中风病因病机新说  

New Theories on the Etiology and Pathogenesis of Stroke

作　　者：秦瑜玲 舒杨 卢岩[1] 孙英霞[1] QIN Yu-ling;SHU Yang;LU Yan;SUN Ying-xia(Shandong University of TCM,Jinan,Shandong,China,250014)

机构地区：[1]山东中医药大学

出　　处：《河南中医》2019年第9期1309-1313,共5页Henan Traditional Chinese Medicine

基　　金：2017年山东省自然科学基金面上项目(ZR2017MH106);2015年山东省重点研发计划立项计划项目(2015GSF119019);山东省中医药科技发展计划项目(2017-012);中国科协学科发展项目(XKSZ)

摘　　要：对于中风的病因病机,唐宋以前的医家大都持外风论,认为中风的发生是在脏腑失和,气血不足等内虚的基础上受到外邪侵袭所致;金元时期,百家争鸣,内风学说逐渐盛行,元代的王履首次明确提出真中风与类中风的区别;到了明清时期,医家对内风论推崇备至,逐渐接受了王履提出的"类中风"观点,尤以张景岳为代表,他甚至提出"非风论",认为内伤积损是中风的病因;晚清时期,内风论逐渐深化,同时,西学东渐,血气冲脑的中西医结合理论被提出;现代医家也提出了种种新的理论学说。每种学说均有其最佳适用时期及人群,但又不完全对立,而是不断补充,相互完善。临床对于中风的诊治,理清各个理论之间的区别与联系,合理把握其适用范围,方能融会贯通,把各家学说的指导价值最大化。For the etiology and pathogenesis of stroke, physicians before the Tang and Song dynasties mostly held the theory of external wind, believing that the occurrence of stroke caused by external pathogenic invasion on the basis of internal deficiency such as disharmony of internal organs and deficiency of qi and blood. During the Jin and Yuan dynasties, there was contention of a hundred schools of thought and the theory of internal wind was gradually prevalent. For the first time, Wang Lv of the Yuan Dynasty clearly put forward the distinction between true stroke and apoplectoid stroke. In the Ming and Qing dynasties, physicians highly praised the theory of internal wind and gradually accepted Wang Lv′s viewpoint of apoplectoid stroke, especially Zhang Jingyue, who even put forward "non-wind theory" that internal injury accumulation is the cause of stroke. In the late Qing Dynasty, the theory of internal wind deepened gradually. Meanwhile, the theory of integration of TCM and Western medicine was put forward with the spread of Western learning to the East, which believed that qi and blood attack the brain. Modern physicians have also put forward various new theories. Each theory has its best application period and people, but they are not completely opposed, but constantly complement and improve each other. For the diagnosis and treatment of stroke in clinic, we must find out the differences and links between different theories, grasp the scope of their application reasonably, so that we can understand them and maximize the guiding value of each theory.

关 键 词：中风 病因病机 内风 外风 真中风 类中风 

分 类 号：R255.2[医药卫生—中医内科学]