Effect of Angong Niuhuang pill combined with conventional treat-ment on neurological function recovery in patients with phlegm-heat internal closed cerebral hemorrhage:A randomized controlled trial based on the AMPK-PGC1α-NRF2 pathway
10.12092/j.issn.1009-2501.2025.10.011
- VernacularTitle:安宫牛黄丸联合常规治疗对痰热内闭型脑出血患者神经功能恢复的影响:基于AMPK-PGC1α-NRF2通路的随机对照研究
- Author:
Yuxing WU
1
;
Yi LI
;
Xiaoqing YUE
;
Chenlu ZHANG
;
Yanping ZHANG
Author Information
1. 河南中医药大学第一附属医院脑病中心,郑州 450000,河南;河南中医药大学第一临床医学院,郑州 450000,河南
- Publication Type:Journal Article
- Keywords:
Angong Niuhuang pill;
phlegm-heat internal closed intracerebral hemorrhage;
recovery of neurological function;
anti-oxidative stress;
in-flammatory factors;
ferroptosis-related markers;
im-aging
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2025;30(10):1391-1399
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To examine the impact of An-gong Niuhuang pill in conjunction with convention-al therapy on the recovery of neurological function in patients with cerebral hemorrhage(ICH)charac-terized by phlegm-heat internal obstruction,and to evaluate its efficacy in enhancing neurological func-tion,promoting brain tissue repair,and mitigating oxidative stress.Additionally,this study aims to elu-cidate the potential mechanisms underlying these effects through the AMPK-PGC1α-Nrf2 pathway.METHODS:A total of 130 patients with ICH charac-terized by phlegm-heat internal closure were re-cruited and randomly allocated into a control group(receiving conventional treatment)and a study group(receiving Angong Niuhuang pill in combination with conventional treatment)using the random number table method,with 65 cases in each group.Post-treatment assessments included the National Institutes of Health Stroke Scale(NI-HSS)score,Glasgow Coma Scale(GCS)score,modi-fied Rankin scale(mRS)score,as well as tissue lev-els of AMP-activated protein kinase(AMPK),peroxi-some proliferator-activated receptor gamma coacti-vator-1α(PGC1α),and nuclear factor erythroid 2-related factor 2(NRF2).Additionally,serum levels of superoxide dismutase(SOD),malondialdehyde(MDA),reactive oxygen species(ROS),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),inter-leukin-6(IL-6),glutathione peroxidase 4(GPX4),ac-yl-coenzyme A synthetase long-chain family mem-ber 4(ACSL4),iron ions,tumor volume,brain ede-ma volume,and the incidence of adverse reactions were evaluated.RESULTS:Each group comprised 65 cases.Post-treatment,the NIHSS score(9.97±1.22)and mRS score(2.29±0.33)in the Research Group were significantly lower than those in the Control Group(11.17±1.52 and 2.64±0.45,respec-tively),with p-values less than 0.05.Additionally,the GCS score for the Research Group(14.57±1.19)was notably higher compared to the control group(13.18±1.05)(P＜0.05).After treatment,the expres-sions of AMPK[(3.34±0.81)ng/mL],PGC1α[(2.30±0.67)ng/mL]and NRF2[(3.72±0.85)ng/mL]in the tissues of the group were higher than those of the control group[(2.63±0.65)ng/mL,(1.83±0.70)ng/mL,(2.91±0.96)ng/mL](P＜0.05).After treatment,the levels of serum SOD[(98.76±6.67)U/mL]and IL-10[(40.37±5.61)pg/mL]in the research group were higher than those in the Control group group[(89.65±6.89)U/mL,(35.69±4.65)pg/mL](P＜0.05);the serum levels of MDA[(3.36±0.62)nmol/mL],ROS[(126.35±23.74)U/mL],TNF-α[(17.22±2.07)pg/mL]and IL-6[(33.37±3.76)pg/mL]in the group were lower than those in the control group group[(3.76±0.83)nmol/mL,(159.85±26.67)nmol/mL,(19.15±2.34)nmol/mL,(41.26±4.91)nmol/mL](P＜0.05).After treatment,the serum GPX4 level in the Research Group[(9.87±1.25)ng/mL]was higher than that in the control group[(8.16±1.12)ng/mL](P＜0.05).The serum levels of ACSL4[(8.74±1.45)ng/mL]and iron ion[(27.44±3.35)μmol/L]in the study group were lower than those in the control group(10.12±2.11)ng/mL,(30.46±3.17)μmol/L](P＜0.05).After treatment,the hematoma volume[(6.46±1.13)mL]and brain edema volume[(11.47±1.76)mL]in the research group were bet-ter than those in the Control group[(8.71±1.02)mL,(3.41±2.04)mL](P＜0.05).CONCLUSION:The combination of Angong Niuhuang pill with conven-tional treatment demonstrates significant efficacy in improving neurological function,promoting brain tissue repair,and alleviating oxidative stress,thereby exhibiting high application value in clinical practice.
