RESUMEN
OBJECTIVE: This study was carried out to probe the clinical effect and mechanism of Huatan Tongluo decoction combined with acupuncture in the treatment of patients with ischemic stroke. METHODS: The clinical data of 100 patients with ischemic stroke were retrospectively collected. On the basis of treatment method, they were split into two groups, each with 50 cases: the conventional treatment group (acupuncture) and the combined treatment group (Huatan Tongluo decoction + acupuncture). After treatment, the neurological function and clinical therapeutic effects of the two groups were evaluated. The treatment of ischemic stroke with Huatan Tongluo decoction was studied by the method of traditional Chinese medicine (TCM) network pharmacology. Resources from databases such as GeneCards, TCMSP, PubChem, Swiss Target Prediction, String, and WebGestalt were integrated, in order to screen for targets of stroke treatment, the active compound composition of Huatan Tongluo decoction, and the targets of compound composition by the use of Cytoscape and R language software. Finally, from the perspective of a protein-protein interaction (PPI) co-expression network, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, the significance of Huatan Tongluo decoction in the treatment of ischemic stroke was discussed. RESULTS: The total effectiveness rate in the combined treatment group was superior to the conventional treatment group. The combined group had higher scores of neurological function, limb movement function, and ability to perform daily living tasks than the conventional treatment group (all P < 0.05). 368 pharmacological targets for Huatan Tongluo decoction and a total of 5690 ischemic stroke targets were retrieved from the database, and 215 intersection targets were found. The results of the PPI network indicated that 43 targets, including EGFR (epidermal growth factor receptor), SRC (proto-oncogene, non-receptor tyrosine kinase), PTPN11 (protein tyrosine phosphatase non-receptor type 11), PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha), AKT1 (serine/threonine kinase 1), VEGFA (vascular endothelial growth factor A), STAT3 (signal transducer and activator of transcription 3), and FYN (FYN proto-oncogene, Src family tyrosine kinase), had the strongest interactions, so they could be used as targets for subsequent basic research verification. The results suggested that pathways such as vascular endothelial growth factor (VEGF) signaling pathway and other pathways were enriched. CONCLUSION: The combination of Huatan Tongluo decoction and acupuncture can help patients with sequelae of stroke promote the regaining of neurological function, thus improving their movement and enhancing their abilities to perform daily living. Huatan Tongluo decoction can mediate the VEGF signaling pathway and other pathways to treat ischemic stroke.
RESUMEN
OBJECTIVE: To determine the therapeutic effect and potential mechanism of Huatan Tongluo decoction on rats with collagen-induced arthritis. METHODS: Forty specific pathogen-free Wistar rats were selected, and 10 were randomly selected as the control (group 1). The remaining rats were injected intradermally with emulsified type II bovine collagen at the tail base and back, followed by a booster 7 d post first immunization. After establishing collagen-induced arthritis (CIA), rats were randomly divided into three groups (n = 10). The rats were treated orally for 30 d as follows: group 1, saline; group 2, model (saline); group 3, tripterygium polyglycoside (TP; 7.81 mg/kg, positive control); group 4, Huatan Tongluo decoction (HTTL; 7.5 g/kg). Body weight, ankle swelling and arthritis index were measured over the course of the study. The rats were sacrificed 30 d after treatment. Morphological changes in the synovium were observed by hematoxylin and eosin staining. Pannus formation and synovial thickness in the left ankle were observed by color Doppler ultrasoundVascular endothelial growth factor (VEGF) and VEGFR2 protein levels were measured by immunohistochemistry. VEGF/VEGFR2 mRNA levels were measured by real-time quantitative polymerase chain reaction. RESULTS: Compared with the model group, a significantly lower arthritis index was observed in the positive control group (P < 0.05) and HTTL group (P < 0.01), after treatment. Both positive control and HTTL reduced intra-articular pannus formation and synovial thickening. Furthermore, VEGF mRNA, and VEGFR2 protein and mRNA levels were significantly downregulated (P < 0.05) in the treatment groups. CONCLUSION: Inhibition of the expression of VEGF and VEGFR2 in synovial tissues and the formation of pannus and synovial hyperplasia may be part of the mechanism of HTTL for relieving the symptoms of rheumatoid arthritis in CIA rats.