张钟爱运用调气通腑法治疗急性期中风经验
|
摘要
中风病急性期多为本虚标实,病见便秘、苔黄、脉弦滑,此为痰浊日久滋生毒邪所致。治疗应以通腑调气为主,辅以平肝、清胃、化痰、泻热、活血。临证用药首选大黄、枳实,并根据不同病机酌情加减,初期痰热毒邪偏胜,加以天南星、浙贝母、瓜蒌皮加强化痰;肝阳上亢或肝火上逆,辅以天麻钩藤汤;后期伴有血瘀之象,加用赤芍、紫丹参、地龙、蜈蚣之品。通导大便,排除胃肠积滞、荡涤实热,攻下毒邪,气机调畅,使邪有去路,气血运行顺畅,经络得利,症状缓解。
In the acute phase of stroke,most of the cases are characterized as excess in symptoms and deficiency in constitution.The symptoms may be constipation,yellow tongue coating,or Xuan Hua pulse,which is caused by the turbidity for a long time and the existence of toxic evil.Treatment should be carried out aiming at Tongfu Tiaoqi,which can be supplemented by Pinggan,Qingwei,Huayu,Xiere and activating blood circulation.In clinical application,Rheum officinale and Fructus Aurantii Immaturu are usually preferred,and the prescription can be modified according to different conditions.In the early stage,the Phlegm Heat toxic evil is strong,Rhizoma Arisaematis,Thunberg Fritillary Bulb and Pericarpium trichosanthiscan strengthen the effect in resolving phlegm.With excessive Liver Yang or Liver Qi superinverse,Tianma Gouteng Decoction can be used in treatment.In the later phase,with blood stasis,Red paeony root,Salvia yunnanensis,Earthworm and Centipede can be used.By guiding stool down,dispeling gastrointestinal stagnation,smashing the excessive Heat,attacking toxic evil and regulating Qi movement,the evil has a way out and the Qi and blood runs smoothly.The meridians can be benefited,and then the symptoms are relieved.
In the acute phase of stroke,most of the cases are characterized as excess in symptoms and deficiency in constitution.The symptoms may be constipation,yellow tongue coating,or Xuan Hua pulse,which is caused by the turbidity for a long time and the existence of toxic evil.Treatment should be carried out aiming at Tongfu Tiaoqi,which can be supplemented by Pinggan,Qingwei,Huayu,Xiere and activating blood circulation.In clinical application,Rheum officinale and Fructus Aurantii Immaturu are usually preferred,and the prescription can be modified according to different conditions.In the early stage,the Phlegm Heat toxic evil is strong,Rhizoma Arisaematis,Thunberg Fritillary Bulb and Pericarpium trichosanthiscan strengthen the effect in resolving phlegm.With excessive Liver Yang or Liver Qi superinverse,Tianma Gouteng Decoction can be used in treatment.In the later phase,with blood stasis,Red paeony root,Salvia yunnanensis,Earthworm and Centipede can be used.By guiding stool down,dispeling gastrointestinal stagnation,smashing the excessive Heat,attacking toxic evil and regulating Qi movement,the evil has a way out and the Qi and blood runs smoothly.The meridians can be benefited,and then the symptoms are relieved.
引文
[1]MURRAY C J,LOPEZ A D.Measuring the global burden of disease[J].N Engl J Med,2013(369):448-457.
[2]张锡纯.医学衷中参西录[M].石家庄:河北科学技术出版社,2002:586.
[3]王永炎.中医药治疗急性缺血性脑血管病120例疗效观察[J].中医杂志,1981,26(4):31-33.
[4]王永炎,李秀琴,邓振明,等.化痰通腑法治疗中风病158例疗效观察[J].中国医药学报,1986,1(2):22-24.
[5]何清湖.中华传世医典·华氏中藏经[M].长春:吉林人民出版社,1999:469.
[6]张钟爱.谢昌仁临床医学经验[M].南京:南京出版社,1984:61.
[7]祝建材.治风先调气,气调风易息[J].中国中医基础医学杂志,2012,18(8):871-872.
[8]黄玉强.活血利水通腑汤治疗缺血性急性期中风痰热腑实型的临床研究[D].济南:山东中医药大学,2011.
[9]杨慧艳,车志英,陈东晖.化痰通腑泻热法治疗缺血性急性期中风临床研究[J].新中医,2014,46(8):37-39.
[10]刘岑,高颖,邹忆怀.化痰通腑法治疗中风痰热证之临床应用与理论创新[J].中国中医基础医学杂志,2011,17(1):89-91.
[11]李信铭.化痰通腑法治疗中风痰热证的临床观察[J].中医临床研究,2014,6(31):95-96.
[12]张树泉,刘强.脑出血中医治疗研究进展[J].中西医结合心脑血管病杂志,2013,11(5):605-607.
[13]谢颖桢,邹忆怀,孙立满.运用化痰通腑法治疗中风病的体会[J].中国中医基础医学杂志,2010,16(3):221-222.
[14]沈承玲,赵海滨.中风病内生热毒之内涵、演变及特性探析[J].山东中医药大学学报,2002,26(4):242-245.
[15]任丽,曹晓岚,王芳.中风病毒损脑络释义[J].中华中医药学刊,2008,27(8):1703-1704.
[16]王永炎.关于提高脑血管疾病疗效难点的思考[J].中国中西医结合杂志,1997,17 (4):15.
[17]屈静,邹忆怀,张冬梅,等.中风病急性期“毒损脑络”相关性实验室指标研究[J].北京中医药,2010,60(3):163-166.
[18]王凌云.通腑活血汤治疗急性期脑卒中临床观察[J].光明中医,2015,30(5):1004-1005.
[19]马剑飞.通腑活血法治疗急性脑梗死的疗效分析[J].中国现代医生,2015,53(4):135-137.
[2]张锡纯.医学衷中参西录[M].石家庄:河北科学技术出版社,2002:586.
[3]王永炎.中医药治疗急性缺血性脑血管病120例疗效观察[J].中医杂志,1981,26(4):31-33.
[4]王永炎,李秀琴,邓振明,等.化痰通腑法治疗中风病158例疗效观察[J].中国医药学报,1986,1(2):22-24.
[5]何清湖.中华传世医典·华氏中藏经[M].长春:吉林人民出版社,1999:469.
[6]张钟爱.谢昌仁临床医学经验[M].南京:南京出版社,1984:61.
[7]祝建材.治风先调气,气调风易息[J].中国中医基础医学杂志,2012,18(8):871-872.
[8]黄玉强.活血利水通腑汤治疗缺血性急性期中风痰热腑实型的临床研究[D].济南:山东中医药大学,2011.
[9]杨慧艳,车志英,陈东晖.化痰通腑泻热法治疗缺血性急性期中风临床研究[J].新中医,2014,46(8):37-39.
[10]刘岑,高颖,邹忆怀.化痰通腑法治疗中风痰热证之临床应用与理论创新[J].中国中医基础医学杂志,2011,17(1):89-91.
[11]李信铭.化痰通腑法治疗中风痰热证的临床观察[J].中医临床研究,2014,6(31):95-96.
[12]张树泉,刘强.脑出血中医治疗研究进展[J].中西医结合心脑血管病杂志,2013,11(5):605-607.
[13]谢颖桢,邹忆怀,孙立满.运用化痰通腑法治疗中风病的体会[J].中国中医基础医学杂志,2010,16(3):221-222.
[14]沈承玲,赵海滨.中风病内生热毒之内涵、演变及特性探析[J].山东中医药大学学报,2002,26(4):242-245.
[15]任丽,曹晓岚,王芳.中风病毒损脑络释义[J].中华中医药学刊,2008,27(8):1703-1704.
[16]王永炎.关于提高脑血管疾病疗效难点的思考[J].中国中西医结合杂志,1997,17 (4):15.
[17]屈静,邹忆怀,张冬梅,等.中风病急性期“毒损脑络”相关性实验室指标研究[J].北京中医药,2010,60(3):163-166.
[18]王凌云.通腑活血汤治疗急性期脑卒中临床观察[J].光明中医,2015,30(5):1004-1005.
[19]马剑飞.通腑活血法治疗急性脑梗死的疗效分析[J].中国现代医生,2015,53(4):135-137.