| 引用本文:李义春1，王惠1，王明龙1，姚卫东1，代婀娜2.基于PI3K/AKT信号通路探讨四逆汤治疗术后认知障碍的机制[J].世界中医药,2021,(08):. |
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| 基于PI3K/AKT信号通路探讨四逆汤治疗术后认知障碍的机制 |
| Mechanism of Sini Decoction in the Treatment of Postoperative Cognitive Impairment Based on PI3K-AKT Signaling Pathway |
| 投稿时间：2019-09-25 |
| DOI：10.3969/j.issn.1673-7202.2021.08.016 |
| 中文关键词: 四逆汤 磷脂酰肌醇3激酶 丝氨酸-苏氨酸蛋白激酶 信号通路 术后认知障碍 炎症介质 机制 安全性 |
| English Keywords:Sini Decoction Phosphatidylinositol 3-kinase Serine-threonine protein kinase Signaling pathway Postoperative cognitive impairment Inflammatory factors Mechanism Security |
| 基金项目:国家自然科学基金项目(81903780);山东省医学科学院院级科技计划青年基金项目(2015-69) |
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| 中文摘要: |
| 目的:探讨四逆汤作用于PI3K/AKT信号通路对术后认知障碍(POCD)的影响。方法:选取2018年2月至2019年6月山东中医药大学第二附属医院收治的手术麻醉患者92例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组46例。对照组给予常规围手术期治疗,观察组加用四逆汤口服。观察不同时期炎症介质、简易精神状态量表、PI3K/AKT信号通路、生命体征变化。结果:2组插入喉罩后即刻(T1)、手术后6 h(T2)、24 h(T3)、48 h(T4)较T0在PI3K、AKT均显著降低,Bcl、Bax较T0均显著升高(P<0.05),且观察组优于对照组(P<0.05)。对照组术后24 h、术后5 d白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)较治疗前均显著升高(P<0.05),观察组术后24 h IL-6、CRP、TNF-α较手术前均显著升高(P<0.05),术后5 d与术后24 h比较均显著下降(P<0.05),与手术前比较差异无统计学意义(P>0.05),术后24 h、术后5 d观察组优于对照组(P<0.05)。对照组手术后5 d计算力及注意力、延迟回忆、阅读及语言理解、总分较手术前均显著下降(P<0.05),而观察组手术后5 d较手术前差异无统计学意义(P>0.05)。观察组手术后5 d计算力及注意力、延迟回忆、阅读及语言理解、总分显著优于对照组(P<0.05)。2组T1在收缩压、舒张压上较T0、T2均显著下降(P<0.05),但2组T0、T1、T2组间比较差异无统计学意义(P>0.05)。结论:四逆汤可通过影响PI3K/AKT信号通路,抑制炎症反应,从而改善POCD,且安全性高。 |
| English Summary: |
| To explore the effects of PI3K/AKT signaling pathway on postoperative cognitive impairment(POCD).Methods:A total of 2 patients under surgical anesthesia admitted to anesthesia department Affiliated Hospital of Shandong Academy of Medical Sciences from Feb.2018 to Jun.2019 were selected as the research objects and were randomly divided into a control group and an observation group,with 46 cases in each group.The control group(n=46)was given routine perioperative treatment，and the observation group(n=46)was given Sini Decoction orally.The changes of miscellaneous inflammatory factors，simple mental state scale，PI3K/AKT pathway and vital signs in different periods were observed and compared.Results:Immediately after insertion of laryngeal mask(T1)，6 h(T2)，24 h(T3)，48 h(T4)were significantly lower than T0 at PI3K and AKT，while Bcl and Bax were significantly higher than T0(P<0.05)，and the observation group was better than the control group(P<0.05).The levels of IL-6，TNF-alpha and CRP in control group increased significantly 24 h and 5 d after operation(P<0.05)，while the levels of IL-6，CRP and TNF-alpha in observation group increased significantly 24 h after operation(P<0.05).The observation group was better than the control group at 24 hours and 5 days after operation(P<0.05).In the control group，5 days after the operation，computing power and attention，delayed recall，reading and language comprehension，and total scores were significantly lower than those before the operation(P<0.05).However，there was no statistically significant difference between the study 5 days after the operation and before the operation(P>0.05).The observation group's calculation ability and attention，delayed recall，reading and language comprehension，and total scores were significantly better than those of the control group on the 5th day after surgery(P<0.05).The systolic and diastolic blood pressure of the 2 groups of T1 were significantly lower than that of T0 and T2(P<0.05)，but there was no significant difference between the 2 groups of T0，T1，and T2(P>0.05).Conclusion:Sini Decoction can improve POCD by affecting PI3K/AKT signaling pathway and inhibiting inflammation. |
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