从本虚标实论治血管性痴呆临床研究进展
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摘要
血管性痴呆(Vascular dementia,VD)是一种具有可逆性的痴呆类型,故早期干预具有一定的可预防性,其发病机制较为复杂,现代医学对其相关研究进展推进缓慢,也未有新的突破。中医认为VD是一种本虚标实的病变,临床应首遵本虚标实理论,即脏腑虚损、气血不足为其根本,痰、瘀、浊、毒为其标实,临床治疗应依从补虚泻实、标本兼顾的治疗原则辨证论治。基于标本虚实理论,结合经典文献、临床研究与笔者临证体会,对VD从病机、证候、论治方面进行了归纳、分析和思考。
Vascular dementia(VD)is one of the most common dementia after Alzheimer's disease,however,unlike Alzheimer's disease,it is a kind of dementia which can be prevented and even reversed,therefore,development of effective,safe and affordable prevention for VD is very important. Progress in the disease is slow because of the complex pathogenesis. The pathogenesis of vascular dementia is deficiency in origins and excess in superficiality according to the traditional Chinese medicine theory. The deficiency in Qi,blood and origins is the root,phlegm,blood-stasis,turbidity or toxicity is the superficiality. Therefore,the principle of the TCM treatment is tonifying the deficiency syndrome and purgative the excess syndrome,and treating both the manifestation and root cause of disease. This article is a review in pathogensis,syndrome and treatment.
Vascular dementia(VD)is one of the most common dementia after Alzheimer's disease,however,unlike Alzheimer's disease,it is a kind of dementia which can be prevented and even reversed,therefore,development of effective,safe and affordable prevention for VD is very important. Progress in the disease is slow because of the complex pathogenesis. The pathogenesis of vascular dementia is deficiency in origins and excess in superficiality according to the traditional Chinese medicine theory. The deficiency in Qi,blood and origins is the root,phlegm,blood-stasis,turbidity or toxicity is the superficiality. Therefore,the principle of the TCM treatment is tonifying the deficiency syndrome and purgative the excess syndrome,and treating both the manifestation and root cause of disease. This article is a review in pathogensis,syndrome and treatment.
引文
[1]刘峘,田金洲.血管性痴呆患者证候学研究[J].北京中医药大学学报,2006,29(1):52-55.
[2]尹博睿,王娟.从《脾胃论》思想论治血管性痴呆[J].云南中医中药杂志,2017,38(3):10-11.
[3]袁欢,王飞.从“郁”论老年痴呆[J].湖南中医杂志,2017,33(9):143-144.
[4]朱明瑾,唐启盛.益肾调气法治疗血管性痴呆的理论探讨[J].四川中医,2017,35(4):53-54.
[5]唐农,胡跃强,吴林,等.益肺宣肺降浊胶囊治疗血管性痴呆的随机对照临床研究[J].中华中医药杂志,2014,29(12):3778-3781.
[6]李涓,于建春,于涛,等.韩景献治疗痴呆的经验介绍[J].辽宁中医杂志,2011,38(5):837-838.
[7]冯兴建.痰瘀搏结是血管性痴呆的病机关键[J].现代中西医结合杂志,2010,19(3):386-388.
[8]蔡建伟.清毒活血化痰是治疗血管性痴呆的基本法则[J].辽宁中医药大学学报,2008,10(7):34-35.
[9]李杨帆,李丽.络病理论在血管性痴呆中的应用[J].北京中医药,2011,30(6):407-408.
[10]崔远武,江丰,马妍,等.张伯礼分期论治老年期血管性痴呆述要[J].中医杂志,2015,56(15):1276-1279.
[11]张航.血管性痴呆中医治疗探析[J].中医研究,2014,27(10):10-11.
[12]陈金亮,黄涛.运用络病理论探讨脑血管性痴呆及其证治[J].辽宁中医杂志,2011,38(5):879-880.
[13]田金州,韩明向,涂晋文,等.血管性痴呆诊断,辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329-331.
[14]王玮,于文涛,张文天.血管性痴呆临床方药组成的文献研究[J].中国中医基础医学杂志,2012,18(9):1031-1032.
[15]李根龙.辨证分型治疗老年痴呆120例临床观察[J].实用中医内科杂志,2013,27(4):9-10.
[16]卢瑞丽.血管性痴呆的中医论治研究进展[J].海南医学,2011,22(18):125-127.
[17]梅建伟,王辞晓,张英强.辨证论治血管性痴呆[J].四川中医,2009,27(11):22-23.
[18]廖少君,尤劲松.血管性痴呆辨证论治的研究概况及思考[J].中国中医基础医学杂志,2015,21(12):1599-1601.
[19]杨泽峰,马云枝.马云枝教授论治血管性痴呆经验[J].中医临床研究,2014,6(10):70-71.
[20]张文学.祛痰化瘀、益脑开窍法治疗血管性痴呆66例[J].中医杂志,2002(1):48-49.
[21]郝军生,丁现琴.补脾益心汤治疗老年血管性痴呆心脾两虚证患者临床疗效评估[J].亚太传统医药,2014(24):95-96.
[22]何小容.补肾化痰法治疗轻中度血管性痴呆的临床疗效观察[D].北京:北京中医药大学,2013.
[23]缪峰,李会琪,袁有才.补肾化痰颗粒治疗血管性痴呆肾精亏虚痰浊蒙窍证[J].长春中医药大学学报,2015(1):124-126.
[24]郭强,朱玉霞,赵欢,等.补肾活血法与西医治疗血管性痴呆疗效比较的Meta分析[J].山东医药,2014(46):35-38.
[25]伍大华,姚婷,蒋军林.滋肾活血法治疗血管性痴呆肾阴虚血瘀证的临床研究[J].中西医结合心脑血管病杂志,2015(12):1372-1374.
[26]曹银洲,赵敏.祛痰逐瘀法治疗血管性痴呆临床研究[J].中医学报,2015,30(1):127-129.
[27]易继龙.配伍风药治疗血[]管性痴呆1例[J].河南中医,2014,34(2):256-257.
[2]尹博睿,王娟.从《脾胃论》思想论治血管性痴呆[J].云南中医中药杂志,2017,38(3):10-11.
[3]袁欢,王飞.从“郁”论老年痴呆[J].湖南中医杂志,2017,33(9):143-144.
[4]朱明瑾,唐启盛.益肾调气法治疗血管性痴呆的理论探讨[J].四川中医,2017,35(4):53-54.
[5]唐农,胡跃强,吴林,等.益肺宣肺降浊胶囊治疗血管性痴呆的随机对照临床研究[J].中华中医药杂志,2014,29(12):3778-3781.
[6]李涓,于建春,于涛,等.韩景献治疗痴呆的经验介绍[J].辽宁中医杂志,2011,38(5):837-838.
[7]冯兴建.痰瘀搏结是血管性痴呆的病机关键[J].现代中西医结合杂志,2010,19(3):386-388.
[8]蔡建伟.清毒活血化痰是治疗血管性痴呆的基本法则[J].辽宁中医药大学学报,2008,10(7):34-35.
[9]李杨帆,李丽.络病理论在血管性痴呆中的应用[J].北京中医药,2011,30(6):407-408.
[10]崔远武,江丰,马妍,等.张伯礼分期论治老年期血管性痴呆述要[J].中医杂志,2015,56(15):1276-1279.
[11]张航.血管性痴呆中医治疗探析[J].中医研究,2014,27(10):10-11.
[12]陈金亮,黄涛.运用络病理论探讨脑血管性痴呆及其证治[J].辽宁中医杂志,2011,38(5):879-880.
[13]田金州,韩明向,涂晋文,等.血管性痴呆诊断,辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329-331.
[14]王玮,于文涛,张文天.血管性痴呆临床方药组成的文献研究[J].中国中医基础医学杂志,2012,18(9):1031-1032.
[15]李根龙.辨证分型治疗老年痴呆120例临床观察[J].实用中医内科杂志,2013,27(4):9-10.
[16]卢瑞丽.血管性痴呆的中医论治研究进展[J].海南医学,2011,22(18):125-127.
[17]梅建伟,王辞晓,张英强.辨证论治血管性痴呆[J].四川中医,2009,27(11):22-23.
[18]廖少君,尤劲松.血管性痴呆辨证论治的研究概况及思考[J].中国中医基础医学杂志,2015,21(12):1599-1601.
[19]杨泽峰,马云枝.马云枝教授论治血管性痴呆经验[J].中医临床研究,2014,6(10):70-71.
[20]张文学.祛痰化瘀、益脑开窍法治疗血管性痴呆66例[J].中医杂志,2002(1):48-49.
[21]郝军生,丁现琴.补脾益心汤治疗老年血管性痴呆心脾两虚证患者临床疗效评估[J].亚太传统医药,2014(24):95-96.
[22]何小容.补肾化痰法治疗轻中度血管性痴呆的临床疗效观察[D].北京:北京中医药大学,2013.
[23]缪峰,李会琪,袁有才.补肾化痰颗粒治疗血管性痴呆肾精亏虚痰浊蒙窍证[J].长春中医药大学学报,2015(1):124-126.
[24]郭强,朱玉霞,赵欢,等.补肾活血法与西医治疗血管性痴呆疗效比较的Meta分析[J].山东医药,2014(46):35-38.
[25]伍大华,姚婷,蒋军林.滋肾活血法治疗血管性痴呆肾阴虚血瘀证的临床研究[J].中西医结合心脑血管病杂志,2015(12):1372-1374.
[26]曹银洲,赵敏.祛痰逐瘀法治疗血管性痴呆临床研究[J].中医学报,2015,30(1):127-129.
[27]易继龙.配伍风药治疗血[]管性痴呆1例[J].河南中医,2014,34(2):256-257.