基于“心脑同治”理论探讨血管性痴呆中医辨治  

Discussion on TCM syndrome differentiation and treatment of vascular dementia based on the theory of treating the heart and brain together

作　　者：石星月 周小莉[2] SHI Xingyue

机构地区：[1]湖北中医药大学中医学院,湖北武汉430000 [2]湖北省中医院,湖北武汉430000

出　　处：《中医临床研究》2024年第32期57-60,共4页Clinical Journal Of Chinese Medicine

基　　金：湖北省中医药管理局中医药科研项目(ZY2023F133)。

摘　　要：血管性痴呆是继发于出血性或缺血性脑血管病所致的严重认知功能障碍综合征。此病是继阿尔茨海默病之后的第二大痴呆类型,临床表现为认知功能障碍和神经功能障碍,严重影响患者的生活质量,增加社会负担。根据血管性痴呆的临床表现,将其归为中医“痴呆”范畴,此病病位在脑,且与心关系密切。中医“心脑同治”理论是在“心脑共主神明”及“心脑血脉相连”等理论基础上提出的,体现了心、脑的相关性。此理论认为,心脑血管疾病异病同源,有相似的致病因素、共患疾病相兼,可采取同样的治疗方法。笔者从“心脑同治”理论探讨血管性痴呆的中医病因病机、病理演变机制、辨证分型及相应的防治策略,将该理论运用在中药、针刺等多种治疗中,以期为临床提供新思路,体现中医整体观念和异病同治思想,对改善血管性痴呆患者病情和生活质量具有现实意义。Vascular dementia(VaD)is a clinical syndrome of severe cognitive dysfunction secondary to hemorrhagic or ischemic Vcerebrovascular disease,and is the second most common type of dementia after Alzheimer’s disease.Its clinical manifestations are cognitive dysfunction and neurological dysfunction,which seriously affect the quality of life of patients and increase the social burden.According to the clinical manifestations of vascular dementia,it is classified as dementia in traditional Chinese medicine,the disease is located in the brain and is closely related to the heart.The theory of treating the heart and brain together in traditional Chinese medicine is put forward on the basis of the theories of the heart and brain are both in charge of the mental activity,and the heart and brain are connected by blood vessel,which reflects the correlation between the heart and brain.This theory holds that cardiovascular and cerebrovascular diseases are different diseases of the same origin,with similar pathogenic factors and comorbidities,and can be treated by the same method.The author discusses the etiology,pathological evolution mechanism,syndrome differentiation and classification,and corresponding prevention and treatment strategies of VaD based on the theory of treating the heart and brain together,and applies this theory in various treatments such as Chinese medicine and acupuncture,in order to provide new ideas for the prevention and treatment of the disease,which embodies the overall concept of TCM and the idea of treating different diseases by the same method,and has practical significance for ameliorating the condition and improving quality of life of VaD patients.

关 键 词：血管性痴呆 心脑同治 中医药防治 认知障碍 

分 类 号：R749.13[医药卫生—神经病学与精神病学]