中医对阿尔茨海默病的病机认识与治疗方法探讨

Approach of Pathogenesis and Therapy of Alzheimer Disease in TCM

阿尔茨海默病是一种由于大脑皮质的弥漫性萎缩,高级神经系统功能的广泛障碍所导致的智能全面低下的疾病。目前尚无确切的治疗方法。笔者以中医理论为指导,参考现代医学的相关知识,结合临床观察和文献资料的综合分析,阐释阿尔茨海默病的发病机理为以肾虚精亏、脾胃虚弱、气血不足为本,痰瘀互结、阻闭脑络、蒙蔽神明为标。治疗应根据虚实标本,补肾填精,健脾补心以培其本;祛痰散结,化瘀通络以治其标。临证只要抓住本虚标实这一病机纲领,就能执简驭繁,取得较好的疗效。

Alzheimer disease is thoroughly mentally subnormal because of corticocerebral diffuse atrophy and generally handicap of high function activities of the central nerve system. There is no exact therapy at present. Guided by TCM theory, referring to modern medical knowledge, and aggregatedly analyzing clinical observation and literature documents, the author explained etiopathogenesis of Alzheimer disease, that was renal deficiency and essence losing, weakness of the spleen and stomach, insufficiency of vital energy and blood （ these were the origin of the disease）, and phlegm and blood stasis interties to block brain collaterals and disorder mind （this was the superficiality of disease）. According to asthenia and sthenia, origin and superficiality, therapy could be invigorating the kidney and replenishing essence, invigorating the spleen and reinforcing heart to cultivate the origin, and eliminating expectoration and dispersing stagnation to disperse blood stasis and dredge collateral so as to treat the superficiality. In clinical practice the pathogenesis outline of the disease was asthenia in origin and sthenia in superficiality, which should be got hold of. And physicians would hold the brief to manage multiplicity and achieve good effect.