊治疗浊瘀毒损型轻度血管性认知障碍患者的临床疗效及对铁死亡标记物水平的影响()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第32卷
期数:
2025年02期
页码:
136-145
栏目:
认知功能障碍
出版日期:
2025-04-20

文章信息/Info

Title:
Clinical efficacy of Zhuhuang Xingnao Capsule in treating patients with mild vascular cognitive impairment of turbid-stasis and toxin-injury type and its impact on levels of ferroptosis markers
文章编号:
1007-0478(2025)02-0136-10
作者:
张亚; 赵见文; 刘杰; 冯娜娜; 单婷; 穆晨晨
061000 河北省沧州中西医结合医院[张亚 赵见文(通信作者)刘杰 冯娜娜 单婷 穆晨晨]
Author(s):
Zhang Ya;  Zhao Jianwen;  Liu Jie;  et al.
Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou Hebei 061000
关键词:
竺黄醒脑胶囊 浊瘀毒损 血管性认知障碍 铁死亡标记物
Keywords:
Zhuhuang Xingnao Capsule Turbid-stasis and toxin-injury Vascular cognitive impairment Ferroptosis markers
分类号:
R743.9
DOI:
10.3969/j.issn.1007-0478.2025.02.006
文献标志码:
A
摘要:
目的 探讨竺黄醒脑胶囊治疗浊瘀毒损型轻度血管性认知障碍患者(Vascular cognitive impairment,VCI)的临床疗效及对铁死亡标记物水平的影响。方法 本研究纳入2023年1月-2024年7月在本院就诊的浊瘀毒损型轻度VCI患者158例; 将患者随机分为对照组(n=73):使用阿司匹林肠溶片、瑞舒伐他汀钙片、盐酸多奈哌齐联合认知功能训练治疗; 观察组(n=85):在对照组的基础上加用竺黄醒脑胶囊治疗,为了平衡2组之间的潜在差异,进一步采用了倾向性评分匹配(Propensity score matching,PSM)法,按照1:1的比例进行匹配,最终2组各包含60例患者; 观察2组的神经功能、血液流变学指标水平、临床疗效和血清中铁死亡相关指标水平的变化。结果 观察组的神经元特异性烯醇化酶(Neuron-specific enolase,NSE)、中枢神经特异蛋白(S-100β protein,S-100β)、纤维蛋白原水平、红细胞比容、血小板聚集率和血浆黏度比显著低于对照组,而认知功能评分、脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)水平和日常生活能力评分显著高于对照组; 铁死亡指标的主效应和单独效应检验显示,与治疗前比较,2组患者治疗后的长链脂酰辅酶A合成酶4(Acyl-CoA synthetase long-chain family member 4,ACSL4)、谷胱甘肽过氧化物酶-4(Glutathione peroxidase 4,GPX4)、谷胱甘肽(Glutathione,GSH)、胱氨酸/谷氨酸反向转运体(Cystine/glumate antiporter,System Xc-)、血清铁和转铁蛋白水平均有改善; 观察组治疗2和4周后的转铁蛋白水平显著高于对照组,而ACSL4,GPX4,GSH,System Xc-和血清铁水平显著低于对照组; 多元线性回归分析显示,ACSL4,GPX4,GSH,System Xc-、血清铁和转铁蛋白水平均为神经功能的独立影响因素; 广义估计方程回归分析显示,治疗2、4周后观察组患者的ACSL4,GPX4,GSH,System Xc-和血清铁水平较对照组更低,而转铁蛋白水平较对照组更高; 观察组临床疗效的总有效率显著高于对照组(P<0.05)。结论 竺黄醒脑胶囊治疗浊瘀毒损型轻度VCI,可以提高临床疗效,改善铁死亡情况,促进神经功能恢复。
Abstract:
ObjectiveTo investigate the clinical efficacy of Zhuhuang Xingnao Capsule in treating patients with mild vascular cognitive impairment of turbid-stasis and toxin-injury type and its impact on levels of ferroptosis markers.Methods 158 patients with mild vascular cognitive impairment of turbid-stasis and toxin-injury type who visited our hospital from January 2023 to July 2024 were included. They were randomly divided into control group(n=73)who were treated with aspirin enteric-coated tablets, rosuvastatincalcium tablets, donepezil hydrochloride combined with cognitive function training and an observation group(n=85)who received additional Zhuhuang Xingnao Capsule treatment on the basis of the control group. To balance potential differences between the two groups, the Propensity Score Matching(PSM)method was further used for 1:1 matching, resulting in 60 patients in each group. Neurological function, hemorheological indicator, clinical efficacy, and changes in serum levels of ferroptosis-related indicator were observed in both groups.Results The Neuron-specific enolase(NSE), S-100β protein(S-100β), fibrinogen, hematocrit, platelet aggregation rate, and plasma viscosity ratio in the observation group were significantly lower than those in the control group. The cognitive function score, Brain-derived neurotrophic factor(BDNF), and daily living ability score were significantly higher than those in the control group. The main effect and individual effect test results of ferroptosis indicators showed that compared with before treatment, the levels of Acyl-CoA synthetase long-chain family member 4(ACSL4), Glutathione peroxidase 4(GPX4), Glutathione(GSH), Cystine/glutamate antiporter(System Xc-), serum iron, and transferrin in both groups improved after treatment. The results demonstrated a notable elevation in transferrin concentrations in the observational cohort at 2 and 4 weeks post-treatment, markedly surpassing those seen in the control group. Conversely, a pronounced decrease was observed in ACSL4, GPX4, GSH levels, as well as the activity of System Xc- and serum iron levels, when compared to the control. Multiple linear regression analysis showed that ACSL4, GPX4, GSH, System Xc- activity, serum iron, and transferrin levels were independent influences on neurological functioning. The results of Generalized estimating equation regression analysis showed that the levels of ACSL4, GPX4, GSH, System Xc-, and serum iron in the observation group were lower than those in the control group after 2 weeks' and 4 weeks' treatment, while the transferrin level was higher than that in the control group. The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Zhuhuang Xingnao Capsule in treating patients with mild vascular cognitive impairment of turbid-stasis and toxin-injury type can enhance treatment effect and clinical efficacy, reduce ferroptosis mortality, and promote the recovery of neurological function.

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备注/Memo

备注/Memo:
基金项目:2024年度中医药类科学研究课题计划项目(课题编号为2024472)
更新日期/Last Update: 2025-04-20