对卒中后认知障碍的中医病机认识  

Revisiting the TCM pathologic understanding of post-stroke cognitive impairment

作　　者：谢荃[1] 李艳青[2] 陈均莉 张晓云[1] 李懿鹏 雷雪[1] XIE Quan;LI Yanqing;CHEN Junli;ZHANG Xiaoyun;LI Yipeng;LEI Xue(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610073,China;Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Sichuan Xiaojin County Hospital of Traditional Chinese and Tibetan Medicine,Aba State 624299,China)

机构地区：[1]成都中医药大学附属医院,成都610073 [2]成都中医药大学 [3]四川省阿坝州小金县中藏医院

出　　处：《北京中医药大学学报》2022年第10期1077-1080,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家中医药管理局第6批全国老中医药专家学术经验继承项目(No.CJJ2018022);四川省中医药管理局科学技术研究专项(No.2018CP004)。

摘　　要：早期干预卒中后认知障碍更有利于获得疗效和改善患者预后。卒中后认知障碍属中医“痴呆”“多忘”“脑髓消”等范畴,其病机特点可概括为“痰、瘀、虚、郁”,痰瘀既是病理产物,也是疾病不断发展的原因;虚介导痰瘀生成,包括先天元气亏虚和后天脾胃气虚,是疾病的关键环节;郁指肝失条达、气机不畅,或肝郁气滞,或气郁化火、火极生风,在疾病发生发展中发挥重要作用;“痰、瘀、虚、郁”共同导致脑髓受损、神机失用,是卒中后认知障碍的根本病理改变。深入分析卒中后认知障碍的中医病机,对阐述疾病演变过程、为临床治疗提供参考意见均具有重要意义。It will be more conducive to obtain curative effect and improve prognosis to treat cognitive impairment after stroke(PSCI)early.PSCI corresponds to the disorders of"dementia","amnesia"and"loss of brain marrow"in traditional Chinese medicine(TCM).We summarized the TCM pathogenesis characteristics of PSCI as"phlegm,stasis,deficiency and stagnation".The phlegm and stasis are both causes and effects in the continuous development of the disease.The deficiency includes congenital qi deficiency and acquired deficiency of spleen and stomach qi,which are the key links in the development of PSCI.The stagnation refers to liver qi stagnation,or qi stagnation transforming into fire and fire generating wind,which plays an important role in the occurrence and development of PSCI.Phlegm,stasis,deficiency and stagnation lead to damage of brain marrow and dysfunction of cognition.In depth analysis of TCM pathogenesis of PSCI is of great significance to expound the disease evolution process and to guide clinical treatment.

关 键 词：卒中后认知障碍 中风病 痴呆 中医病机 虚瘀痰郁 

分 类 号：R255.2[医药卫生—中医内科学]