基于“阳化气,阴成形”分型论治多系统萎缩  

Treating multiple system atrophy based on the theory of“yang transforms into qi and yin constitutes form”

作　　者：周晓磊 吴圣贤[2] 董兴鲁[1] ZHOU Xiaolei;WU Shengxian;DONG Xinglu(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;National Drug Clinical Trial Institution,Dongzhimen Hospital,Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学东直门医院国家药物临床试验机构

出　　处：《现代中医临床》2025年第1期92-96,共5页Modern Chinese Clinical Medicine

基　　金：北京市中医管理局委托项目。

摘　　要：多系统萎缩(multiple system atrophy,MSA)是一种成年多发的以自主神经功能障碍、帕金森样症状和小脑共济失调为主要临床表现的神经退行性疾病。主要有帕金森型(MSA-P型)、小脑型(MSA-C型)和混合型(MSA-C+P型)等临床亚型。中医学将MSA归属于“颤证”“眩晕”“骨繇”“虚劳”“喑痱”等范畴,因肾“阳化气,阴成形”失衡所致,其发病以肾虚为本,累及心肝脾肺,以痰浊、瘀血、湿毒为标,涉及阴阳盛衰。MSA主要中医证候包括肝肾亏虚证、脾肾阳虚证及阴阳两虚证,可分别予以补益肝肾、填精益髓,补益脾肾、温阳化气以及阴阳双补等治法。并结合临床案例对基于“阳化气,阴成形”分型论治MSA进行阐述。Multiple system atrophy(MSA)is a neurodegenerative disease characterized by autonomic dysfunction,parkinson-like symptoms and cerebellar ataxia.Patients can be categorized into the Parkinson’s type(MSA-P type),cerebellar type(MSA-C type)and mixed type(MSA-C+P type).MSA belongs to the categories of chanzheng(trembling syndrome),xuanyun(vertigo),guyao(bone trembling),xulao(deficiency due to overstrain)and yinfei(aphonia),due to the imbalance of“yang transforms into qi and yin constitutes form”of the kidney,its onset is based on kidney deficiency,involving the heart,liver,spleen and lung,with phlegm turbidness,blood stasis and dampness toxicity as the root,involving the rise and fall of yin and yang.The main TCM syndromes of MSA include deficiency of liver and kidney,deficiency of spleen and kidney,deficiency of spleen and kidney,deficiency of yin and yang,and deficiency of both yin and yang,which should be treated by tonifying liver and kidney,filling essence and nourishing marrow,tonifying spleen and kidney,warming yang and transforming qi,and supplementing both yin and yang.Combined with clinical cases,the treatment of MSA based on the theory of“yang transforms into qi and yin constitutes form”was expounded.

关 键 词：病因病机 多系统萎缩 分型论治 阳化气 阴成形 

分 类 号：R259[医药卫生—中西医结合] R256.46[医药卫生—中医内科学]