解毒通腑法对卒中后神经肽Y及心肌酶谱影响临床观察.docVIP

解毒通腑法对卒中后神经肽Y及心肌酶谱影响临床观察 　　[摘要] 目的 探讨解毒通腑法对急性脑卒中后血浆神经肽Y（neuropeptide Y，NPY）水平的影响及与心肌酶谱异常的相关性，探寻中医药防治脑心综合征（Cerebral-cardiac syndrome，CCS）的有效方法。 方法 收集符合入院条件的急性脑卒中患者134例，其中实验组71例，对照组63例。实验组在常规治疗基础上同时使用我科自研的中药解毒通腑汤，对照组则不口服中药。分次检测血浆神经肽Y与心肌酶谱水平，同时对所得数据进行对比观察。结果 实验组血浆神经肽Y水平较对照组降低更显著，差异有统计学意义（P0.05）。 结论 解毒通腑法能够显著降低脑卒中患者体内的神经肽Y水平，但是这一水平的改变并没有反映在心肌酶谱异常率的下降趋势上。 　　[关键词] 解毒通腑法；神经肽Y；脑心综合征；心肌酶谱 　　[中图分类号] R277.7 [文献标识码] B [文章编号] 1673-9701（2017）35-0139-03 　　[Abstract] Objective To investigate the effect of Tongfu detoxification method on plasma neuropeptide Y（NPY） level after acute stroke and its correlation with abnormal myocardial enzymes， and to explore the effective method of Chinese herbal medicine in the prevention and treatment of brain cerebral-cardiac syndrome（CCS）. Methods A total of 134 acute stroke patients meeting the admission conditions were enrolled in this study.Among them， 71 patients were included in the experimental group and 63 patients were included in the control group. The experimental group was treated with Chinese medicine Tongfu detoxification soup developed in our department based on the conventional treatment.The control group was not given oral Chinese medicine. Plasma levels of neuropeptide Y and myocardial enzymes were measured at different levels， and the data obtained were compared. Results The level of plasma neuropeptide Y in experimental group decreased more significantly than that in control group， with significant difference between the two groups（P0.05）. Conclusion Tongfu detoxification method can significantly reduce the level of neuropeptide Y in stroke patients， but the change of this level does not respond to the downward trend of abnormal rate of myocardial enzymes. 　　[Key words] Tongfu detoxification method； Neuropeptide Y； Cerebral-cardiac syndrome； Myocardial enzymes 　　急性脑卒中后出现脑心综合征（CCS）在临床中极为普遍，王鹏等[1]在对急性脑卒中并发脑心综合征80例临床分析中发现患者脑心综合征的发生率达40%。脑心综合征发生的机制尚不十分明确，许志强等[2]研究中发现中枢及外在神经肽Y含量增高可能参与脑心综合征的发生发展。针对中风后的脑心综合征，结合中风毒邪论这一中医病机，我们提出了中