| Objectives:To discuss the distribution of TCM syndromes and pathogenesis of cerebral stroke at acute period complicated with gastrointestinal dysfunction. Meanwhile, observing the changes of EGG and gastrointestinal hormones of acute stroke,in order to look for evidence on objectiveness of TCM Syndrome differentiation by exploring the internal relations between TCM syndrome and microcosmic index.Methods:Reviewed 192 cases of acute stroke patients with clinical data integrity which come from the Medical Group Qingdao Qingdao Hiser Hospital of Neurology in March—ctober 2009.According to the unified diagnostic criteria, inclusion criteria and exclusion criteria of patients selection, with reference to "Chinese in herbal medicine science" and "Guiding Principles of Chinese Medicine Clinical Research Drug",for expert advice and feasibility analysis, we make a TCM observe syndromes form,and record clinical symptoms, tongue and pulse within one week after admission.At the same time.we test serum Gastrin(GAS),plasma Motilin (MTL)and Vasoactive Intestinal Peptide(VIP) levels and record surface of gastric electrical(EGG) of the patients in 24 hours and 1 week after.We consolidate data and,analysis clinical syndromes'features and related indicators'changes of the acute stroke patients with gastrointestinal dysfunction by test.Results:1.Constipation is the most common symptoms in the acute phase of stroke patients with gastrointestinal dysfunction,and eat less is the next.Tan Re Yun Pi (24.5%), Wei Chang Ji Re (17.6%) and Gan Qi Fan Wei (15.7%),the three types were in majority of all the secondary gastrointestinal dysfunction syndromes in TCM syndrome type.2.In 24 hours and 1 week after admission,Serum Gastrin (GAS),Plasma Motilin (MTL)and Vasoactive Intestinal Peptide (VIP) levels of acute phase of stroke patients with gastrointestinal dysfunction secondary was significantly higher than normal control group(P<0.01).In the acute phase of stroke patients with gastrointestinal dysfunction,MTL fasting levels of Tan Re Yun Pi group and Wei Chang Ji Re group is the highest,while of Wei Yin Bu Zu group is the lowest.3.The EGG parameters of patients with acute stroke in 24 hours admitted to hospital changed markedly with 1 week after.the amplitude of the gastric antrum and body were significantly lower compared with normal control group (P<0.05),while the frequency was not reduced significantly.Between TCM syndrome type and the main parameters of gastric electrical about stroke patients with acute gastrointestinal dysfunction was not have obvious correlation.Conclusions:The basic pathogenesis of the acute phase of stroke is the Qi including inverse disorderly.Phlegm,fire,blood stasis,deficiency and other pathological factors influence the spleen and stomach,and affect the movements of the Qi,while which cause complicated gastrointestinal diseases.Clinical observation shows that acute stroke patients with gastrointestinal dysfunction in TCM syndrome type is in real mainly.The levels of fasting GAS,MTL and VIP were increased in various degreesin Acute Period of Cerebral Apoplexy,and the levels of gastrointestinal hormone of 24 hours and 1 week after admission with gastrointestinal dysfunction patients were higher prominently than healthy volunteers,which suggested that the change of gastrointestinal hormone play an important role in pathogenesis of acute stroke patients with gastrointestinal dysfunction.Increased levels of three kinds of gastrointestinal hormones could provide an objective for TCM Syndrome type,Also have a certain relevance with its symptoms of gastrointestinal. The gastric antrum and gastric peristalsis frequency of stroke patients with acute period did not have obvious changes,but the peristalsis strength is decrease,which suggested that gastric motility in patients with acute stroke have abnormal changes, gastrointestinal hormone may be one of many important regulating factors. |
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