2023年脑小血管病中医药诊疗进展  

A review on the traditional Chinese medicine diagnosis and treatment of cerebral small vessel disease in 2023

作　　者：张伟峰[1] 王瑞召 张璟 冯丽莎[2] ZHANG Weifeng;WANG Ruizhao;ZHANG Jing;FENG Lisha

机构地区：[1]天津中医药大学,天津301617 [2]天津市中医药研究院附属医院,天津300120

出　　处：《中医临床研究》2024年第33期20-24,共5页Clinical Journal Of Chinese Medicine

摘　　要：脑小血管病(Cerebral Small-vessel Disease,CSVD)由多种因素引起,是临床表现、影像学与病理的综合征。CSVD在我国发病率较高,因其年龄相关性,并有突出的认知、步态功能损害症状,对老年患者的危害尤为突出,近年来受到越来越多学者的关注。本研究搜集近年中医治疗CSVD的相关文献,有“虚”“痰”“瘀”“风”四端,在一定条件下可以相互作用、相互影响,依据临床表现可归于“眩晕”“中风”“痴呆”等范畴。CSVD中医辨证分型及治疗尚无专家共识,各家对CSVD的中医证候分型总属本虚标实,虚实相兼。虚证主要有气虚、阴虚、阳虚,脾虚及肾虚为其主要虚损脏腑,实证为气滞、血瘀、风动、痰阻,治疗上当扶正祛邪,攻补兼施。根据其辨证分型,扶正重在补气、补阴、补阳、补脾、补肾,祛邪包括理气、活血、化痰、祛风等。中医具有中药、中成药、针灸等特色疗法,各家医者提出“化浊行血汤、脑泰方、化瘀通络合剂、化浊行血颗粒、脑络通颗粒、养血清脑颗粒、脑栓通胶囊”方剂及“醒脑开窍针法”等针法,对CSVD的治疗具有独特优势。本研究主要探讨近期中医药治疗CSVD的研究进展,期望为CSVD的诊治提供更多路径。Cerebral small-vessel disease(CSVD)is a syndrome of clinical manifestation,imaging and pathology caused by many factors.The incidence of cerebral small-vessel disease is relatively high in our country.Due to its age-related and prominent symptoms of cognitive and gait impairment,it is especially harmful to the elderly patients,which has attracted more and more attention in recent years.By collecting relevant literature on the treatment of cerebral small-vessel disease in traditional Chinese medicine in recent years,this paper summarizes that the pathogenesis of cerebral small-vessel disease in traditional Chinese medicine is generally characterized by asthenia in origin and sthenia in superficiality,and concludes that there are four aspects of‘deficiency’,‘phlegm’,‘stasis’and‘wind’,which can interact and influ-ence each other under certain conditions,and can be classified into the categories of‘vertigo’,‘stroke’and‘dementia’according to their clinical manifestations.There is no expert consensus on TCM syndrome differentiation and treatment of cerebral small-vessel disease.All kinds of TCM syndromes of cerebral small-vessel disease belong to sthenia in origin and sthenia in superficiality,which is a mixture of excess and deficiency.Deficiency syndrome mainly includes Qi(气)deficiency,Yin(阴)deficiency,and Yang(阳)deficiency,and spleen deficiency and kidney deficiency is the main deficiency that damages Zangfu organs(脏腑),the demonstration of excess syndrome mainly lies in Qi stagnation,blood stasis,wind movement,phlegm obstruction,and treatment should focus on strengthening the body resistance to eliminate pathogenic factors and combining tonification and purgation.According to its differential classification,the emphasis of strengthening the body resistance lies in sup-plementing Qi,Yin,Yang,spleen and kidney;Eliminating pathogenic factors includes regulating Qi,promoting blood circulation,eliminating phlegm,expelling wind,etc.TCM has the characteristics treatment of Chinese medi

关 键 词：脑小血管病 研究进展 中医诊疗 证候分型 

分 类 号：R255.2[医药卫生—中医内科学]