运用通阳法辨治血管性痴呆  

Differentiation and Treatment of Vascular Dementia Applying the Method of Promoting Yang

作　　者：邱鸿帆 崔玮璐 李海霞[1] QIU Hongfan;CUI Weilu;Li Haixia(Guang'anmen Hospital,CChina Academy of Chinese Medical Sciences,Beijing,100053)

机构地区：[1]中国中医科学院广安门医院,北京市100053

出　　处：《中医杂志》2025年第5期537-540,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81973682);首都卫生发展科研专项重点攻关项目(2024-1-4151)。

摘　　要：认为元阳不充、无力行血为血管性痴呆发病之本,痰瘀互结、脉道不利为发病关键;治疗总则为益气通阳、祛邪通阳,即补益脾肾先天、后天之阳气,祛除痰浊、瘀血等有形实邪,以达恢复阳气气化功能、通行脉道血气的功效。用药以黑顺片、制川乌、桂枝、人参、黄芪为基础方益气通阳,根据实邪类型的不同,以通窍活血汤加郁金、香附化瘀通阳,或以法半夏、陈皮、枳实加四君子汤祛痰通阳,标本同治,阳气行则气血上荣,邪实祛则脉道通利,以期为临床治疗血管性痴呆提供思路。It is believed that the root cause of vascular dementia lies in insufficient primal yang and weakness in the circulation of blood.The key pathological factors are the mutual stagnation of phlegm and blood stasis,and the obstruction of blood vessels.The general treatment principle is to tonify qi and promote yang,expel pathogenic factors,and unblock yang.This involves supplementing the innate and acquired yang qi of the spleen and kidneys,removing pathogenic factors like phlegm,turbidity,and blood stasis,in order to restore the function of yang qi and promote the circulation of blood and qi.The basic prescription for tonifying qi and promoting yang includes Heishunpian(Lycium Ruthenicum),Zhichuanwu(Aconitum Carmichaelii),Guizhi(Cinnamomum Cassia),Renshen(Panax Ginseng),and Huangqi(Astragalus Membranaceus).Depending on the type of pathogenic excess,the treatment can be modified with Tongqiao Huoxue Decoction(通窍活血汤),adding Yujin(Curcuma Longa)and Xiangfu(Cyperus Rotundus)to invigorate blood and promote yang,or with Fabanxia(Pinellia Ternata),Chenpi(Citrus Reticulata),Zhishi(Citrus Aurantium)plus Sijunzi Decoction(四君子汤)to resolve phlegm and promote yang.Both the root and branch are treated simultaneously.When yang qi is activated,blood and qi are nourished,and when pathogenic excess is expelled,the blood vessels are unblocked.This approach aims to provide a treatment strategy for vascular dementia.

关 键 词：血管性痴呆 通阳法 益气 化瘀 祛痰 

分 类 号：R277.7[医药卫生—中医学]