气虚血瘀-补阳还五汤与中风

Qi-Deficiency And Blood-Stasis--Bu Yang Huan Wu On Stroke

中风被列为"风""痨""臌""膈"四大难症之首,自灵枢首次提出病名后,历代医家不断研究,在张仲景邪实之说的基础上,巢元方将正虚主要归为气血亏虚,李东垣将"体虚"具体到"气虚",朱丹溪把血瘀与气虚并列,作为独立的致病因素,认为气虚、血虚、瘀血等亦为中风的病因,至王纶撰气虚血瘀理论已初见端倪,王清任继承发展了前人学术思想,正式提出气虚血瘀致中风论。现代研究认为中风之血液流变学的改变亦与气虚血瘀相吻合,从现代研究校对论证了以气虚为本,血瘀为标的病机特点。治疗以益气活血为基本大法,应用补阳还五汤疗效显著,可明显降低血液黏滞性,溶解血栓,抗脑缺血损伤,改善神经元超微病理结构,抑制脑缺血再灌注模型大鼠脑细胞Ca2+超载,提高脑缺血再灌注模型大鼠血清及脑组织超氧化物歧化酶(SOD)含量,降低丙二醛(MDA)及一氧化氮(NO)含量,具有抗自由基的作用.临证时,须根据症状,审其气虚、血瘀之偏,遣方用药。未来应开展大样本随机对照研究,寻找循证医学支持。

Stroke is on top of the list of ＂wind pathogen ＂, ＂tuberculosis＂, ＂tympanites＂, ＂dysphagia ＂, Ling Shu was first proposed the name of stroke, past dynasties doctors did the research constantly, on the basis of Zhang Zhongjing＇s evil real theory, Chao Yuanfang considered the weakenedbody resistance mainly classified as deficiency of Qi and blood, Li Dongyuan specific the ＂weakened body resistance＂ as ＂Qi-deficiency＂,Zhu Danxi considered The Qi deficiency and blood stasis are coordinating relation as an independent etiological factor. He considered that Qi deficiency, blood deficiency, blood stasis, etc. also for the cause of stroke, and qi deficiency and blood stasis theory have already produced up until the period of Wang Guan, Wang Qingren developed the predecessors＇ academic thinking, formally put forward the theory that stroke is caused by qi deficiency and blood stasis. Modern research suggests that the change of blood rheology of stroke were also fits with the theory of Qi deficiency and blood stasis, so proofread proved to qi deficiency and blood stasis is the underlying pathogenesis characteristics,Yi Qi Huo Xue as the basic treatment of the stroke, BYHWD is effectiveness,it can obviously reduce blood viscosity, dissolve thrombus, antagonising cerebral ischemia injury, improve the ultrastructural structure of neurons, inhibition of cerebral ischemia reperfusion model rats cells Ca2 ＋ overload, improve cerebral ischemia reperfusion model rats serum and brain tissue superoxide dismutase（SOD） content, lower malondialdehyde（MDA） and nitric oxide（NO） content,has an anti-oxide free radical effect. But,we must according to the symptoms, sift its partial of Qi deficiency and blood stasis, to guide the clinical treatment. In The future we should carry out large sample randomized controlled studies, looking for support on evidencebased medicine.