To observe the effect of Modified Huoxue Tongqiao Decoction (活血通窍汤加减方) combined with hyperbaric oxygen therapy on the clinical prognosis and peripheral blood levels of microRNA-193b-3p (miR-193b-3p) and hypoxia-inducible factor-1 α (HIF-1 α) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Ninety-four patients with aSAH admitted from January 2022 to February 2024 were selected and divided into a hyperbaric oxygen group (47 cases) and a traditional Chinese medicine group (47 cases) using a lottery method. Both groups were treated with endovascular intervention or craniotomy clipping surgery. The hyperbaric oxygen group was treated with hyperbaric oxygen therapy after surgery, while the traditional Chinese medicine group was treated with Modified Huoxue Tongqiao Decoction on the basis of hyperbaric oxygen therapy. The thromboelastography parameters, relative expression levels of miR-193b-3p and miR-27a, HIF-1 α, oxidative stress markers, National Institutes of Health Stroke Scale (NIHSS) scores, traditional Chinese medicine symptom scores, Barthel (BI) index and short-term prognosis of two groups were compared.

After treatment, the levels of maximal amplitude (MA) and coagulation index (CI) and alpha angle of the hyperbaric oxygen group and traditional Chinese medicine group were lower than those before treatment, and these indexes of the traditional Chinese medicine group were lower than those of hyperbaric oxygen group (P<0.05) . After treatment, the miR-193b-3p levels were lower in the hyperbaric oxygen group and traditional Chinese medicine group than those before treatment, and the level in the traditional Chinese medicine group was higher than that in the hyperbaric oxygen group (P<0.05). The relative expression of miR-27a was higher in the hyperbaric oxygen group and traditional Chinese medicine group than those before treatment and the expression in the traditional Chinese medicine group was higher than that in the hyperbaric oxygen group (P<0.05) . After treatment, the levels of HIF-1 αand malondialdehyde (MDA) in the hyperbaric oxygen group and traditional Chinese medicine group were lower than those before treatment, and the levels of the traditional Chinese medicine group were lower than those of the hyperbaric oxygen group (P<0.05). The levels of superoxide dismutase (SOD) and total antioxidant capacity (T-AOC) in the hyperbaric oxygen group and traditional Chinese medicine group were higher than those in the hyperbaric oxygen group, and the levels of the traditional Chinese medicine group were higher than those of the hyperbaric oxygen group (P<0.05) . After treatment, NIHSS scores and traditional Chinese medicine symptom scores of the hyperbaric oxygen group and traditional Chinese medicine group were lower than those before treatment, and the scores of the traditional Chinese medicine group were lower than those of the hyperbaric oxygen group (P<0.05) . BI indexes of the hyperbaric oxygen group and traditional Chinese medicine group were higher than those before treatment, and the index of the traditional Chinese medicine group was higher than that of the hyperbaric oxygen group (P<0.05). The short-term prognosis of the traditional Chinese medicine group was better than that of the hyperbaric oxygen group (P<0.05) . Comparison of adverse reactions between the two groups showed no difference (P>0.05) .

The combination of Modified Huoxue Tongqiao Decoction and hyperbaric oxygen therapy can alleviate the oxidative stress damage and improve the neurological function and short-term prognosis in patients with aSAH.