摘要
中医学认为人之认知出于脑髓,脑髓功能正常主要依赖于肾中精气充养以及脑络结构完整通畅。肾中精气亏虚导致荣养脑髓的精微物质减少,即出现头晕、眼花、耳鸣、健忘等血管性痴呆前驱症状;当肾中精气亏虚日久,无以推动气血津液运行,则形成痰浊、瘀血等病理产物,阻滞并损伤脑络,此时荣养脑髓的精微物质因络脉受损无以上输于脑,且脑髓还因痰浊、瘀血等浊邪侵扰失其清轻纯明之性,当脑髓失荣亦伴随失清而形成髓伤之时,即出现神情呆滞、转盼遗忘、思维迟钝等血管性痴呆初期症状。基于此提出“肾虚络损髓伤”为血管性痴呆发生发展的核心病机,并强调在髓伤轻浅之时进行干预可以延缓血管性痴呆的病情进展,治疗应以补肾填精为主,化痰祛瘀为辅,以期为中医药防治血管性痴呆提供理论依据。
According to the theory of traditional Chinese medicine(TCM), cognition is derived from the brain marrow, and normal functioning of the brain marrow depends mainly on nourishment of the essence in the kidney and the integrity and smoothness of brain collaterals.When there is a deficiency of essence in the kidney, the essence that nourishes the brain marrow decreases, leading to dizziness, blurred vision, tinnitus, forgetfulness, and other precursory symptoms of vascular dementia.When there is a deficiency of essence in the kidney for a long time, it is not possible to promote the movement of qi, blood, and fluid, resulting in phlegm, static blood, and other pathological products blocking and damaging the brain collaterals.At this time, the essence that nourishes the brain marrow is not transferred to the brain because of the collateral damage, and the brain marrow is disturbed by phlegm and static blood and loses its clear, light, and pure nature.When the brain marrow loses its clarity, the initial symptoms of vascular dementia such as dullness, forgetfulness, and slow thinking will appear.Based on this, we propose that “kidney deficiency, collateral damage, and brain marrow injury” comprise the core pathogenesis of vascular dementia, and we emphasize that intervention at the time of superficial marrow injury can delay the progression of vascular dementia and that early treatment should be based on tonifying the kidney, supplementing the essence, resolving phlegm, and dispelling stasis.The aim of this paper is to provide a theoretical basis based on TCM to prevent and treat vascular dementia and slow the progression of vascular dementia.
作者
曾子修
张允岭
金香兰
ZENG Zixiu;ZHANG Yunling;JIN Xianglan(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China;Xiyuan Hospital of China Academy of Chinese Medi-cal Sciences,Beijing 100091,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)
出处
《北京中医药大学学报》
CAS
CSCD
北大核心
2022年第7期649-653,共5页
Journal of Beijing University of Traditional Chinese Medicine
基金
全国中医临床特色技术传承骨干人才培训项目(No.国中医药人教函[2019]36号)
国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202007)
中医药防治脑病传承创新团队项目(No.CI2021B006)。
关键词
血管性痴呆
肾虚络损髓伤
病机
理论探讨
vascular dementia
kidney deficiency
collateral damage
and brain marrow injury
pathogenesis
theoretical discussion
