从肝论治脑卒中后认知障碍的机制及临床应用  

The Mechanism and Clinical Application of Post-stroke Cognitive Impairment from the Viewpoint of the Liver

作　　者：彭天忠[1] 朱满华[1] 林星镇 胡思彦 周峰 袁娟[1] 占琦楠 黄学娣 PENG Tianzhong;ZHU Manhua;LIN Xingzhen;HU Siyan;ZHOU Feng;YUAN Juan;ZHAN Qi’nan;HUANG Xuedi(Department of Rehabilitation Medicine,Nanchang Hongdu Hospital of Traditional Chinese Medicine,Jiangxi Province,Nanchang 330008,China;Department of Pharmacy,Jiangxi Province Hospital of Integrated Traditional Chinese and Western Medicine,Jiangxi Province,Nanchang 330006,China)

机构地区：[1]南昌市洪都中医院康复医学科,江西南昌330008 [2]江西省中西医结合医院药剂科,江西南昌330006

出　　处：《中国中医药现代远程教育》2025年第2期80-82,共3页Chinese Medicine Modern Distance Education of China

基　　金：江西省卫健委科技计划项目【No.202120088】;江西省中医药中青年骨干人才培养项目【No.赣中医药科教字〔2020〕5号】。

摘　　要：认知障碍是脑卒中后常见并发症之一,临床主要表现为理解能力下降、记忆力减退、执行能力下降和注意力不集中等症状。目前,脑卒中后认知障碍(PSCI)西医发病机制尚不明确,其治疗以应用药物(如胆碱脂酶抑制剂多奈哌齐、兴奋性氨基酸受体拮抗剂美金刚、钙通道阻滞剂尼莫地平和脑代谢改善剂奥拉西坦等)、认知功能康复训练和脑功能调控为主,在一定程度上可控制病情进展,但需长期坚持且见效较为缓慢,而长期服用药物可能引起肝肾功能损伤等不良作用。南昌市洪都中医院采用柔肝调神针刺法治疗PSCI,取得较好效果,为临床治疗PSCI提供新思路和方法。Cognitive impairment is one of the common complications after stroke,and its main clinical manifestations include decreased comprehension ability,memory loss,executive ability loss and inattention.At present,the pathogenesis of post-stroke cognitive impairment(PSCI)remains unclear in Western medicine.Its treatment mainly includes drug therapy(such as cholinacetin inhibitor donepezil,excitatory amino acid receptor antagonist memantine,calcium antagonist nimodipine,brain metabolism improvement agent oxacetam,etc.),cognitive function rehabilitation training and brain function regulation.To some extent,the progression of the disease can be controlled,but long-term persistence is required and the effect is relatively slow.In addition,long-term use of drugs may cause liver and kidney function damage and other side effects.According to many years of clinical experience,Nanchang Hongdu Hospital of Traditional Chinese Medicine has adopted the method of Rougan Tiaoshen acupuncture as the main treatment of PSCI and achieved good curative effect,which provides a new idea and method for the clinical treatment of cognitive impairment after stroke.

关 键 词：呆证 脑卒中 认知障碍 柔肝调神针刺法 

分 类 号：R277.7[医药卫生—中医学]