从肾虚血瘀论治血管性帕金森综合征

Treating Vascular Parkinsonism from Kidney Deficiency and Blood Stasis

[目的]探讨从肾虚血瘀论治血管性帕金森综合征(vascular Parkinsonism,VPS)的理论依据和临床经验。[方法]在总结前人经验的基础上,分析笔者对VPS发病机制的新认识,介绍从肾虚血瘀论治VPS的理论,分别从该病的病因病机、病理演变、临床特征进行分析,并结合中医学相关理论来阐释从肾虚血瘀论治VPS的学术观点及临证经验,并分析典型临床案例以佐证。[结果]VPS以肾精亏虚、瘀血内阻为主要病机。肾精亏虚是VPS形成的基础,瘀血内阻是VPS发生的病机关键,肾虚与血瘀相合,虚、瘀相互影响,交互为患,形成VPS复杂的发病基础。治疗上以补肾填精、活血化瘀为主,并巧用虫类药搜风剔络,临床疗效满意,故从肾虚血瘀论治VPS符合临床实际。所举验案中患者辨为肾虚血瘀证,治以补肾活血,收效良好。[结论]从肾虚血瘀论治VPS,见解独到,符合临床实际,值得进一步深入研究和推广应用。

[Objective] To explore the theoretical basis of treating vascular Parkinsonism(VPS) from kidney deficiency and blood stasis.[Methods] On the basis of summarizing the experience of previous predecessors,this paper analyzed the writer’s new understanding of the pathogenesis of VPS,and introduced the theory of treating VPS from kidney deficiency and blood stasis,which explained the theory of treating VPS from kidney deficiency and blood stasis from the aspects of the etiology and pathogenesis,pathologic evolution and clinical features of VPS,combined with traditional Chinese medicine related theory of VPS academic point of view and clinical experience.And a typical clinical case was presented as prove.[Results] The main pathogenesis of VPS is deficiency of kidney essence and stagnation of blood stasis.Kidney deficiency is the basis of VPS,and blood stasis is the key of the pathogenesis.The deficiency and stasis is very closely associated with each other,which is the basis for the complex formation of VPS.The treatment was based on tonifying kidney and replenishing essence,promoting blood circulation and removing blood stasis,and skillfully using insect drugs to search wind and tick collaterals.The clinical curative effect is satisfactory,and it confirms that this theory is in line with clinical practice.The case was differentiated with kidney deficiency and blood stasis,and achieved good results after treatment of strengthening kidney and promoting blood.[Conclusion]The writer’s opinion and experience of treating VPS from kidney deficiency and blood stasis has unique understanding and worth to spread.