从“肾虚痰瘀”论治脑白质变性  

Differentiating and treating cerebral white matter lesions from the perspective of kidney fideficiency and phlegm stasis

作　　者：胡天时 马培[2] 龚洲 付宏宇 贾岳津 刘鑫雨 吴柔燕 刘金瑛 李志更[3] 岳利峰 HU Tianshi;MA Pei;GONG Zhou;FU Hongyu;JIA Yuejin;LIU Xinyu;WU Rouyan;LIU Jinying;LI Zhigeng;YUE Lifeng(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Peking Union Medical College Institute of Medicinal Plant Development,Chinese Academy of Medical Sciences,Beijing 100193,China;Institute of Basic Theory for Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]中国医学科学院药用植物研究所,北京100193 [3]中国中医科学院中医基础理论研究所,北京100700

出　　处：《吉林中医药》2024年第5期501-504,共4页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金面上项目(82174046);中国医学科学院医学与健康科技创新工程(2021-I2M-1-031)。

摘　　要：脑白质变性(white matter lesions,WML)是常见的脑小血管病,以信息处理速度下降、行动迟缓和大小便异常为主要临床表现,临床发展为痴呆的可能性大。从“肾虚痰瘀”探析脑白质变性的机制与治疗,病性本虚标实,肾虚为本,髓海失养,精血化生不足,脑不得充,“技巧”不出;痰瘀阻络为标,多由肾虚气血化生不足,推动无力,痰瘀互结,闭阻脉络,脉络失养,形衰神减。临床治疗应紧抓该病的病机要点,培补肾精固其本,化痰通络祛其标,可提高临床疗效。Cerebral white matter lesions(WML),a common type of cerebral small vessel disease,is in clinic primarily manifested as decreased information processing speed,slow motor function,and urination and defecation abnormalities,which has a significant potential for clinical progression to dementia,causing a considerable inconvenience to patients,their families,and the society.This article examines the mechanisms and treatment of cerebral white matter lesions from the perspective of"kidney deficiency and phlegm stasis",concluding that it is of nature of deficiency in its root cause and excess in its manifestations,among which kidney deficiency acts as its root cause,inducing the malnutrition of marrow sea,the inadequate transformation of essence and blood,leading to insufficient cerebral nourishment and impaired cognitive function.On the other hand,phlegm stasis blocking collaterals is perceived as its manifestation,which mostly arises from deficient kidney essence and insufficient qi and blood transformation,leading to a weak propulsion,intermingled phlegm and blood stasis,obstructing vessels and meridians,resulting in a malnutrition in them and a decline in a person's physical and mental aspects.The clinical treatment of the disease should underscore its key pathogenesis,cultivating and reinforcing kidney essence to consolidate body resistance,resolving phlegm and unblocking collaterals to eliminate its manifestations,improving its clinical efficacy.

关 键 词：肾虚 痰瘀 脑白质变性 

分 类 号：R277.7[医药卫生—中医学]