摘要
目的:观察平胃散加减对阻塞性呼吸暂停低通气综合征患者认知功能和睡眠结构、心室复极参数变化及血清γ-谷氨酰转肽酶(GGT)、过氧化物酶体增殖物激活受体γ(PPAR-γ)、miR-233表达的影响。方法:选择阻塞性呼吸暂停低通气综合征患者100例,通过随机数字表法分组,对照组50例,给予常规西医治疗,治疗组50例,常规西医治疗同时给予平胃散加减治疗,检测患者治疗前后可溶性血管细胞黏附分子-1(sVCAM-1)、巨噬细胞炎症蛋白-1α(MIP-1α)、GGT、中性粒细胞明胶酶相关载脂蛋白(NGAL)、脂氧素A4(LXA4)、缺氧诱导因子-1α(HIF-1α)、PPAR-γ、miR-233水平,检测患者夜间Tp-e间期、QT间期、Tp-e/QT、快速眼动睡眠(REM)期、Ⅰ期+Ⅱ期、Ⅲ期+Ⅳ期占比及睡眠呼吸暂停低通气指数(AHI),蒙特利尔认知评估量表(MoCA)、认知功能简易智能精神状态检查量表(MMSE)评价,比较两组临床疗效。结果:治疗组患者sVCAM-1、MIP-1α、HIF-1α含量较对照组明显降低(P<0.05);治疗组患者GGT、NGAL含量较对照组明显降低(P<0.05),治疗组LXA4含量较对照组明显升高(P<0.05);治疗组患者PPAR-γ含量较对照组明显降低(P<0.05),治疗组miR-233含量较对照组明显升高(P<0.05);治疗组夜间Tp-e间期、QT间期、Tp-e/QT较对照组明显缩短(P<0.05);治疗组患者Ⅰ期+Ⅱ期百分比、AHI较对照组明显降低(P<0.05),治疗组REM期、Ⅲ期+Ⅳ期占比较对照组明显升高(P<0.05);治疗组MMSE、MoCA评分明显较对照组高(P<0.05),治疗组总有效率高于对照组(98.00%与90.00%)(P<0.05)。结论:平胃散加减治疗阻塞性呼吸暂停低通气综合征患者,可抑制患者炎症,减少氧化反应损伤,降低PPAR-γ、HIF-1α水平,提升miR-233水平,调节心室复极参数,改善睡眠结构及认知功能,提升临床疗效。
Objective:To observe the effects of modified Pingweisan on cognitive function,sleep structure,ventricular repolarization parameters,serumγ-glutamyl transpeptidase(GGT),peroxisome proliferators in patients with obstructive apnea-hypopnea syndrome.The effect of activating receptor gamma(PPAR-γ)and miR-233 expression.Methods:A total of 100 patients with obstructive apnea-hypopnea syndrome were selected.50 patients as thecontrol group were given conventional western medicine treatment.50 patients as the treatment group,conventional western medicine treatment was given modified Pingweisan and subtracted treatment at the same time,before and after treatment,soluble vascular cell adhesion molecule-1(sVCAM-1),macrophage inflammatory protein-1α(MIP-1α),GGT,neutrophil gelatinase-associated apolipoprotein(NGAL),lipoxin A4(LXA4),hypoxia-inducible factor-1α(HIF-1α),PPAR-γ,miR-233 levels were detected in patients Nocturnal Tp-e interval,QT interval,Tp-e/QT,rapid eye movement sleep(REM)stage,stageⅠ+stageⅡ,stageⅢ+stageⅣ,and sleep apnea hypopnea index(AHI),cognition the functional Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)were used to evaluate the clinical efficacy of the treatment group and the control group.Results:The contents of sVCAM-1,MIP-1αand HIF-1αin the treatment group were significantly lower than those in the control group(P<0.05).The contents of GGT and NGAL in the treatment group were significantly lower than those in the control group(P<0.05).The contents of LXA4 in the treatment group were lower than those in the control group.The content of PPAR-γin the treatment group was significantly increased(P<0.05),the treatment group content of PPAR-γwas significantly lower than that in the control group(P<0.05),and the treatment group content of miR-233 was significantly higher than that in the control group(P<0.05).Compared with the control group,Tp-e interval,QT interval and Tp-e/QT were significantly shortened(P<0.05).The proportion of stageⅢ+stageⅣwas significantly higher in the control group(P<0.05).The MMSE and MoCA scores of the treatment group were significantly higher than those of the control group(P<0.05),and the total effective rate of the treatment group was higher than that in the control group(98.00%versus 90.00%)(P<0.05).Conclusion:Modified Pingweisan in the treatment of patients with obstructive apnea-hypopnea syndrome can inhibit inflammation,reduce oxidative damage,reduce PPAR-γ,HIF-1αlevels,increase miR-233 levels,regulate ventricular repolarization parameters,and improve sleep structure and cognitive function to improve clinical efficacy.
作者
荀军锋
杨亚倩
刘萍萍
徐华
刘博
王充
XUN Junfeng;YANG Yaqian;LIU Pingping;XU Hua;LIU Bo;WANG Chong(Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang 050051,China)
出处
《陕西中医》
CAS
2023年第1期50-54,共5页
Shaanxi Journal of Traditional Chinese Medicine
基金
河北省中医药管理局科研计划项目(2020330)。
关键词
阻塞性呼吸暂停低通气综合征
炎症
氧化反应
平胃散加减
心室复极参数
睡眠结构
认知功能
Obstructive apnea hypopnea syndrome
Inflammation
Oxidative response
Modified Pingweisan
Ventricular repolarization parameters
Sleep structure
Cognitive function
