基于张锡纯理论从痰火虚论治重症加强病房谵妄  

Treatment of ICU Delirium from Phlegm Fire and Deficiency Based on ZHANG Xichun's Theory

作　　者：梅琳茜 杨志旭[2] MEI Lin-xi;YANG Zhi-xu(Beijing University of Chinese Medicine,Beijing 100029;ICU,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院ICU,北京100091

出　　处：《世界中西医结合杂志》2025年第2期387-392,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：中国中医科学院科技创新工程重大攻关项目(C12021A02908)。

摘　　要：张锡纯是我国中西医汇通学派的代表人物之一,其借鉴西医解剖学、生理学和药理学等理论,与中医理论结合,为中西医结合提供了衷中参西的理念、中西药并用的方法、理论与实践相结合、病症解释与选方用药等思路。张锡纯论述的“癫狂”疾病可视为西医学上的重症加强病房(Intensive care unit,ICU)谵妄。ICU谵妄是ICU病房内的一种急性临床综合征,基于张锡纯的癫狂理论,归纳ICU谵妄的病机为其人本虚,又心肝气郁、肝火上炎,心血暗耗,致痰火上壅,堵塞窍络,神明错乱。其治疗从豁痰开窍、重镇安神、补虚扶正着手,其预防则需升补宗气。ZHANG Xichun is one of the representatives of the school of integrated traditional Chinese and Western medicine.Learning from the theories of both Western medicine(such as anatomy,physiology,and pharmacology)and traditional Chinese medicine,ZHANG Xichun provided the ideas of integrating traditional Chinese and Western medicine,theory and practice,and disease explanation and prescription selection,The psychosis expounded by ZHANG Xichun can be regarded as intensive care unit(ICU)delirium in Western medicine.ICU delirium is an acute clinical syndrome in ICU.According to ZHANG Xichun's theory of psychosis,the pathogenesis of ICU delirium is summed up as follows:the body deficiency combined with qi depression in the heart and liver and inflammation due to liver fire leads to consumption of heart blood.As a result,phlegm fire obstructs orifices and collaterals and leads to mental disorders.The treatment should focus on clearing phlegm to open orifices,tranquilizing mind with heavy sedatives,and tonifying deficiency and reinforcing healthy qi.The clinical prevention of ICU delirium should target at tonifying pectoral qi.

关 键 词：ICU谵妄 张锡纯 癫狂 中医 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]