基于“清阳不升”理论探讨持续性姿势-感知性头晕的辨证施治思路  

Discussion on syndrome differentiation and treatment thinking of persistent postural-perceptual dizziness based on the theory of“qingyang failing to ascend”

作　　者：张永辉 张道培 张怀亮 王伟涛 王昱斐 黄一帆 练梦园 王俪霖 ZHANG Yonghui;ZHANG Daopei;ZHANG Huailiang;WANG Weitao;WANG Yufei;HUANG Yifan;LIAN Mengyuan;WANG Lilin(Department of Neurology,the First Affiliated Hospital of Henan University of Chinese Medicine,Henan Province,Zhengzhou450000,China;Collaborative Innovation Center of Prevention and Treatment of Major Diseases by Chinese and Western Medicine,Henan Province,Zhengzhou450000,China;the First Clinical College of Medicine,Henan University of Chinese Medicine,Henan Province,Zhengzhou450000,China)

机构地区：[1]河南中医药大学第一附属医院脑病科,河南郑州450000 [2]中西医防治重大疾病河南省协同创新中心,河南郑州450000 [3]河南中医药大学第一临床医学院,河南郑州450000

出　　处：《中国医药导报》2025年第5期167-171,共5页China Medical Herald

基　　金：河南省中医药科学研究专项课题(2023ZY2023,2024ZY1008)。

摘　　要：持续性姿势-感知性头晕(PPPD)是一种慢性前庭功能障碍性疾病,以持续非旋转性头晕、走路不稳为主要症状,属于中医学“眩晕”范畴。“清阳不升”理论认为,其基本病机为清阳之气不能上升濡润脑窍,脑髓失养而引发头晕,以脾肾虚弱、清阳化源不足、升举无力为本,以枢机不利、气机升降失调、痰气瘀阻塞清阳为标,有正虚、邪实两个方面,两者常互为因果。临证治疗当以养其真、顺其性、降其浊为治疗原则。本文基于“清阳不升”理论,详细阐释PPPD病机内涵,为临床治疗提供新的辨证论治思路和理论依据。Persistent postural-perceptual dizziness(PPPD)is a chronic vestibular dysfunction with persistent non-rotational dizziness and unsteady walking as main symptoms,which belongs to the category of“vertigo”in traditional Chinese medicine.According to the theory of“qingyang failing to ascend”,its basic pathogenesis is that qingyang qi can not rise and moisten brain,and brain marrow is lost and causes dizziness.Weakness of spleen and kidney,insufficient source of qingyang,inability to lift up and down in origin,and unfavorable cardinal condition,imbalance of qi movement rise and fall,phlegm,qi,and blood stasis blockage of qingyang in superficislity.There are two aspects of positive deficiency and evil substance,the two often cause and effect each other.This article is based on the theory of“qingyang failing to ascend”,elaborates in detail on pathogenesis of PPPD,providing new diagnostic and treatment ideas and theoretical basis for clinical treatment.

关 键 词：持续性姿势-感知性头晕 “清阳不升” 气机升降 理论探讨 

分 类 号：R255.3[医药卫生—中医内科学]