急性脑血管病辨证分型与血浆胃动素关系研究

目的探讨急性脑血管病中医辨证分型与血浆胃动素的关系.方法将350例急性脑血管病患者辨证分为痰热腑实、风痰火亢、风痰瘀阻、风火上扰、痰湿蒙神、气虚血瘀、阴虚风动型7个证型,每个证型各5 0例,另设健康对照组50例,观察组与对照组均在入院后翌日、排便后翌日、病程第7天和第14天清晨空腹平卧采肘静脉血测定血浆胃动素.最后运用华西医科大学卫生统计学教研室提供的Pems软件包进行统计学处理.结果急性脑血管病患者血浆MTL水平显著高于正常人.其中以痰热腑实型、风痰瘀阻型、痰湿蒙神型、气虚血瘀型的空腹血浆胃动素水平较正常对照组显著升高,差异有非常显著性(P＜0.01).其中急性出血性脑血管病(ICH)的其余各证型差异亦有非常显著性(P＜0.01),急性缺血性脑血管病(CI)的风火上扰、阴虚风动型差异有显著性(P＜0.05).结论急性脑血管病中医辨证分型与血浆胃动素浓度有相关性.为临床辨病与辨证相结合,指导临床合理应用通腑药提供了一个客观指标.

Study on the Relationship between Stratified Syndrome of TCM in Acute Cerebrovascular Disease and Plasma motilin

Objective Explorate the relationship between stratified syndrome of TCM in acute cerebrovascular disease and plasma motilin. Method According their syndrome of TCM, we classify 350 cases into 7 groups, and they are all in accord with observing conditions. Every group has 50 patients. 7 groups are: Tan Re Fu Shi, Feng Tan Huo Kang, Feng Tan Yu Zu, Feng Huo Shang Rao, Tan Shi Meng Shen, Qi Xu Xue Yu, Yin Xu Feng Dong. We also select a healthy control group. There aren't statistical difference in age and sexuality among groups. Each two groups have comparability. All patients are adopted elbow vein blood 4 times when they are empty stomach (the day after admission date, the day after defecation date,the seventh day and the forteenth day after admission date) to measure plasma motilin. At last, we do statistic analysis by pems software. Result Acute cerebrovascular disease's (not only ischemic one but also hemorrhagic one) plasma motilin level is higher than normal adult. Motilin in group of Tan Re Fu shi, Feng Tan Yu Zu, Tan Shi Meng Shen, Qi Xu Xue Yu are highest of all, and they are obviously significance (P<0.01). The other groups are obviously significance too (P<0.01), in acute hemorrhagic cerebrovascular disease. Feng Huo Shang Rao and Yin Xu Feng Dong is significance (P<0.05) in acute ischemic cerebrovascular disease. The study shows that ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease in acute stage have respectively specially nosopoietic time (cerebral infarction is 4-7th day, cerebral hemorrhage is 1-3rd day). At this time, motilin is peak level. And then, plasma motilin level declines step by step. In resolving stage, motilin level restorates normal level (cerebral infarction is 14th day, cerebral hemorrhage is 21th day). Conclusion There is correlation between stratified syndrome of TCM in acute cerebrovascular disease and plasma motilin, especially in Tan Re Fu shi, Feng Tan Yu Zu, Tan Shi Meng Shen and Qi Xu Xue Yu (Tan Re Fu Shi is obviously significance). The study provides a objective level in combinating clinical diagnosis with differentiating symptoms and signs, instructing to medicate (especially in diagnosing Tan Re Fu Shi and rational treatment of laxatives and purgatives). Dynamic monitoring plasma motilin indirectedly instructs treatment and forecasts prognosis.