变通炙甘草汤治疗肝肾不足型帕金森病患者的临床观察及对神经元信号相关蛋白的影响  

Clinical Observation of Modified Zhigancao Tang in Treating Patients with Liver and Kidney Deficiency of Parkinson's Disease and Its Effect on Neuronal Signal-related Proteins

作　　者：韦一佛 吕富荣 姚佳 李国年 罗贤毅 罗蒙 文铮铮 李秋琦 刘一晗 杨琳琳 左瑞 党文欣 米芳 王晓燕 陈志刚[5] 刘凡 WEI Yifo;LYU Furong;YAO Jia;LI Guonian;LUO Xianyi;LUO Meng;WEN Zhengzheng;LI Qiuqi;LIU Yihan;YANG Linlin;ZUO Rui;DANG Wenxin;MI Fang;WANG Xiaoyan;CHEN Zhigang;LIU Fan(Xi'an Hospital of Traditional Chinese Medicine(TCM),Xi'an 710016,China;Shaanxi University of Chinese Medicine,Xianyang 712046,China;Gem Flower Xi'an Changqing Staff Hospital,Xi'an 710201,China;Xi'an Yanliang District Hospital of TCM,Xi'an 710089,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]西安市中医医院,西安710016 [2]陕西中医药大学,陕西咸阳712046 [3]西安宝石花长庆医院,西安710201 [4]西安市阎良区中医医院,西安710089 [5]北京中医药大学东方医院,北京100078

出　　处：《中国实验方剂学杂志》2025年第4期166-173,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82174328);陕西省科技厅-陕西省重点研发计划项目(2021-SF405);西安市科技局-西安市创新能力强基计划-医学研究项目(21YXYJ0057);西安市科技局-医学研究项目(24YXYJ0086);陕西中医药大学校级科研项目(2021FS08)。

摘　　要：目的:微管关连蛋白-2(MAP-2)、α-微管蛋白(α-tubulin)、突触素(SYP)是神经元信号通信中的重要蛋白。该研究通过观察变通炙甘草汤对帕金森病(PD)患者血清中α-突触核蛋白(α-Syn)及其寡聚体与血清中MAP-2、α-tubulin、SYP的表达的影响及其相关性分析,评价变通炙甘草汤基于神经元信号通信介导的α-Syn在体内传播途径对肝肾不足型PD患者的治疗作用的可能机制。方法:符合纳入标准的60例PD患者,随机分为治疗组和对照组,各30例。两组均以抗PD西药治疗为基础,治疗组加用变通炙甘草汤;两组均治疗12周。观察各组患者治疗前及治疗12周后帕金森综合评分量表(UPDRS)评分、中医证候积分、血清α-Syn及其寡聚体、MAP-2、α-tubulin、SYP表达的变化。并对前述血清生物学指标与血清α-Syn及其寡聚体水平进行相关性分析。结果:治疗组患者治疗后中医证候评分、PDRS总分、UPDRS-Ⅱ、UPDRS-Ⅲ分值较本组治疗前明显下降(P<0.05,P<0.01);治疗组患者治疗后较对照组患者治疗后UPDRS总分、UPDRS-Ⅱ、UPDRS-Ⅲ分值明显下降(P<0.05)。治疗后对照组总有效率63.3%(19/30),治疗组总有效率86.7%(26/30);两组临床疗效比较,观察组优于对照组(Z=-2.03,P<0.05);总有效率比较,观察组优于对照组(χ^(2)=5.136,P<0.05)。治疗组患者治疗后血清α-Syn寡聚体水平、血清MAP-2水平较治疗前明显下降(P<0.05,P<0.01);治疗组患者治疗后较对照组患者治疗后血清α-Syn及其寡聚体、血清α-tubulin水平明显下降(P<0.05,P<0.01)。PD患者血清α-Syn与血清MAP-2、α-Syn寡聚体具有相关性(P<0.05,P<0.01),与血清SYP水平无相关性;PD患者血清α-Syn寡聚体与血清MAP-2、α-tubulin具有相关性(P<0.05,P<0.01),与血清SYP水平无相关性;PD患者血清SYP水平与血清MAP2水平具有相关性(P<0.05)。结论:变通炙甘草汤可通过干预α-Syn寡聚体的产生及干预α-Syn在体内通过微管运输途径的传播,�Objective:Microtube associated protein-2(MAP-2),alpha-tubulin(α-tubulin),and synaptophysin(SYP)are important proteins in neuronal signal communication.This paper observed the effects of modified Zhigancao Tang on the expression of serumα-Synuclein(α-Syn)and its oligomers,MAP-2,α-tubulin,and SYP of patients with liver and kidney deficiency of Parkinson's disease(PD),analyzed their correlation,and evaluated the therapeutic effect of modified Zhigancao Tang in patients with liver and kidney deficiency of PD based onα-Syn transmission pathway mediated by neuronal communication in vivo.Methods:A total of 60 patients with PD who met the inclusion criteria were randomly divided into a treatment group(30 cases)and a control group(30 cases).Both groups were treated on the basis of PD medicine,and the treatment group was treated with modified Zhigancao Tang.Both groups were treated for 12 weeks.The changes in UPDRS score,TCM syndrome score,and expression of serumα-Syn and its oligomers,MAP-2,α-tubulin,and SYP were observed before and after 12 weeks of treatment in each group.The correlation between the above-mentioned serum biological indexes and the levels of serumα-Syn and its oligomers was analyzed.Results:After treatment,the TCM syndrome score,UPDRS score,UPDRS-Ⅱscore,and UPDRS-Ⅲscore of the treatment group were significantly decreased(P<0.05,P<0.01).The UPDRS score,UPDRS-Ⅱscore,and UPDRS-Ⅲscores in the treatment group were significantly decreased compared with those in the control group after treatment(P<0.05).After treatment,the total effective rate of the control group was 63.3%(19/30),and that of the treatment group was 86.7%(26/30).The clinical effect of the observation group was better than the control group(Z=-2.03,P<0.05).The total effective rate of the observation group was better than that of the control group,and the difference was statistically significant(χ^(2)=5.136,P<0.05).After treatment,the oligomer level of serumα-Syn and MAP-2 level in the treatment group were significantly decrease

关 键 词：帕金森病 Α-突触核蛋白 神经元信号通信 微管运输 变通炙甘草汤 

分 类 号：R242[医药卫生—中医临床基础] R287[医药卫生—中医学] R161