Effect of Tongsheng Prescription on Trimethylamine N-Oxide and Related Metabolites Substrate in Patients with Acute Cerebral Infarction After Intervention and Its Efficacy Evaluation
10.13359/j.cnki.gzxbtcm.2024.09.002
- VernacularTitle:通圣方对急性脑梗死介入术后患者TMAO及相关代谢底物的影响与疗效评估
- Author:
Bin LIAO
1
;
Hui-Shan ZHU
;
Jing-Ling ZHU
;
Wei-Min NING
;
Zhan ZHAO
Author Information
1. 广州中医药大学东莞医院,广东东莞 523000
- Keywords:
Tongsheng Prescription;
acute ischemic stroke with large vessel occlusion(AIS-LVO);
stroke;
neurological deficit;
endovascular treatment(EVT);
trimethylamine N-oxide(TMAO);
L-carnitine;
choline;
betaine
- From:
Journal of Guangzhou University of Traditional Chinese Medicine
2024;41(9):2232-2238
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of Tongsheng Prescription on trimethylamine N-oxide(TMAO)and related metabolites substrate in patients with acute cerebral infarction after intervention and to evaluate its clinical efficacy.Methods A prospective randomized controlled study was conducted in 48 patients with acute ischemic stroke with large vessel occlusion(AIS-LVO)who had received endovascular treatment(EVT).The patients were divided into an observation group(25 cases)and a control group(23 cases).After emergency EVT,the control group was treated with routine western medicine,and the observation group was treated with nasogastric feeding or oral use of Tongsheng Prescription on the basis of treatment for the control group.The course of treatment lasted for seven days,and then the patients were followed up for three months.Before operation,7 days and 90 days after operation,National Institutes of Health Stroke Scale(NIHSS)scores in the two groups were observed.The functional prognosis evaluated with Modified Rankin Scale(MRS)scores was compared between the two groups,and the effects of Tongsheng Prescription on serum TM AO and related metabolites choline,betaine and L-carnitine were investigated.Results(1)On the postoperative day 7 and 90,the NIHSS scores of the two groups were decreased compared with those before operation(P＜0.01),and the decrease of NIHSS scores on the postoperative day 7 and 90 in the observation group was significantly superior to that in the control group(P＜0.01).(2)On the postoperative day 90,the rate of good functional outcome in the observation group was 96.00％(24/25),which was significantly higher than 69.57％(16/23)in the control group,and the difference was statistically significant(P＜0.05).(3)On the postoperative day 7 and 90,the levels of TMAO,L-carnitine and betaine in the observation group tended to decrease compared with those before operation,but the difference was not statistically significant(P＞0.05).However,the levels of TMAO,L-carnitine and betaine in the control group were significantly increased compared with those before operation(P＜0.01).On the postoperative day 7,the levels of TMAO,L-carnitine and betaine in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).(4)Spearman correlation analysis showed that TMAO was positively correlated with NIHSS score,L-carnitine and choline(P＜0.05 or P＜0.01).Conclusion Tongsheng Prescription has a significant effect on AIS-LVO patients seven days after EVT.The Prescription is beneficial to obtain a good functional outcome,and its mechanism may be related to the decrease of TMAO level through L-carnitine and betaine pathways,so as to improve the neurological deficit symptoms of stroke patients.
