Li Ying, Wang Pei, Chai Mei-Jing, Yang Fan, Li Hong-Shan, Zhao Jing, Wang Huan, Lu Dan-Dan
Chengde Medical University, Chengde 067000, China.
Baoding No.1 Central Hospital, Baoding 071000, China.
Zhongguo Zhong Yao Za Zhi. 2016 Nov;41(21):4066-4071. doi: 10.4268/cjcmm20162128.
This study aims to analyze the effect of berberine on serum inflammatory factors and carotid atherosclerotic plaques in ppatients with acute cerebral ischemic stroke(AIS). In the study, 120 patients with AIS were randomly divided into berberine group(n=60) and general group (n=60). The 60 cases in the general group were provided with general therapy according to the latest guidelines of diagnosis and treatment of AIS. The berberine group received berberine 300 mg(tid) in addition to the therapy of the general group. The levels of serum inflammatory factors, the nerve function defect grades and the indexes of carotid atherosclerosis plaques [including the total plaque area(TPA), intima-media thickness(IMT) and the number of unstable carotid atherosclerotic plaques] were measured and compared. The results indicated that the levels of serum inflammatory factors, the NIHSS(national institute of health stroke scales) cores and the indexes of carotid atherosclerosis plaques were not significantly different between the berberine groups of general group, with positive correlation between serum inflammatory factors and NIHSS scores(P<0.05). The levels of serum inflammatory factors and NIHSS scores of the berberine groups on 14 d were significantly lower than those on 1 d(P<0.05). The levels of serum inflammatory factors and NIHSS scores of the berberine group on 14 d were significantly lower than those of the general group(P<0.05). The TPA and the number of unstable carotid atherosclerotic plaques of the berberine groups on 90 d were significantly lower than those of general group, with significant differences(P<0.05). The IMT showed a downward trend, but with significant difference.The mRS(modified rankin scale) scores of the berberine group on 90 d were significantly lower, with a higher rate of short-term favorable prognosis (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. This study showed that berberine in addition to the general therapy can significantly lower the levels of serum MIF and IL-6, reduce the degree of carotid atherosclerosis to some extent and improve neurological impairment and the prognosis of patients with AIS.
本研究旨在分析黄连素对急性脑缺血性卒中（AIS）患者血清炎症因子及颈动脉粥样硬化斑块的影响。研究中，120例AIS患者被随机分为黄连素组（n = 60）和常规组（n = 60）。常规组的60例患者按照AIS最新诊疗指南给予常规治疗。黄连素组在常规组治疗基础上，加用黄连素300mg（每日3次）。检测并比较血清炎症因子水平、神经功能缺损分级及颈动脉粥样硬化斑块指标[包括总斑块面积（TPA）、内膜中层厚度（IMT）及不稳定颈动脉粥样硬化斑块数量]。结果显示，黄连素组与常规组血清炎症因子水平、美国国立卫生院卒中量表（NIHSS）评分及颈动脉粥样硬化斑块指标无显著差异，血清炎症因子与NIHSS评分呈正相关（P<0.05）。黄连素组14天时血清炎症因子水平及NIHSS评分显著低于1天时（P<0.05）。黄连素组14天时血清炎症因子水平及NIHSS评分显著低于常规组（P<0.05）。黄连素组90天时TPA及不稳定颈动脉粥样硬化斑块数量显著低于常规组，差异有统计学意义（P<0.05）。IMT呈下降趋势，但差异无统计学意义。黄连素组90天时改良Rankin量表（mRS）评分显著更低，短期良好预后率更高（P<0.05）。两组不良反应发生率无显著差异。本研究表明，黄连素在常规治疗基础上可显著降低血清巨噬细胞移动抑制因子（MIF）和白细胞介素-6水平，在一定程度上减轻颈动脉粥样硬化程度，改善AIS患者神经功能缺损及预后。
