张智龙治疗脑病经验  

ZHANG Zhi-long′s Experience of Treating Encephalopathy

作　　者：杨秀娟[1] 卢轩[1] 张智龙[1] YANG Xiu-juan;LU Xuan;ZHANG Zhi-long(Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin,China,300120)

机构地区：[1]天津市中医药研究院附属医院,天津300120

出　　处：《河南中医》2022年第1期63-66,共4页Henan Traditional Chinese Medicine

摘　　要：张智龙教授认为,脑的生理特点为"宜实宜满,宜清宜静",脑的病理特点为"髓海空虚,空则神浮,虚则邪害,浊邪害清,元神受损,神机失用"。髓海空虚、痰瘀闭阻、神机失用是脑病的病机关键,本虚标实、虚实错杂,治疗应辨证论治,依据病情虚实之偏重,养精益髓补其虚,清浊开闭泻其实,或攻补兼施,补虚不碍邪,祛邪不伤正。脑病易虚易闭,治疗应以"清""养"为原则。张教授认为,治疗中风中脏腑,治宜分清闭脱,以调理脏腑为先,中风日久,勿忘祛邪;治疗痴呆,以养精益髓、清浊开闭、调神益智的治疗原则,创立了调神益智针法及定志益聪颗粒,并根据虚实偏重的不同随证加减;治疗癫痫,依据动态平衡理论,采用"动极者镇之以静,阴亢者胜之以阳"的方法,以通督镇静针法和柴桂温胆定志汤治疗;治疗眩晕,勿忘中焦升降,强调脾胃为气血生化之源,五官诸窍皆赖清阳上升而以为养,脾胃为气机升降之枢,周身气机得以舒展,故采用"调理脾胃针法"治疗。Professor Zhang Zhi-long believes that the physiological characteristics of the brain are"solid and full,clear and quiet",and the pathological characteristics of the brain are"deficient and empty marrow sea,resulting in floating mind and pathogens,damaging clearing state and original qi of the mind."The key pathogenesis of encephalopathy is the deficiency and emptiness of marrow sea,the obstruction of phlegm and blood stasis,and the loss of magic mechanism of life,marked by deficiency as primary aspect and excess as secondary,deficiency and excess in complexity,so the treatment should be based on syndrome differentiation.According to the degree of deficiency and excess,it is necessary to nourish marrow essence to supplement its deficiency,clear turbidity to purge its excess,or attack and supplement at the same time,so as to supplement deficiency without hindering to remove pathogens and dispel pathogens without harming the healthy qi.Encephalopathy is prone to deficiency and closure,and the treatment should be based on the principle of"clearing"and"nourishing".According to Professor Zhang,for stroke in viscera,closure or collapse should be distinguished,then nourishing the viscera is adopted first;for long-time stroke,removing pathogens is important.For dementia,based on the treatment principles of nourishing marrow essence,clearing turbidity,opening the closed orifices,regulating spirit and benefiting intelligence,he has established acupuncture for regulating mind and benefiting intelligence,Granules for Stabilizing the Mind and Benefiting Intelligence,and modified them flexibly according to different degrees of deficiency and excess.For epilepsy,according to the theory of dynamic balance,he adopts the method that"excessive movement should be controlled by quietness,and hyperactivity of yin should be controlled by yang",and often uses acupuncture for dredging GV and calming the mind,and Bupleurum and Cinnamon Twig Gallbladder-Warming Mind-Stabilizing Decoction.For vertigo,he pays attention to the ascending and d

关 键 词：脑病 “清” “养” 中风 中脏腑 痴呆 癫痫 眩晕 调神益智针法 定志益聪颗粒 通督镇静针法 柴桂温胆定志汤 调理脾胃针法 张智龙 

分 类 号：R259[医药卫生—中西医结合]