Study on Jiawei Wendan Decoction Participating in Post-Stroke Depression Treatment Through Inhibiting HCN Ion Channel
10.13359/j.cnki.gzxbtcm.2024.12.006
- VernacularTitle:加味温胆汤抑制HCN离子通道参与抗卒中后抑郁作用的研究
- Author:
You-Song SHU
1
;
Jie LI
;
Sai-Hua WANG
;
Zhi HE
Author Information
1. 武汉市第一医院康复科,湖北武汉 430010
- Keywords:
Jiawei Wendan Decoction;
hyperpolarization-activated cyclic nucleotide-gated channel(HCN);
post-stroke depression;
liver depression and phlegm obstruction type;
monoamine neurotransmitters;
activities of daily living
- From:
Journal of Guangzhou University of Traditional Chinese Medicine
2024;41(12):3125-3132
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the outcomes of Jiawei Wendan Decoction participating in post-stroke depression treatment through inhibiting the hyperpolarization-activated cyclic nucleotide-gated channel(HCN).Methods A total of 300 patients with post-stroke depression of liver depression and phlegm obstruction type were randomly divided into the control group and the observation group,with 150 patients in each group.The two groups were treated with the conventional basic treatment for stroke,including anticoagulants and medicines for controlling blood glucose,lipids and blood pressure.In addition,the control group was given Deanxit orally and the observation group was given Deanxit combined with Jiawei Wendan Decoction orally.The course of treatment for the two groups covered four weeks.After treatment,the clinical efficacy of the patients in the two groups was evaluated.Before and after treatment,the two groups were observed in the changes of Hamilton Depression Scale(HAMD)scores,Self-Rating Depression Scale(SDS)scores,modified Barthel Index scores,and the serum levels of monoamine neurotransmitters of neuropeptide,brain-derived neurotrophic factor(BDNF),5-hydroxytryptamine,substance P,neuron-specific enolase(NSE),and retinol-binding protein 4(RBP4),and mRNA expression levels of HCN1 and HCN2 subtypes in peripheral blood.Moreover,the correlation between peripheral blood mRNA expression levels of HCN1 and HCN2 subtypes and HAMD scores and SDS scores were analyzed.Results(1)After four weeks of treatment,the total effective rate of the observation group was 92.00%(138/150),and that of the control group was 80.00%(120/150);the intergroup comparison showed that the total effective rate(tested by chi-square test)and the overall efficacy(tested by rank sum test)of the observation group were significantly superior to those of the control group(P＜0.01).(2)After treatment,the modified Barthel index scores in the two groups were significantly increased(P＜0.05)and the scores of HAMD and SDS were significantly decreased when compared with those before treatment(P＜0.05),the increase of modified Barthel Index scores as well as the decrease of scores of HAMD and SDS in the observation group was superior to that in the control group(P＜0.01).(3)After treatment,the serum levels of monoamine neurotransmitters of BDNF,neuropeptide,and 5-hydroxytryptamine in the two groups were significantly increased(P＜0.05),and the serum levels of NSE,substance P,and RBP4 were significantly decreased when compared with those before treatment(P＜0.05);the increase of serum levels of BDNF,neuropeptide,and 5-hydroxytryptamine as well as the decrease of the serum levels of NSE,substance P,and RBP4 in the observation group was superior to that in the control group(P＜0.05).(4)After treatment,the mRNA expression levels of HCN1 and HCN2 subtypes in the two groups were significantly decreased when compared with those before treatment(P＜0.01),and the decrease of the mRNA expression levels of HCN1 and HCN2 subtypes in the observation group was significantly superior to that of the control group(P＜0.05).(5)The correlation analysis showed that the mRNA expression levels of HCN1 and HCN2 subtypes in the peripheral blood were positively correlated with both SDS scores and HAMD scores(P＜0.001).Conclusion Jiawei Wendan Decoction combined with conventional western medicine has achieved satisfactory efficacy for the treatment of patients with post-stroke depression of liver depression and phlegm obstruction type,which can effectively reduce the degree of depression,improve the serum levels of monoamine neurotransmitters,and improve the activities of daily living,and its anti-depression mechanism may be related to the inhibition of HCN ion channels.
