基于“填精补髓、清脑通络法”探讨血管性认知障碍中医证治规律  

Discusses the TCM syndrome and treatment law of vascular cognitive impairment based on the method of “Tianjing Busui Qingnao Tongluo”

作　　者：孙海洋 孙景波[1,2] 程骁[1,2] 李岩 SUN Haiyang;SUN Jingbo;CHENG Xiao;LI Yan(Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省中医院广州中医药大学第二附属医院,广东广州510120 [3]广西国际壮医医院,广西南宁530201

出　　处：《陕西中医》2023年第8期1098-1101,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82160946);国家重点研发计划项目(2019YFC1708601);省部共建中医湿证国家重点实验室建设项目(SZ2021ZZ14);广州市科技计划项目(202102010268,202102010339)。

摘　　要：血管性认知障碍(VCI)是脑血管病变及其危险因素导致的血管性损伤,涉及至少1个认知域受损的临床综合征,涵盖从轻度认知障碍到痴呆、合并阿尔兹海默病等混合性病理所致的不同程度认知障碍。从中医“整体观念”出发,肝风内动是VCI的始动因素,肾虚髓减,痰瘀阻滞脑络是VCI的关键环节,根据“治病求本、杂合以治”的原则,治疗上应“间者并行,甚者独行”,须“标本兼顾,通补兼施”,临床运用填精补髓、清脑通络之法,以补肾填髓方药坚固脑之脉络,在痰瘀等病理产物尚未戕害清窍之时,阻断其阻滞脑脉或侵入脑内,基于以上理念探讨VCI中医证治规律,以飨同道。Vascular cognitive impairment(VCI) is a clinical syndrome of vascular damage caused by cerebrovascular lesions and their risk factors,involving at least one cognitive domain,covering different degrees of cognitive impairment from mild cognitive impairment to dementia,including the combination of alzheimer's disease and other mixed pathologies.According to the “holistic concept” of TCM,the internal movement of liver wind is the initiating factor of VCI,while the deficiency of kidney and marrow,the blockage of brain channels by phlegm and stasis are the key aspects of VCI.Based on the principle of “treating the disease to seek the root and treating by mixing method”,the treatment should be “parallel between the two,or even alone”,and should “take both the symptoms and the root into account,and apply both the generalization and the remedy”.In clinical application,the method of filling the essence and tonifying the marrow,clearing the brain as well as clearing the ligaments,is used to strengthen the veins and ligaments of the brain by tonifying the kidneys and filling the marrow,to block the phlegm and other pathological products from blocking the brain veins or invading the brain when they have not invaded the clear orifices.Based on the above concepts,we will discuss the rules of Chinese medicine for VCI to share our colleagues.

关 键 词：血管性认知障碍 填精补髓、清脑通络法 整体观念 标本兼治 证治规律 肾虚痰瘀 

分 类 号：R743[医药卫生—神经病学与精神病学]