基于中医“五脏辨治理论”探析脑卒中后失语症的病机与治法  

Exploration of the Pathogenesis and Treatment of Post-stroke Aphasia based on the"Five Viscera Theory of Identification and Treatment"of Traditional Chinese Medicine

作　　者：王梦雪 林冰冰[1] 黄佳[1] WANG Mengxue;LIN Bingbing;HUANG Jia(Rehabilitation Medical College of Fujian University of Traditional Chinese Medicine,Fujian Fuzhou 350122,China)

机构地区：[1]福建中医药大学康复医学院,福建福州350122

出　　处：《中医药临床杂志》2024年第5期823-828,共6页Clinical Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82074512)。

摘　　要：脑卒中后失语症(post-stroke aphasia,PSA)是一种获得性语言功能障碍,会导致平均住院时间延长、院内病死率升高、医疗费用增加等多种负面结局。研究证明中医能够改善脑卒中所导致的各项语言功能障碍,然而该病的中医证型目前仍存在争议,有可能限制了中医的临床疗效。文章通过中医“五脏辨治理论”为PSA的五脏病位辨证提供理论依据,为从中医五脏角度辨证论治PSA提供思路和方法,从而提高临床疗效。基于该理论,阐述五脏通过各自生理功能、经络循行,及其与体、华、窍的对应关系能够影响语言的生成;指出PSA以五脏为发病基础,五脏功能异常所导致的脏腑阴阳失调、经脉运行失常是PSA的根本发病机制。依据该理论中五脏与外界事物的通应关系,结合近年来的临床研究结果,强调PSA的治则以“和脏腑,通经络”为总纲,以达到“开窍解语”的治疗目的。Post-stroke aphasia(PSA)is an acquired language dysfunction that can lead to multiple negative outcomes such as prolonged average length of stay,increased in-hospital mortality,and increased medical costs.Research has proven that traditional Chinese medicine can improve various language dysfunctions caused by stroke.However,the traditional Chinese medicine syndrome type of this disease is still controversial,which may limit the clinical efficacy of traditional Chinese medicine.This article provides a theoretical basis for the syndrome differentiation of the five viscera of PSA through the"five viscera theory of identification and treatment"of traditional Chinese medicine,and provides ideas and methods for the syndrome differentiation and treatment of PSA from the perspective of traditional Chinese medicine's five viscera,thereby improving clinical efficacy.Based on this theory,it is explained that the five viscera can affect the generation of language through their respective physiological functions,the circulation of meridians,and their corresponding relationships with the body,hua,and orifices;it is pointed out that PSA is based on the five viscera,and the imbalance of yin and yang in the five viscera and the abnormal operation of meridians,caused by abnormal function of the five viscera,is the fundamental pathogenesis of PSA.Based on the communication relationship between the five viscera and external things in this theory,combined with the clinical research results in recent years,it is emphasized that the treatment principle of PSA is to"harmonize the five viscera and unblock the meridians"as the general guideline,in order to achieve the therapeutic purpose of"opening up the mind and explaining the language".

关 键 词：脑卒中后失语症 五脏辨治理论 五脏 语言生成 失语发病机制 治法 

分 类 号：R241.6[医药卫生—中医诊断学] R242[医药卫生—中医临床基础]