Objective: This study was carried out to probe the clinical effect and mechanism of Huatan Tongluo decoction combined with acupuncture in the treatment of patients with ischemic stroke.
Methods: The clinical data of 100 patients with ischemic stroke were retrospectively collected. On the basis of treatment method, they were split into two groups, each with 50 cases: the conventional treatment group (acupuncture) and the combined treatment group (Huatan Tongluo decoction + acupuncture). After treatment, the neurological function and clinical therapeutic effects of the two groups were evaluated. The treatment of ischemic stroke with Huatan Tongluo decoction was studied by the method of traditional Chinese medicine (TCM) network pharmacology. Resources from databases such as GeneCards, TCMSP, PubChem, Swiss Target Prediction, String, and WebGestalt were integrated, in order to screen for targets of stroke treatment, the active compound composition of Huatan Tongluo decoction, and the targets of compound composition by the use of Cytoscape and R language software. Finally, from the perspective of a protein-protein interaction (PPI) co-expression network, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, the significance of Huatan Tongluo decoction in the treatment of ischemic stroke was discussed.
Results: The total effectiveness rate in the combined treatment group was superior to the conventional treatment group. The combined group had higher scores of neurological function, limb movement function, and ability to perform daily living tasks than the conventional treatment group (all P < 0.05). 368 pharmacological targets for Huatan Tongluo decoction and a total of 5690 ischemic stroke targets were retrieved from the database, and 215 intersection targets were found. The results of the PPI network indicated that 43 targets, including EGFR (epidermal growth factor receptor), SRC (proto-oncogene, non-receptor tyrosine kinase), PTPN11 (protein tyrosine phosphatase non-receptor type 11), PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha), AKT1 (serine/threonine kinase 1), VEGFA (vascular endothelial growth factor A), STAT3 (signal transducer and activator of transcription 3), and FYN (FYN proto-oncogene, Src family tyrosine kinase), had the strongest interactions, so they could be used as targets for subsequent basic research verification. The results suggested that pathways such as vascular endothelial growth factor (VEGF) signaling pathway and other pathways were enriched.
Conclusion: The combination of Huatan Tongluo decoction and acupuncture can help patients with sequelae of stroke promote the regaining of neurological function, thus improving their movement and enhancing their abilities to perform daily living. Huatan Tongluo decoction can mediate the VEGF signaling pathway and other pathways to treat ischemic stroke.
Keywords: Huatan Tongluo decoction; acupuncture; clinical effect; molecular mechanisms; network pharmacology; stroke.
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