摘要
血管性痴呆(vascular dementia,VaD)以认知损害、精神行为症状和日常生活能力下降为主要症状,常继发于出血性或缺血性脑血管病,即“中风后善忘”。VaD已成为继阿尔茨海默病后最常见的痴呆类型,引起社会的广泛关注。本文试从“痰瘀蒙窍”论治VaD,认为“痰瘀蒙窍”是导致VaD的高危病因、核心病机。痰瘀留滞于中风后各阶段,二者相互胶结,闭阻脑络,上蒙清窍而发为呆病。痰气越深,呆气越重;瘀血越重,呆气越深。以化痰通络、开窍醒神为法,详分病期,标本兼顾,以冀为临床论治VaD提供思路。
Vascular dementia(VaD)primarily presents with cognitive impairment,psychobehavioral symptoms,and decreased reduced daily life functionality.It often arises as a sequel to hemorrhagic or ischemic cerebrovas cular disease,i.e.,“post-stroke amnesia”.VaD has become the most prevalent type of dementia following Alzheimer's disease,drawing considerable societal attention.This paperexplores the treatment of VaD from the perspective of “phlegm and blood stasis clouding the orifices”,and suggest that “phlegm and blood stasis clouding the orifices” is the high-risk etiology and core pathogenesis of VaD.Phlegm and stasis remain stagnant at various stages after stroke,and they are intertwined with each other,blocking the cerebral channels and obscuring the clear orifices,resulting in dullness.The severity of cognitive impairment increases with deeper phlegm and intensified stasis.The proposed method advocates for removing phlegm,opening the orifices and mental reinvigoration,addressing symptoms and root causes across different disease stages,aiming to provide ideas for the clinical VaD management.
作者
龚洲
马培
刘鑫雨
吴柔燕
贾岳津
齐欣
胡天时
刘金瑛
李志更
岳利峰
GONG Zhou;MA Pei;LIU Xinyu;WU Rouyan;JIA Yuejin;QI Xin;HU Tianshi;LIU Jinying;LI Zhigeng;YUE Lifeng(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700;Institute of Medicinal Plant Development,Chinese Academy of Medical Sciences;Institute of Basic Theory for Chinese medicine,China Academy of Chinese Medical Science)
出处
《现代中医临床》
2024年第1期81-84,共4页
Modern Chinese Clinical Medicine
基金
国家自然科学基金面上项目(No.8217404,No.81302960)
中国医学科学院医学与健康科技创新工程项目(No.2022-I2M-2-002)
北京中医药大学青年名医培育项目(No.BUCM-2019-QNMYB011)。
关键词
痰
瘀
痰瘀蒙窍
血管性痴呆
phlegm
stasis
phlegm and stasis clouding the orifices
vascular dementia
作者简介
龚洲,男,在读硕士生;通信作者:岳利峰,男,博士,主任医师,硕士生导师,E-mail:yuelifeng100@sina.com。
