李宗智从肝肾阴虚论治老年性眩晕经验  

LI Zongzhi’s experience in treating senile vertigo from liver and kidney Yin deficiency

作　　者：杨仁柳 赵芳芳 陈杨 YANG Renliu;ZHAO Fangfang;CHEN Yang

机构地区：[1]贵州中医药大学,贵州贵阳550000 [2]贵州中医药大学第一附属医院,贵州贵阳550000

出　　处：《中医临床研究》2023年第27期59-61,共3页Clinical Journal Of Chinese Medicine

摘　　要：眩晕为神经内科常见病,轻则闭目即止,重则如坐舟船,不能站立,严重时影响人的生活质量,是一种患者感觉到自身或者周围事物旋转或摇动的主观感觉障碍。其基本病机分虚实,虚者为气血精不足,髓海失养;实者为风、火、痰、瘀扰乱清窍。眩晕以肝肾阴虚、气血不足为本,风、火、痰、瘀为标。其基本治疗原则为补虚泻实、调整阴阳。虚证以肾精亏虚、气血衰少居多。精虚者填精生髓,滋补肝肾;气血虚者宜益气养血,调补脾肾。实证则以潜阳、泻火、化痰、逐瘀为主要治法。李宗智教授认为老年性眩晕多由气血亏虚、肝肾亏虚、痰浊蒙窍等导致,故其主要病变脏腑为肝、脾、肾。气虚不能生血或者血虚无以化气,导致气血两虚。气血不足,不能上荣于面,发为眩晕,治则宜益气补血,健脾和胃。肝肾亏虚,髓海失养,发为眩晕,故其治则为滋补肝肾,滋水涵木。饮食不节,饮酒无度,或者过食辛辣油腻肥甘之品,损伤脾胃,以致脾胃功能虚弱,其健运失司,水湿内停,积聚生痰,痰阻中焦,阻遏清阳,致清阳不升,头(清)窍失养,加之痰浊上蒙清窍,发为眩晕,治宜健脾祛湿,平肝息风。Vertigo is a common disease in neurology,which can be relieved by closing the eyes in mild cases,or it is like sitting in a boat and not being able to stand in severe cases,which seriously affect the quality of life.It is a subjective sensory disorder in which patients feel themselves or things around them rotating or shaking.The basic pathogenesis of vertigo is divided into deficiency and excess.The deficiency is due to deficiency of Qi(气),blood and essence and loss of nourishment of the medulla,the excess is loss of tranquility of the clear orifices due to disturbance of wind,fire,phlegm and stasis.The basic etiology of vertigo is to the deficiency of the liver and kidney and the deficiency of Qi and blood,accompanied by wind,fire,phlegm and stasis.The basic treatment principle is to tonify the deficiency and purge the excess,and regulate Yin(阴)and Yang(阳).In deficiency cases,deficiency of kidney essence and deficiency of Qi and blood are the most common.For deficiency of essence,the treatment focuses on filling in the essence to produce marrow,nourishing the liver and kidney,for deficiency of Qi and blood,the treatment focuses on regulating Qi and nourishing the blood,regulating the spleen and kidney.In the case of excess symptoms,the main treatment is to submerge Yang,relieve fire,resolve phlegm,and expel blood stasis.Professor LI Zongzhi believes that senile vertigo is mostly caused by deficiency of Qi and blood,deficiency of liver and kidney,and phlegm clouding the orifice,so the main internal organs are liver,spleen and kidney.Qi deficiency leads to failure in generating blood,blood deficiency fails to transform Qi,resulting in deficiency of both Qi and blood.Insufficient Qi and blood cannot nourish the face,resulting in vertigo.The treatment is to regulate Qi and nourish blood,strengthen the spleen and stomach.Deficiency of liver and kidney,loss of nourishment of the medulla oblongata,leads to vertigo,so the treatment is to nourish the liver and kidney and cultivate water and wood.Inadequate diet,ex

关 键 词：眩晕 肝肾阴虚 辨证施治 

分 类 号：R255.3[医药卫生—中医内科学]