“血-脉-心-神”一体观指导中风病防治理论刍议
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摘要
中风病的发生和转归涉及到了血、脉、心、神多个环节的动态病理变化过程。目前临床侧重于"罪犯血管"因素的脑卒中治疗策略具有一定的局限性,对患者脏腑功能和神志状态的整体干预相对不足。以"血-脉-心-神"一体观为指导的中风病防治策略契合该病的病机特点,弥补了重结构而轻功能治疗策略的不足,充分发挥了中医整体观的优势。
The occurrence and prognosis of stroke involve dynamic pathological changes of "Blood","Pulse","Heart"and"Spirit". The present clinical treatment strategy of stroke which focuses on the"culprit vessel"has some limitations,and has shortcomings of holistically interventing patients' "Zang-Fu"orgnas functions and mental atatus. The prevention and treatment strategies of apoplexy guided by the holistic idea based on"Blood-Pulse-Heart-Spirit"fit the pathogenesis features of the disease,cover the shortages of the current strategy which focus on structure while neglect fuction and fully play the advantages of the holistic view of TCM.
The occurrence and prognosis of stroke involve dynamic pathological changes of "Blood","Pulse","Heart"and"Spirit". The present clinical treatment strategy of stroke which focuses on the"culprit vessel"has some limitations,and has shortcomings of holistically interventing patients' "Zang-Fu"orgnas functions and mental atatus. The prevention and treatment strategies of apoplexy guided by the holistic idea based on"Blood-Pulse-Heart-Spirit"fit the pathogenesis features of the disease,cover the shortages of the current strategy which focus on structure while neglect fuction and fully play the advantages of the holistic view of TCM.
引文
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[20]Dutta P,Courties G,Wei Y,et al.Myocardial infarction accelerates atherosclerosis[J].Nature,2012,487(7407):325-329.
[2]徐安定,丁燕,李牧.中国缺血性卒中早期静脉溶栓的现状、阻碍因素及改进策略[J].中国卒中杂志,2014,9(6):522-528.
[3]周欢,张军平.“血-脉-心-神”共调理念在冠心病治疗中的阐释[J].中国中医基础医学杂志,2017,23(5):651-653.
[4]张运,陈文强.缺血性心脏病发病机制的新观点[J].中华心血管病杂志,2014,42(2):94-97.
[5]Marzilli M,Merz CN,Boden WE,et al.Obstructive coronary atherosclerosis and ischemic heart disease:An elusive link![J].Journal of the American College of Cardiology,2012,60(11):951-956.
[6]周欢,张军平,仲爱芹,等.基于“血-脉-心-神”一体观探讨缺血性心脏病的时空整体性[J].时珍国医国药,2017,28(5):1161-1163.
[7]吴以岭.脉络学说构建及其指导血管病变防治研究[J].中国中西医结合杂志,2017,37(2):147-148.
[8]亓鹏浩,刘创,李宁.基于络病理论的中风“气络失调,血络不通,络伤毒浸”病机刍议[J].辽宁中医药大学学报,2014,16(7):162-164.
[9]季帅,张军平,吕仕超,等.从玄府学说论中医药防治脑缺血再灌注损伤[J].中医杂志,2013,54(14):1197-1199.
[10]吕仕超,张军平.经皮冠状动脉介入术后无复流现象与玄府开闭的研究[J].世界科学技术-中医药现代化,2012,14(5):1981-1984.
[11]Hall CN,Reynell C,Gesslein B,et al.Capillary pericytes regulate cerebral blood flow in health and disease[J].Nature,2014,508(7494):55-60.
[12]O'Farrell FM,Attwell D.A role for pericytes in coronary no-reflow[J].Nature reviews Cardiology,2014,11(7):427-432.
[13]Deguchi K,Liu N,Liu W,et al.Pericyte protection by edaravone after tissue plasminogen activator treatment in rat cerebral ischemia[J].Journal of Neuroscience Research,2014,92(11):1509-1519.
[14]葛源森.从“玄府之司使-周细胞”新视点探讨缺血性卒中溶栓后出血转化[J].中国煤炭工业医学杂志,2016,19(2):271-274.
[15]蔡向红,梁昕.“心脑共主神明”新释[J].世界中医药,2013,8(6):620-622.
[16]杨涛,赵明镜,王蕾,等.“心主神明”的内涵及现代科学依据[J].北京中医药大学学报,2016,39(10):811-814.
[17]许晓敏,仲爱芹,徐士欣,等.论心脑异病从络同治[J].辽宁中医杂志,2015,42(7):1236-1238.
[18]袁卓,张军平.冠心病抑郁与络损神伤[J].上海中医药大学学报,2007,21(1):31-32.
[19]仲爱芹,徐士欣,张军平.从瘀毒论治缺血性中风的理论探析[J].中华中医药学刊,2015,33(3):573-575.
[20]Dutta P,Courties G,Wei Y,et al.Myocardial infarction accelerates atherosclerosis[J].Nature,2012,487(7407):325-329.