血管性痴呆分期辨证及综合治疗的探讨

Studies on TCM Differentiation of Clinical Stages of Vascular Dementia and Its Combined Treatment

通过既往对血管性痴呆 (VaD)病情及证候的系统观察发现 ,其病情演变存在平台期、波动期和下滑期 ,各期证候特点不同、病情演化趋势不同。在此基础上 ,本文提出分期辨证、各期采取不同治疗原则的观点 :平台期 ,充分发挥中医药整体调节的作用 ,延缓病程进展 ;波动下滑期 ,采取中医急救措施或中西医结合治疗 ,有效控制和防止阶梯样下滑。VaD又是多因素性疾病 ,涉及生物社会心理范畴 ,控制多种VaD相关危险因素并结合各种康复措施的综合治疗 ,对改善患者生活质量、稳定病情同样具有重要意义。

It was found by the authors through a systematical analysis of the past cases that there were 3 stages in the development of vascular dementia, namely the plateau, undulation and staircase descent, which showed different characteristic symptoms and developing tendencies. For diagnosing and treating vascular dementia, the authors raised the viewpoint of adopting TCM differentiation of clinical stages and using different treatments at different stages. According to the authors, when vascular dementia reaches a plateau, TCM therapies for regulating the whole function of the body should be fully used to delay its development; when it reaches the stages of undulation and staircase descent, TCM emergency treatment or combined therapies of TCM and modern medicine should be adopted in order to effectively control and prevent the staircase descent of the disease. The authors hold that vascular dementia is a multifactor disease involving biological, sociological and psychological fields; and it is important for improving the living quality and stabilizing the state of illness of the patients to control the various relative risk factors and to adopt the combined treatments involving various rehabilitating measures.