持续性姿势-知觉性头晕的中医病机及证治探讨  

Traditional Chinese Medicine mechanism and pattern-based treatment of persistent postural-perceptual dizziness

作　　者：陈雅静 孟忆 龙子弋[1] 李婷[1] 魏明清[1] 倪敬年[1] 时晶[1] 田金洲[1] CHEN Yajing;MENG Yi;LONG Ziyi;LI Ting;WEI Mingqing;NI Jingnian;SHI Jing;TIAN Jinzhou(Department of Neurology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学东直门医院脑病三科,北京100700

出　　处：《现代中医临床》2024年第5期27-30,45,共5页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金项目(No.82074362);北京中医药大学解码中医项目(No.BZY-JMZY-2022-002);中国工程院咨询研究项目(No.2023-PP-05)。

摘　　要：持续性姿势-知觉性头晕(persistent postural-perceptual dizziness,PPPD)是一种临床常见的慢性功能性头晕,以持续性的头晕、不稳或非旋转性眩晕,且在直立姿势、主动/被动运动视觉刺激下加重为主要临床表现,其核心症状整合了慢性主观性头晕和其他相关疾病的关键特征,在临床中极易被医生误诊和漏诊。PPPD可归属于中医的头晕/眩晕范畴,根据中医古籍中所记载的头晕/眩晕的病因病机、中医证候及中医治疗策略,联系PPPD的临床表现,可将其临床症状归属于三大类证候,将历代医家的中医治疗方案提炼为五个方面七项治则,突显了多方位、多层次的PPPD中医治疗思路。此外,总结历代医家针对头晕/眩晕的不同病机推荐的一系列中药方剂,如四逆散、七气汤、酸枣仁汤等,为临床医生提供中医药治疗参考。Persistent postural-perceptual dizziness(PPPD) is a prevalent chronic functional dizziness observed in clinical practice.It is primarily characterized by persistent dizziness,instability,or non-rotational vertigo,which exacerbates with upright posture,and during active or passive visual motion stimuli.PPPD's core symptoms incorporate key aspects of chronic subjective dizziness and related conditions,often leading to frequent misdiagnosis or underdiagnosis by clinicians.In Traditional Chinese Medicine(TCM),PPPD is categorized under dizziness/vertigo.Drawing on the etiology,pathogenesis,TCM syndromes,and treatment strategies for dizziness/vertigo documented in ancient Chinese medical texts,PPPD's clinical symptoms can be classified into three primary syndrome types.Over time,TCM practitioners have distilled PPPD treatment into five aspects and seven therapeutic principles,emphasizing a multifaceted and multi-level approach to managing the condition.Additionally,TCM doctors have recommended various herbal prescriptions tailored to different pathophysiological mechanisms of dizziness/vertigo,such as Sini Powder(Frigid Extremities Powder),Qiqi Decoction(Seven Qi Decoction),and Suanzaoren Decoction(Sour Jujube Decoction).These formulations offer valuable references for clinicians employing TCM in the treatment of PPPD.

关 键 词：持续性姿势-知觉性头晕 头痛 失眠 焦虑 中医药 

分 类 号：R259[医药卫生—中西医结合]