椎基底动脉扩张延长症病机的中医“虚气留滞”病机假说阐释  

Explanation of the Pathogenesis of Vertebrobasilar Dolichoectasia Based on the Hypothesis of“Deficiency of Qi and Stagnation” in TCM

作　　者：董兴鲁[1,2] 齐宝云[1,2] 高颖 DONG Xinglu;QI Baoyun;GAO Ying(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China;Institute for Brain Disorders,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学中医脑病研究院,北京100700

出　　处：《世界中医药》2023年第13期1789-1792,1799,共5页World Chinese Medicine

基　　金：第六批北京市级中医药专家学术经验继承工作项目(京中医科字[2021]169号);北京中医药脑血管病防治办公室建设项目;2019年重大疑难疾病中西医临床协作能力建设项目——脑梗死。

摘　　要：椎基底动脉扩张延长症是一种预后不良的后循环血管变异疾病,目前尚缺乏有效的防治手段。通过对其病理机制、临床特征与转归的总结分析,与中医“虚气留滞”理论相结合,提出了创新病机假说,以“虚气”为发病之本,以“留滞”为发病之标,二者具有互为因果、相互促进的特点,切合疾病螺旋进展、动态演变的模式。并据此形成“扶正护脑以补虚、解毒通络而通滞”的治法,为进一步探索椎基底动脉扩张延长症的中医证治规律与疗效评价方法,为临床实践提供依据,对提高临床疗效,降低其相关的神经系统疾病负担具有重要意义。Vertebrobasilar dolichoectasia(VBD)is a posterior circulation vascular anomaly with a poor prognosis,and effective preventive and treatment measures are currently lacking.Through a summary and analysis of its pathological mechanisms,clinical features,and outcomes,combined with the theory of traditional Chinese medicine(TCM)on“deficiency of qi and stagnation”,an innovative pathogenesis hypothesis has been proposed.It postulates that“deficiency of qi”is the root cause of VBD,while“stagnation”is the pathological manifestation.These two aspects are mutually causal and reinforcing,aligning with the disease′s spiral progression and dynamic evolution pattern.Based on this hypothesis,a treatment strategy has been developed,which emphasizes“reinforcing healthy qi and supporting the brain to tonify deficiency,removing toxins,and dredge collaterals,thereby alleviating stagnation”.This approach aimed to explore the TCM syndrome differentiation and evaluation methods for VBD and provide a basis for clinical practice.It is of significant importance in improving clinical efficacy and reducing the burden of related neurological disorders.

关 键 词：椎基底动脉扩张延长症 虚气留滞 扶正护脑 毒损脑络 解毒通络 病机理论 脑血管病 血管变异 

分 类 号：R255.2[医药卫生—中医内科学] R277.7[医药卫生—中医学]