从“五脏应时”论老年出血中风不同季节发病的机制  

Discussion on the Pathogenesis of Senile Hemorrhagic Stroke in Different Seasons Based on the Theory of“Five-Zang Corresponding to the Seasons”

作　　者：闫书华 李燕[2] 李芳[3] Yan Shuhua;Li Yan;Li Fang(Guangzhou University of Tradi-tional Chinese Medicine,Guangdong,Guangzhou 510000,China)

机构地区：[1]广州中医药大学,广东广州510000 [2]广东省中医院,广东广州510000 [3]广东省中医院二沙分院,广东广州510000

出　　处：《中国中医急症》2020年第9期1614-1617,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省科学技术厅广东省中医急症研究重点实验室(2017B030314176)。

摘　　要：目的尝试运用五脏应时理论分析不同季节老年出血中风的发病机制,依此体现中医天人相应的整体观念,并为中医药防治老年出血中风的临床工作提供指导。方法回顾性整理广东省中医院老年出血中风患者不同季节发病情况及四诊资料,采用中风病二代标准辨证分型,尝试运用五脏应时理论分析在不同季节出血中风病因病机。结果老年出血中风高发季节为冬春季,证候以"风火上扰"为主,不同季节具有不同的发病机制特点。四季证型均以风火上扰为主,尤其是冬春季节,风火上扰证型占比超过50%;风痰火亢、痰热腑实证在夏季较其他季节比率较高,阴虚风动在秋季(较其他季节)中医证型占比较高。结论脏腑功能受四时阴阳变化的影响,不同季节发病机制不尽相同,根据各自不同特点,可尝试通过冬滋肾阴、春平肝阳、夏清心火、秋滋肺阴等治法预防及治疗老年出血中风。Objective:To analyze the pathogenesis of senile hemorrhagic stroke in different seasons by using the theory of“Five-Zang Corresponding to the Seasons”,which not only reflects nature and people are a corre⁃sponding whole,but also provides guidance for the clinical work of traditional Chinese medicine in preventing and treating senile hemorrhagic stroke.Methods:A retrospective review of the incidence of senile patients with hemor⁃rhagic stroke in Guangdong Provincial Hospital of Traditional Chinese Medicine in different seasons and their four clinical data of Chinese medicine,to conduct Chinese medicine syndrome differentiation using the second genera⁃tion standard of stroke syndrome and try to analyze the TCM pathogenesis of hemorrhagic stroke in different sea⁃sons by the theory of“Five-Zang Corresponding to the Seasons”.Results:The high season of senile hemorrhagic stroke was winter and spring,and the syndrome was mainly based on“wind and fire disturbance”.Different sea⁃sons had characteristics of different pathogenesis.The syndromes of the four seasons were dominated by“wind and fire disturbance”,especially in winter and spring,which accounted for more than 50%;the syndrome of hyperactivi⁃ty of wind-phlegm-fire and the syndrome of endogenous cough with phlegm-heat were higher in summer than it in other seasons,and the syndrome of stirring wind due to yin deficiency accounted for a higher proportion of TCM syndromes in autumn(compared to other seasons).Conclusion:The function of viscera is affected by the change of yin and yang of the four seasons and the pathogenesis of different seasons is different.According to their differ⁃ent characteristics,we could try to prevent and treat senile hemorrhagic stroke by nourishing kidney yin in winter,suppressing liver yang in spring,clearing heart fire in summer,and nourishing lung yin in autumn.

关 键 词：出血中风 五脏应时 防治 

分 类 号：R743.3[医药卫生—神经病学与精神病学]