从“一气周流”理论论治脑鸣  

Treatment of Tinnitus Cerebri Based on Theory of"Yi Qi Zhou Liu"

作　　者：李冰[1] 王嘉麟[2] 曹慧颖 LI Bing;WANG Jialin;CAO Huiying(Beijing University of Chinese Medicine,Beijing China 100029;Dongfang Hospital Affiliated to Beijing University of Chinese Medicine,Beijing China 100078)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中医学报》2024年第8期1643-1647,共5页Acta Chinese Medicine

基　　金：2020年度北京中医药大学基本科研业务费重点攻关项目(2020-JYB-ZDGG-130)。

摘　　要：脑鸣发病的核心为中气斡旋失司,脾虚湿盛;木郁金滞,风痰瘀化生是脑鸣进展的关键;肾虚水寒,寒水侮土,浊毒阻窍是脑鸣最终的发展形态。脑鸣的治疗强调健脾祛湿,复中土斡旋之枢,方用术甘苓泽汤合黄芽汤加减一以贯之;进展期宜健脾为先,以上方为基础,同时疏肝肃肺,运金木升降之轴,针对风痰瘀予疏肝清风、化痰降浊、理气行滞之法;脑鸣的终期予天魂汤加减温肾补脾,同时化痰逐瘀解毒。如此方可把握脏腑气机变化,使一气周流循环有序,脑鸣即止。The core pathogenesis of tinnitus cerebri is the dysfunction of Zhong Qi in mediation,Spleen deficiency and Dampness as well as Liver Qi depression and Lung Qi stagnation.The outcome of that,namely,Wind,Phlegm and blood stasis is the key to the progression of the disease;Kidney deficiency and the Cold in Water cause the Water element insulting the Earth element,and turbidity and toxin obstruction are the final development forms of tinnitus cerebri.Therefore,in treatment of the disease strengthening the Spleen and dispelling Dampness is emphasized to recover the mediation function of the Spleen in center.Modified Zhugan Lingze Decoction combined with Huangya Decoction can be used during the whole treatment process.In the advanced stage,tonifying the Spleen is the top priority.At the same time,the ascending the Liver Qi and descending the Lung Qi means to accelerate the Qi movement axis in lifting and lowering Qi.Clearing Wind,dissolving Phlegm and reducing Turbidity bring about the effect of regulating Qi and removing stagnation in case of Wind,Phlegm,and blood stasis.In the terminal stage of the disease,Tianhun Decoction is used to warm Kidney and tonify Spleen,and at the same time dissolve Phlegm,chase away stasis and detoxify.In this way,the Yi Qi Zhou Liu condition of the patient(Qi movement changes in the internal Zang)can be known and the circulation of one′s Qi is orderly,and eventually the tinnitus cerebri is cured.

关 键 词：脑鸣 “一气周流” 术甘苓泽汤 黄芽汤 天魂汤 

分 类 号：R242[医药卫生—中医临床基础]