建立中风病证结合诊疗防治康复体系考量  

Considerations on Establishing a System of Diagnosis,Treatment,Prevention and Rehabilitation of Stroke Disease and Syndrome

作　　者：丁元庆[1] 陈哲 李佳静 高振梅[1] DING Yuanqing;CHEN Zhe;LI Jiajing;GAO Zhenmei(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Rizhao Hospital of Traditional Chinese Medicine,Rizhao 276800,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]日照市中医医院,山东日照276800

出　　处：《山东中医药大学学报》2021年第5期571-575,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：全国中医学术流派传承工作室第二轮建设项目(批文号:国中医药人教函〔2019〕62号);2018年山东省名老中医药专家传承工作室建设项目(批文号:鲁卫中发展字〔2018〕1号);齐鲁医派中医学术流派建设项目齐鲁丁氏脑科六经心法中医药特色技术(批文号:鲁卫函〔2020〕132号);2020年度山东省中医药科技项目(批文号:鲁卫函〔2021〕46号);2021年度齐鲁医派中医学术流派传承项目(批文号:鲁卫函〔2021〕45号)。

摘　　要：基于中风多元性与病机链复杂性特征,在回顾中风诊断、辨证及治疗原则现状基础上,提出建立病证结合中风诊疗防治康复体系的构想。中风之病类、病期、病因、病机、病情、病位、证类、证候各异,治疗措施多端,将上述内容以病类、分期为主线,以病情、病位、证候为核心,整合其救治原则,以期形成融中西医诊断、防治、康复为一体的综合干预体系,更合理地指导临证。其中要在超早期与急性期合理干预,超早期以通脉救脑怡神为主;急性中风分病分期,急救在先;恢复期(康复期)分证论治;辨危险因素,随处设防;通调营卫,防治康复结合。治中寓防,兼顾康复。Based on the characteristics of the diversity of stroke and the complexity of the pathogenesis chain,the concept of establishing a system of diagnosis,treatment,prevention and rehabilitation combined with disease and syndrome is proposed by reviewing the current status of stroke diagnosis,syndrome differentiation and treatment principles.There are various types of stroke,disease stages,disease causes,pathogeneses,conditions,disease locations,syndrome types,syndromes,and treatment measures.The above content is mainly based on disease types and stages,and disease conditions,disease locations and syndromes are the core to integrate its treatment principles,so as to form a comprehensive intervention system integrating Chinese and Western medicine diagnosis,prevention,and rehabilitation,and guide clinics more reasonably.Among them,reasonable intervention should be made in the super early and acute stages,and the main purpose is to activate vessels,rescue brain and tranquilize mind in the super early stage.Acute stroke is divided into different types and stages,and should be rescued first.Stroke in recovery period(rehabilitation period)should be treated according to syndromes.Risk factors are differentiated and prevented everywhere.Prevention,treatment and rehabilitation are combined by regulating nutrient-defense.Prevention and rehabilitation should be considered in the treatment.

关 键 词：中风 脑血管病 中风分期 病证结合 急救护脑 调气通脉 通调营卫 防治康复 

分 类 号：R255.2[医药卫生—中医内科学]