中风病湿痰瘀体质初探

Preliminary exploration of phlegm-dampness and blood-stasis constitution and stroke

脑卒中是我国第一位致死病因,是成年人致残的首位因素,发病人数成倍增长,呈现出高发病率、高致残率、高死亡率、高复发率、高经济负担五大特点,其发生与体质有着密切相关性,中医认为中风病的发生、发展与痰湿及瘀血体质密切相关。其病位在脑,但与五脏关系密切,血瘀为中风最主要、最根本之病机。痰湿是中风病的重要致病因素,中风病发病前多有伏痰存在。目前生存环境和生活方式的变化,使现代人群形盛体实、湿热蕴积等体质特征日益明显。痰湿既是中风病脏腑功能失调、气血津液代谢失常的病理产物;同时作为新的致病因素,又会加重脏腑功能失调和气血津液运行障碍,导致湿痰再生,日久痰瘀互结,加重病情进展。临床应用黄连温胆汤加减化痰祛湿,化瘀通络标本同治,治疗中风体现了"治病求本"和"整体治疗"的原则。

The stroke is the first disease cause of death and the first factor to lead to adult disability in our counwy. The number of morbidity people has increased muhiply. The stroke has shown five main features of high incidence rate, high disability rate, high death rate,high recurrence rate and high economic burden. Its pathogen- esis is related closely to constitution. Traditional Chinese medicine thinks that the pathogenesis and development of stroke are related closely to constitution of phlegm - dampness and blood - stasis. Although the stroke is in brain, it is closely related to five viscera. Blood - stasis is the mainest and most fundamental pathogenesis of stroke. Phlegm turbidity is an important pathogenic factor of stroke. Before the onset of stroke, latent phlegm has existed commonly. At present, because of the changes of living environment and life style, the constitution characteristics of modem population with fat body and overweight as well as damp and heat stagnation etc. are increasingly obvi- ous. Phlegm - dampness is both pathological product of stroke due to viscera function disorder and metabolic disor- der of qi ,blood and body fluid; and at the same time as a new pathogenic factor, it can again aggravate the viscera function disorder and running obstacle of qi, blood and body fluid, which leads to regeneration of phlegm - damp- hess. With the passing of time, phlegm and blood stasis are intemfingled, which can aggravate the progress of this disease. The them-y of phlegm stagnating in brain collaterals has been emphasized, modified Huanglian Wendan de- coction can dissipate phlegm and remove dampness, dissipate blood stasis and dredge collaterals, and treat both manifestation and root cause, which embodies the principle of ＂treating disease according to its origin ＂ and ＂ho- listic treatment＂ in treatment of stroke.