杨承芝教授补肾化痰活血三法论治老年性痴呆经验浅析

The Experience of Professor YANG Chengzhi in Treating Senile Dementia by Three Methods

[目的]探析杨承芝教授临证治疗老年性痴呆经验。[方法]通过跟师临诊、收集病例,对杨承芝教授运用补肾化痰活血三法治疗老年性痴呆的经验进行分析总结,并举两例验案佐证。[结果]杨承芝教授认为肾虚证、痰浊证、瘀血证是老年性痴呆的常见证候,肾精不足、髓海空虚是本病的基本病机,痰浊、瘀血既是疾病发生发展过程中的病理产物,又是进一步加重病情的病理因素。临床辨证施治强调分清标本虚实,本虚者宜补肾填精、佐以健脾;标实者以化痰开窍、活血化瘀通络为主,佐以补肾。根据病情严重程度,辨证应用补肾、化痰、活血等药物,能一定程度上改善患者认知功能和躯体症状,减轻患者痛苦。[结论]杨承芝教授补肾化痰活血三法辨治老年性痴呆特色鲜明,值得学习。

[Objective] To explore the clinical experience of Professor YANG Chengzhi in the treatment of senile dementia. [Method] Through the clinical examination and collection of cases, Professor YANG Chengzhi＇s experience of treating three cases of senile dementia with tonifying kidney, resolving phlegm and activating blood circulation was analyzed and summarized, and two cases were proved. [Result] Professor YANG Chengzhi believes that kidney deficiency, phlegm and blood stasis are the common syndromes of senile dementia, kidney essence deficiency is the basic pathogenesis of the disease, and the phlegm and blood stasis disease are the pathological product in the process of development, but also further aggravate the pathological factors. Clinical dialectical treatment emphasizes the distinction the manifestation and root cause of disease. The deficiency should be filled with the essence of the kidney, accompanied by tonifying spleen. The standard of the essence of phlegm should reduce phlegm, promoting blood circulation,accompanied with tonifying kidney. According to the severity of the disease, the application of drugs such as tonifying the kidney, resolving phlegm and activating blood circulation can improve the cognitive function and somatic symptoms and relieve the pain of the patients to some extent. [Conclusion]Professor YANG＇s unique experience in the diagnosis and treatment of senile dementia is worth learning.