补阳还五汤治疗高血压合并脑梗死的疗效及对血清PI3K/AKT信号通路的影响

摘要 目的：探讨补阳还五汤治疗高血压合并脑梗死的疗效及对血清磷脂酰肌醇-3激酶（PI3K）/丝氨酸-苏氨酸蛋白激酶（AKT）信号通路的影响。方法：选取2018年2月~2021年2月期间我院收治的高血压合并脑梗死患者100例，经随机数字表法分为观察组（补阳还五汤联合常规西医治疗，50例）和对照组（常规西医治疗，50例），均治疗3周。对比两组治疗3周后的临床总有效率；对比两组治疗前、治疗3周后的血压[收缩压( SBP)、舒张压（DBP）]、神经功能及日常生活活动能力[美国国立卫生院神经功能缺损量表（NIHSS）评分、Barthel指数]、血液流变学指标（血浆黏度、全血低切黏度、全血高切黏度、纤维蛋白）及PI3K/AKT信号通路相关蛋白表达水平。结果：对照组的总有效率为74.00%，低于观察组的92.00%，两组对比有明显差异（P<0.05）。与对照组相比，观察组治疗3周后Barthel指数更高，NIHSS评分、DBP、SBP更低（P<0.05）。与对照组相比，观察组治疗3周后血浆黏度、全血低切黏度、全血高切黏度、纤维蛋白水平更低（P<0.05）。与对照组相比，观察组治疗3周后PI3K、AKT蛋白表达水平更低（P<0.05）。结论：补阳还五汤可有效改善高血压合并脑梗死患者的血液流变学、血压，提高日常生活活动能力，减轻神经功能损伤，同时还能下调 PI3K/AKT 信号通路相关蛋白表达水平。

Effect of Buyang Huanwu Decoction on Hypertension Complicated with Cerebral Infarction and Its Effect on Serum PI3K/AKT Signal Pathway

ABSTRACT Objective: To investigate the therapeutic effect of Buyang Huanwu Decoction on hypertension complicated with cerebral infarction and its effect on serum phosphatidylinositol-3 kinase (PI3K)/serine threonine protein kinase (AKT) signal pathway. Methods: 100 patients with hypertension complicated with cerebral infarction in our hospital from February 2018 to February 2021 were selected and randomly divided into observation group (Buyang Huanwu Decoction Combined with conventional Western Medicine, 50 cases) and control group (conventional western medicine, 50 cases), all for 3 weeks. The clinical total effective rate of the two groups 3 weeks after treatment was compared, the blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], neurological function and activities of daily living [national Institutes of health neurological deficit scale (NIHSS), Barthel Index], hemorheological indexes (plasma viscosity, whole blood low shear viscosity, whole blood high shear viscosity, fibrin), mean blood flow velocity (VM)] and PI3K/AKT signaling pathway related proteins before and 3 weeks after treatment were compared between the two groups. Results:The total effective rate of the control group was 74.00%, which was lower than 92.00% of the observation group (P<0.05). Compared with the control group, SBP, DBP and NIHSS scores were lower and Barthel index was higher in the observation group after 3 weeks of treatment (P<0.05). Compared with the control group, the plasma viscosity, whole blood low shear viscosity, whole blood high shear viscosity and fibrin level of the observation group were lower after 3 weeks of treatment (P<0.05). Compared with the control group, PI3K, AKT protein levels in the observation group were lower after 3 weeks of treatment (P<0.05). Conclusion: Buyang Huanwu Decoction can effectively improve hemorheology, blood pressure in patients with hypertension complicated with cerebral infarction, reduce nerve injury, improve activities of daily living, and down regulate PI3K/AKT signal pathway related protein levels.