吴犀翎+黄小波+陈文强

摘要：脑血管病又称脑血管意外或脑卒中,属中医“中风”范畴,其发生发展与胃肠道系统有着密切的关系。本文从以下三方面阐述脑血管病急性期胃肠道系统与脑的关系。首先,中医理论认为胃肠道系统与脑在生理功能及经络方面具有密切的联系；其次,临床研究表明痰热腑实证是脑血管病急性期主要证候之一,此证候最突出的表现为腑实便秘,关乎病情转归预后；再者,脑血管病急性期脑肠肽中胆囊收缩素的改变和体表结肠电生理变化也为胃肠道系统与脑具有相关性的理论提供了物质基础和电生理基础。

关键词：脑血管病急性期；脑卒中；胃肠道系统；脑肠肽

DOI：10.3969/j.issn.1005-5304.2014.07.001

中图分类号：R277.73文献标识码：A文章编号：1005-5304(2014)07-0001-03

Correlation Between Gastrointestinal System and Brain in Acute Cerebrovascular DiseaseWU Xi-ling, HUANG Xiao-bo, CHEN Wen-qiang, CHEN Yu-jing (Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

Abstract：Cerebrovascular disease, also known as a cerebral vascular accident, is named “stroke” in traditional Chinese medicine, there is close correlation between acute cerebrovascular disease and gastrointestinal system. In this paper, we discussed 3 parts about the relationship between the gastrointestinal system and brain. First, in the traditional Chinese medicine theory, there is close relationship between gastrointestinal system and brain from the physiological function and Meridian theory. Secondly, clinical practice indicated that heat phlegm fu-organ syndrome is the main syndrome of acute cerebrovascular disease. The main symptom of this syndrome is the constipation, which is an important part of the disease transition. Furthermore, in acute cerebrovascular disease, the brain-gut peptide esp. CCK and surface colonic electrical physiological changes are the material and electrophysiological basic on the relationship between gastrointestinal system and brain.

Key words：acute cerebrovascular disease；stroke；gastrointestinal system；brain-gut peptide

脑血管病是指脑血管破裂出血或血栓形成引起的以脑部出血性或缺血性损伤症状为主要临床表现的一组疾病,又称“脑血管意外”或“脑卒中”,属中医“中风”范畴。现代医学认为,急性脑血管病的发生与高血压、冠心病、糖尿病、高血脂症、高同型半胱氨酸、心磷脂抗体异常,以及吸烟、酗酒、情绪、气候等因素密切相关。近年来,从脾胃论述胃肠道与脑中风的关系日益受到关注[1]。笔者现从中医理论、脑血管病急性期的中医证候学特征,以及神经递

基金项目：国家自然科学基金(81102624)；北京市中医药科技项目(JJ2009-037)

通讯作者：黄小波,E-mail：huangxiaobo@xwh.ccmu.edu.cn

质、结肠电生理等方面对胃肠道系统与脑的关系进行阐述。

1胃肠道系统与脑相关的中医理论基础