从络病理论探讨多发性硬化的因机证治  

Exploring the Pathogenesis and Treatment of Multiple Sclerosis Based on the Theory of Collateral Diseases

作　　者：张云帆 赵迪 魏竞竞 梁晓 刘红喜 苗丽娜 张雪茹 陈云梦 张允岭 ZHANG Yunfan;ZHAO Di;WEI Jingjing(Graduate School,Beijing University of Chinese Medicine,Beijing,100029,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences)

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

出　　处：《浙江中医药大学学报》2025年第2期146-152,共7页Journal of Zhejiang Chinese Medical University

基　　金：中国中医科学院科技创新工程项目(CI2021A01301);国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202007);中国中医科学院中医药防治脑病传承创新团队(CI2021B006)。

摘　　要：[目的]基于中医学络病理论,探讨多发性硬化(multiple sclerosis,MS)的病因病机和证治规律。[方法]通过对中医学“络病”“痿证”等古今文献的分析,结合现代医学治疗MS的效应机制研究,总结基于络病理论辨治MS的思路,并附验案一则予以佐证。[结果]络脉是血气敷布的单元,通过与经脉之间的经气流注与营卫协调,发挥输布气血津液、濡养经脉脏腑的作用。络脉的生理特点决定其在病理上成为邪气侵袭、隐匿、发展的场所。基于络病理论对MS的因机证治进行分析,提出湿热络滞、精虚络枯、血瘀络阻为MS复杂临床表现的病机,并提出健脾利湿通络、肝肾同调通络、行气活血通络的MS的证治规律。所附验案属于肝肾不足之痿证,治以补肝益肾、温润通络,取得较好疗效。[结论]中医学络病理论作为经络学说的重要内容,在治疗神经系统疾病方面具有广阔的前景,能够为中医药辨治MS的理论研究与临证诊治提供方法与思路。[Objective]To explore the etiology,pathogenesis and treatment principles of multiple sclerosis(MS)based on the theory of collateral diseases in traditional Chinese medicine(TCM).[Methods]By analyzing ancient and modern literature on TCM concepts such as“collateral diseases”and“atrophy syndromes”,and integrating modern medical research on the biological mechanisms of MS treatment,this study summarizes the approach to diagnose and treat MS based on the theory of collateral diseases,supported by a case example.[Results]The collaterals are the units for the distribution of blood and Qi,which,through the coordination of meridian Qi flow and the balance of nutrient and defensive Qi,plays a role in distributing blood,Qi and body fluids,and nourishing the meridians and viscera.The physiological characteristics of the collaterals determine that they become sites for the invasion,concealment and development of pathogenic factors.Analysis based on the theory of collateral diseases suggests that damp-heat stagnation,essence deficiency and blood stasis in the collaterals are the underlying mechanisms for the complex clinical manifestations of MS.Treatment principles proposed include strengthening the spleen and promoting diuresis to clear dampness,harmonizing the liver and kidneys to nourish the collaterals,and promoting the circulation of Qi and blood to unblock the collaterals.The attached test case belonged to the impotence of liver and kidney deficiency,treated by supplementing the liver and kidney,warm and smooth meridians,and achieved better curative effect.[Conclusion]The theory of collateral diseases,as an important part of the meridian and collateral system in TCM,holds broad prospects in the treatment of neurological diseases.It can provide methods and ideas for the theoretical research and clinical treatment of MS with TCM.

关 键 词：络病理论 多发性硬化 痿证 病因病机 辨证论治 理论探讨 通络法 医案 

分 类 号：R593[医药卫生—内科学]