基于“心-脑-肾轴”探讨卒中后认知障碍病机及针刺取穴思路  

The Pathogenesis of Post-Stroke Cognitive Impairment and the Acupoint Selection Idea based on the Theory of“Heart-brain-kidney Axis”

作　　者：安成飞 赵琦[1] 杜宇征[1] AN Chengfei;ZHAO Qi;DU Yuzheng(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,300193)

机构地区：[1]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津市西青区300193

出　　处：《中医杂志》2021年第24期2135-2139,共5页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2018YFC1706004);天津市科技计划项目(18PTLCSY00060)。

摘　　要：以督脉为枢机的心-脑-肾轴理论是基于心、脑、肾三者血脉相通、神明共主、经络相关的生理特点而形成的。卒中后认知障碍(PSCI)病位在脑,与心肾关系密切。以心-脑-肾轴理论阐释PSCI的发病机制,认为PSCI是脑器质性病变,痰瘀阻窍为发病的直接原因,心神失用为发病之关键,肾虚髓减为发病之根本。在心-脑-肾轴理论指导下,针对PSCI心脑肾共患的病机特点,提出心脑肾同治取主穴,治脑取百会、四神聪、神庭,调心取内关、神门,补肾取太溪、三阴交,同时再结合患者病情,根据症状辨证论治选取配穴。The theory of“heart-brain-kidney axis”,which takes Du Mai(governor meridian)as the pivot,is formulated based on the characteristic that blood and vessles of heart,brain and kidney are connected in physiology,the channels and collaterals are correlated to each other,and all of them govern the spirit.Post-stroke cognitive impairment(PSCI)is located in the brain and is closely related to the heart and kidney.Under the heart-brain-kidney axis theory,PSCI is an organic brain disease,which is directly induced by phlegm-stasis obstructing the orifices(resuscitate);apraxia is the key to the disease,while the kidney deficiency and marrow reduction is the root.According to the co-morbidity of the heart,brain and kidney and the“heart-brain-kidney axis”theory,it is suggested to treat the three organs simultaneously and to select the main acupoints accordingly,which were Baihui(DU20),Sishencong(EX-HN1)and Shenting(DU24)for treating the brain,Neiguan(PC6)and Shenmen(HT7)for regulating the heart,and Taixi(KI3)and Sanyinjiao(SP6)for supplementing the kidney.Moreover,combined acupoints are selected based on the differentiation results of the symptoms and syndromes of each patient.

关 键 词：卒中后认知障碍 心-脑-肾轴 针刺取穴 

分 类 号：R246.6[医药卫生—针灸推拿学]