从“诸厥固泄,皆属于下”谈中风“脑-脾-肝肾”病机轴  

Discussion About the Stroke Pathogenesis Axis of "Brain-Spleen-Liver-Kidney" Based on the View That "Symptoms Such as Constipation or Incontinence in Syncope Syndrome Belong to Lower Energizer Diseases"

作　　者：周畅 李花[1] 刘旺华[1] 陈心豪 陈佳敏 刘洁菡 ZHOU Chang;LI Hua;LIU Wang-hua;CHEN Xin-hao;CHEN Jia-min;LIU Jie-han(Hunan University of Chinese Medicine,Changsha,Hunan,China,410208)

机构地区：[1]湖南中医药大学,湖南长沙410208

出　　处：《河南中医》2023年第3期354-357,共4页Henan Traditional Chinese Medicine

基　　金：湖南省自然科学基金项目(2019JJ40219);湖南省高校创新平台开放基金项目(20K097);湖南省中医药科研计划重点项目(202008,2021013)。

摘　　要：“诸厥固泄,皆属于下”中“厥固泄”体现了中风病理过程中的气机紊乱状态,而气机紊乱是脾、肝、肾等多个脏器功能失调所致,故可从气机升降纳运失常、“脑-脾-肝肾”上中下相关的角度,联合分析中风之病机。从证候上讲,厥为昏仆之症,固、泄为二便失常之症,均为中风的临床表现;从病机上讲,气机升降失常,气逆于上为厥;浊邪不散,气机郁闭为固;精气亏虚,下元不固为泄,均属于气机紊乱范畴。不论从证候角度还是从病机角度,中风发病均与中焦之脾、下焦之肝肾密切相关,与最终发病部位“脑”一起,构成了上、中、下的“脑-脾-肝肾”病机轴。故因势利导,采取化痰通腑、泄浊解毒之法,上病下治,折其冲逆之势,驱逐浊毒之邪,调畅气机,则可使浊气消散,疾病向愈。According to the view that "symptoms such as constipation or incontinence in syncope syndrome belong to lower energizer diseases," constipation or incontinence reflects the disorder of qi in the pathological process of stroke,and the disorder of qi is caused by the dysfunction of multiple organs such as the spleen,liver and kidney.Therefore,the pathogenesis of stroke can be analyzed jointly from the perspective of the disorder of qi movement,the upper,middle and lower parts of "brain-spleen-liver-kidney".In terms of syndrome,syncope is a symptom of fainting,constipation and incontinence are abnormal symptoms,which are the clinical manifestations of stroke.In terms of pathogenesis,the ascending and descending of qi is abnormal leading to syncope;Turbidity does not disperse,and qi stagnation leads to constipation;Deficiency of essence and qi leads to incontinence in the lower energizer;and the above all belong to the category of disorder of qi movement.No matter from the perspective of syndrome or pathogenesis,the onset of stroke is closely related to the spleen,liver and kidney of the lower energizer.Together with the final diseased site of "brain",a pathogenesis axis of "brain-spleen-liver-kidney" through the upper,middle and lower is formed.Therefore,it is necessary to make use of the tendency,adopt the method of resolving phlegm and dredging six-fu organs,discharging turbid and detoxifying,treating diseases in the upper by dealing with ones in the lower,relieving the counter-flow of qi,expeling turbidity and toxins,regulating qi movement so as to disperse turbid qi and promote the disease recover.

关 键 词：中风 “脑-脾-肝肾”病机轴 “诸厥固泄 皆属于下” 上病下治 

分 类 号：R255.2[医药卫生—中医内科学]