血管性痴呆中医病机理论及证治规律探析

Exploration on the TCM Pathogenesis Theory and Syndrome Differentiation and Treatment Law of Vascular Dementia

目的:探讨血管性痴呆(vascular dcmentia,VD)中医病机理论及证治规律。方法:总结、归纳血管性痴呆发病病源、病机,以及中医辨证治疗的优势。结果:血管性痴呆发病病源、病机应为本虚标实,本虚即肾精亏虚,为发病之源,标实即痰热瘀浊等毒邪,毒损脑络为发病之机。血管性痴呆病情演变规律上呈现出平台、波动、下滑三期交替更迭的过程中以阶梯样进展,每期也都呈现出不同的病机特点。中医药治疗VD的优势在于能改善痴呆的症状及缓解病程进展。结论:中医治疗血管性痴呆应扬长避短,树立预防第一的观念,将药物治疗、行为治疗、康复护理融为一体,进而形成综合防治的新理念。

Objective：To explore the TCM pathogenesis theory and syndrome differentiation and treatment law of vascular dementia.Methods：The pathogen and pathogenesis of vascular dementia,as well as the therapeutic advantage of TCM differentiation and treatment were summarized and concluded.Results：The pathogen and pathogenesis of vascular dementia should be Ben deficiency and Biao excess.Ben deficiency referred to the deficiency of kidney essence,and was the pathogen while Biao excess referred to toxins such as phlegm,heat,stasis,turbidity etc.Toxic objects harming the brain collateral was the pathogenesis.The evolution law of vascular dementia patients′ condition showed an alternation of three stages of platform,fluctuation and fall with the alternated process presenting step-like progress and every stage also showed different characteristics of the pathogenesis.The advantage of treating VD with Chinese medicine was that it could ameliorate the symptoms of dementia and relieve the evolution of course of disease.Conclusion：Treating vascular dementia with TCM should take advantage of its predominance and avoid its weaknesses,establish the concept of prevention first and integrate pharmacotherapy,behavior treatment and recovery nursing in order to further obtain the new concept of comprehensive prevention and treatment.