基于“脑髓-脑神”论治正常颅压脑积水  

Treatment of normal pressure hydrocephalus from the perspectives of brain marrow and brain spirit

作　　者：张凯歌 付月婉 王垚 张新宁 薛静 陈志刚[3] ZHANG Kaige;FU Yuewan;WANG Yao;ZHANG Xinning;XUE Jing;CHEN Zhigang(Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100007,China;Dong Fang Hospital,Beijing University of Chinese Medicine,Beijing 100072,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院,北京100007 [3]北京中医药大学东方医院,北京100072

出　　处：《吉林中医药》2023年第12期1394-1399,共6页Jilin Journal of Chinese Medicine

基　　金：首都卫生发展科研专项(2018-2-4202)。

摘　　要：正常颅压脑积水是一种起病隐匿的神经系统疾病,其常见的临床表现为步态障碍、认知下降及尿失禁。陈志刚教授结合古代医家论述以及临床经验,提出中医脑病“脑髓-脑神”一体论的核心辨治体系,脑髓是脑发挥作用的物质基础,脑功能正常发挥有赖于脑髓充足;脑神是生命活动的主宰,协调控制脏腑功能,指出痰饮留滞脑髓、脑神失用是本病发生的病理基础。治法以补肾益髓,温阳化饮为主,临床上取得较好疗效,本文从脑髓、脑神角度阐述脑积水的特点。附验案一则以佐证。Normal pressure hydrocephalus(NPH)is a nervous system disorder with an insidious onset and common clinical manifestations of gait disturbance,cognitive decline,and urinary incontinence.Professor Chen Zhigang,based on the expositions of ancient doctors and his own clinical experience,proposes the core system of integrated"brain marrow-brain spirit"theory in its syndrome differentiation and treatment in traditional Chinese medicine.According to the theory,brain marrow is the material basis for the brain to function,and the normal function of brain depends on its adequacy,while brain spirit is the dominator of life and adjusts the function of zang-fu organs.He points out that a phlegm retention in brain marrow and a brain spirit dysfunction are the pathological basis of NPH.Therefore,its basic treatment principle is to benefit kidney and brain marrow,and to warm yang for resolving fluid retention,which has achieved good therapeutic effects in clinical practice.This article elaborates on the characteristics of NPH from the perspectives of brain marrow and brain spirit,and an experiential case is presented.

关 键 词：正常颅压脑积水 脑髓 脑神 

分 类 号：R742.7[医药卫生—神经病学与精神病学]