The therapeutic role of Jingchuan tablet on ischaemic cerebral stroke via the HIF-1α/EPO/VEGFA signalling pathway.

CONTEXT: Jingchuan tablet (JCT) is a Chinese medicine prescription for treating ischaemic cerebral stroke (ICS). However, its relevant mechanisms remain unclear. OBJECTIVE: To unravel the intrinsic mechanisms of JCT anti-ICS. MATERIALS AND METHODS: 'Hongjingtian', 'chuanxiong', 'yanhusuo', 'bingpian', 'cerebral infarction', 'cerebral ischemia' or 'stroke' were used as keywords, and then components, targets and underlying mechanisms of JCT anti-ICS were analysed in TCMSP, TTD, DrugBank, STRING and Metascape databases up to June 2020. Male Sprague-Dawley rats under permanent middle cerebral artery occlusion (pMCAO) model, randomly assigned as: model, sham, nimodipine (0.012 g/kg/d) and JCT (0.78, 1.56 and 3.12 g/kg/d) groups, received oral gavage administration for a week. Therapeutic effects were evaluated by detecting the proportion of cerebral infarction, neuronal apoptosis and neurological deficits. Bioactive components were detected by HPLC-MS. Molecular biology and computational docking were used to verify the underlying mechanisms. RESULTS: Eighty-one components, 166 targets and HIF-1α/EPO/VEGFA pathway contributed to the anti-ICS effect of JCT. JCT treatment effectively reduced the proportion of cerebral infarction (33.13%), apoptosis rate (14.80%) and neurobehavioural score (2.00). JCT increased the protein levels of HIF-1α (0.84), EPO (0.64) and VEGFA (0.69), respectively (p < 0.05). Gallic acid, salidroside, chlorogenic acid, ethyl gallate, ferulic acid and tetrahydropalmatine detected by HPLC-MS showed good interaction and binding with HIF-1α/EPO/VEGFA. CONCLUSIONS: Our study demonstrated the mechanisms of JCT anti-ICS associated with the activation of the HIF-1α/EPO/VEGFA pathway, which provided a pharmacological basis for expanding the clinical application and some scientific ideas for further research into the material basis JCT anti-ICS.

Acupuncture Combined with Traditional Chinese Medicine and Drug Therapy for the Treatment of Cerebral Infarction (Phlegm-Blood Stasis Syndrome) and Carotid Atherosclerotic Plaque: A Preliminary Randomized Controlled Study.

Carotid atherosclerotic plaque (CAP) is one of the leading causes of cerebral infarction. Western medicine usually uses lipid-lowering drugs to stabilize plaques. Currently, studies reporting on drugs that can reduce plaques are lacking. Here, we performed a randomized controlled study to investigate the effectiveness of acupuncture combined with drug therapy (TCM and Western) to treat cerebral infarction (phlegm-blood stasis syndrome) and CAP. The control group was treated with atorvastatin calcium tablets (20 mg/d, po for 15 days). The treatment group received atorvastatin calcium tablets 20 mg, traditional Chinese medicine (TCM) decoctions (two matured substance decoction plus peach kernel and Carthamus four substance decoction plus Chinese hawthorn fruit 20 g, gold theragran 20 g, and red yeast rice 3 g), and acupuncture therapy, once daily for 15 days as one treatment course. The patients' neurological deficit score, ultrasonic testing of the carotid artery, and lipoprotein-associated phospholipase A2 (Lp-PLA2) were evaluated. Our findings showed no significant difference in the evaluated indices between the two groups before treatment (P > 0.05). However, compared with the control group after 15 days of treatment and within each group before and after treatment, the differences were significant (P < 0.05). In conclusion, acupuncture combined with drug therapy demonstrated promising effectiveness in treating cerebral infarction (phlegm-blood stasis syndrome) and CAP.