文章摘要
王亚楠,王虹,张大伟,等.通腑醒神汤加减治疗康复期脑出血患者的效果及对肠道菌群和脑肠肽的影响[J].中国临床保健杂志,2026,(1):83-88.
通腑醒神汤加减治疗康复期脑出血患者的效果及对肠道菌群和脑肠肽的影响
The effect of modified Tongfu Xingshen decoction on patients with cerebral hemorrhage during the recovery period and its impact on intestinal flora and brain-gut peptides
投稿时间：2025-12-27  
DOI：10.3969/J.issn.1672-6790.2026.01.014
中文关键词: 大脑出血  植物药疗法  胃肠道微生物组  脑-肠轴
英文关键词: Cerebral hemorrhage  Phytotherapy  Gastrointestinal microbiome  Brain-gut axis Fund program:Heilongjiang Provincial Traditional Chinese Medicine Scientific Research Project
基金项目:黑龙江省中医药科研项目
作者单位E-mail
王亚楠 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
王虹 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
张大伟 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
杨璐 佳木斯市中医医院重症医学科,佳木斯 154004 zhangjinpeng198706@126.com 
陈慧杰 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
蔡国锋 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
裴思颖 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
张金朋 黑龙江中医药大学,哈尔滨 150040
黑龙江中医药大学附属第二医院康复科,哈尔滨 150001 		zhangjinpeng198706@126.com 
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中文摘要:
      目的 探讨通腑醒神汤加减治疗康复期脑出血患者(痰热腑实证)的临床疗效及其对肠道菌群和脑肠肽胃泌素(GAS)、胃动素(MTL)水平的影响。方法 采用随机对照研究。选取2024年10月至2025年10月黑龙江中医药大学附属第二医院康复科收治的90例符合痰热腑实证诊断的脑出血患者。采用随机数字表法将患者分为治疗组(45例)与对照组(45例)。对照组给予常规西医治疗;治疗组在对照组的基础上联合通腑醒神汤加减,疗程4周。比较两组治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、胃肠功能障碍评分、Bristol粪便性状评分、肠道菌群含量、胃泌素、胃动素含量水平,并对两组临床疗效及安全性进行评估。结果 治疗4周后,治疗组总有效率(93.33%)明显高于对照组(77.78%),P＜0.05；两组患者治疗后中医证候积分、NIHSS评分、胃肠功能障碍评分均明显降低(P＜0.05),且治疗组显著低于对照组(P＜0.05)；两组患者治疗后Bristol粪便性状评分、GAS和MTL明显上升(P＜0.05),且治疗组显著优于对照组(P＜0.05)；两组患者治疗后的肠道菌群均呈现一致变化趋势:肠球菌与大肠埃希菌数量减少,双歧杆菌数量增加；治疗后,两组间三种菌群基因拷贝数比较,差异均有统计学意义(均P＜0.05)。结论 通腑醒神汤加减治疗康复期脑出血效果显著,能有效调节肠道菌群,升高GAS、MTL水平,改善胃肠功能、粪便性状。
英文摘要:
      Objective To explore the clinical efficacy of Tongfu Xingshen Decoction in the treatment of patients with cerebral hemorrhage during the recovery period (phlegm-heat and fu-stagnation syndrome) and its impact on intestinal flora and levels of brain-gut peptides gastrin (GAS) and motilin (MTL).Methods A randomized controlled study was conducted.A total of 90 patients with cerebral hemorrhage diagnosed with phlegm-heat and fu-stagnation syndrome were selected from the Rehabilitation Department of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from October 2024 to October 2025.Patients were divided into a treatment group (45 cases) and a control group (45 cases) using a random number table method.The control group was treated with conventional Western medicine,while the treatment group was treated with modified Tongfu Xingshen Decoction in addition to the control group′s treatment.The treatment course was 4 weeks.The changes in TCM syndrome scores,NIHSS scores,gastrointestinal dysfunction scores,Bristol stool form scores,intestinal flora content,and the levels of GAS and MTL before and after treatment were compared between the two groups.The clinical efficacy and safety of the two groups were also evaluated.Results After 4 weeks of treatment,the total effective rate of the treatment group (93.33%) was significantly higher than that of the control group (77.78%) (P<0.05).The TCM syndrome scores,NIHSS scores,and gastrointestinal dysfunction scores of both groups decreased significantly after treatment (P<0.05),and the treatment group was significantly lower than the control group (P<0.05).The Bristol stool form scores of both groups increased significantly after treatment (P<0.05),and the treatment group was significantly better than the control group (P<0.05).The intestinal flora of both groups showed a consistent change trend:the number of Enterococcus and Escherichia coli decreased,and the number of Bifidobacterium,GAS and MTL increased.After treatment,there were statistically significant differences in the gene copy numbers of the three bacterial groups between the two groups (all P < 0.05).Conclusions Modified Tongfu Xingshen Decoction can effectively regulate intestinal flora,increase the levels of GAS and MTL,improve gastrointestinal function and stool form,and has significant clinical efficacy.
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