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Journal of Chinese Integrative Medicine ›› 2011, Vol. 9 ›› Issue (11): 1215-1220.doi: 10.3736/jcim20111109

• Original Clinical Research • Previous Articles     Next Articles

Flavonoids of puerarin versus tanshinone ⅡA for ischemic stroke: A randomized controlled trial

Lei Chen, Xiao-ying Bi, Li-xun Zhu, Yi-qing Qiu, Su-ju Ding, Ben-qiang Deng()   

  1. Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
  • Received:2011-07-26 Accepted:2011-09-01 Online:2011-11-20 Published:2011-11-15

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Background:Flavonoids are widely used today in the treatment of ischemic stroke. The therapeutic effects and functions of flavonoids are, therefore, generating more and more interest.
Objective: To investigate the therapeutic effects and functions of flavonoids of puerarin in treating patients with ischemic stroke. Design, setting, participants and interventions: A total of 67 inpatients suffering from ischemic stroke from the Department of Neurology, Changhai Hospital in China were divided into two groups randomly, the treatment group, which was treated with flavonoids of puerarin, and the control group, administered with tanshinone ⅡA sulfate instead.
Main outcome measures: Defects in neurological function were evaluated according to the National Institutes of Health Stroke Scale (NIHSS) on the first day of onset. Lactate dehydrogenase (LDH), serum interleukin-6 (IL-6) and brain-derived neurotrophic factor (BDNF) levels were determined by radioimmunoassay on the second trial day. After a 14-day treatment, LDH, serum IL-6 and BDNF levels and NIHSS score were also detected, and CT perfusion imaging was used to measure and analyze the regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV) and mean transit time (MTT).
Results: On the first day, NIHSS scores of the two groups were similar. On the second day there was no significant difference in LDH and IL-6 levels between the treatment group and the control group. After a 14-day treatment, LDH and IL-6 levels and the NIHSS score in the treatment group were lower than those in the control group (P<0.05). There was no significant difference in BDNF levels in the two groups. After 14 d, the CT perfusion imaging demonstrated that the treatment group showed more effective blood perfusion than the control group.
Conclusion: Flavonoids of puerarin can restrain the increase of IL-6 after acute ischemic stroke, and depress the LDH raised by reperfusion after cerebral ischemia. It can also enhance blood perfusion of the ischemic region.

Key words: puerarin, flavone, tanshinone, brain ischemia, stroke, lactate dehydrogenases, interleukin-6, brain-derived neurotrophic factor

Figure 1

Flow diagram of this randomized trial"

Table 1

Serum levels of LDH, IL-6 and BDNF and NIHSS score of the two group before and after treatment (x±s)"


Group
n
LDH (U/L)
IL-6 (ng/L)
BDNF (ng/L)
Score of NIHSS

Flavonoids of puerarin

Before treatment
34
313.4±93.3
75.0±17.6
465.5±94.6
7.1±1.8

After treatment
34
158.3±56.4*△
8.5±2.9*△
899.7±211.1△
3.2±1.6*△

Tanshinone ⅡA sulfate

Before treatment
33
295.8±103.9
65.9±37.3
363.4±158.3
7.0±1.7

After treatment
33
228.2±95.6
28.3±10.8△
702.1±123.4△
4.3±1.9△

Table 2

CT perfusion imaging analysis of the two group (n, %)"


Group
n
Normal perfusion
Delayed perfusion
Insufficient perfusion

Flavonoids of puerarin
34
8 (23.5%)
12 (35.3%)
14 (41.2%)

Tanshinone ⅡA sulfate
33
5 (15.2%)
8 (24.2%)
20 (60.1%)
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