脑水肿的中医证治探讨

Discussion on TCM syndrome differentiation and treatment for cerebral edema

脑水肿属于中医脑病中的临床危急重症,它通常由颅脑外伤、大面积脑梗死、脑出血、脑脓肿、脑肿瘤、败血症、过敏或缺氧等毒性或代谢因素引起。如何有效控制脑水肿进展是现代医学及中医学共同面临的挑战。脑水肿涉及多种中医病症,临床证候错综复杂,病机多为虚实夹杂。笔者将现代医学对脑水肿的病因学的认识和中医临证经验相结合,认为脑水肿的中医证治主要为分两大类:实证者多为肝胆湿热证、肝阳亢盛证或兼有腑气不通,虚证者多为气虚血瘀证和脾肾亏虚、水浊蒙窍证,并在此基础上阐述常用的中医治法。

Cerebral edema is a life-threatening condition that results from brain trauma,large area cerebral infarction,hemorrhage,abscess,tumor,allergy,sepsis,hypoxia and other toxic or metabolic factors.The generation and development of cerebral edema is the key factor leading to the deterioration of the disease and poor outcomes.How to effectively manipulate the progression of cerebral edema is a great challenge for both modern medicine and traditional Chinese medicine.Cerebral edema involves a variety of traditional Chinese medicine symptoms,the clinical syndrome is complicated,and the pathogenesis is mostly intermingled deficiency and excess.In this essay,the authors integrated the understanding of modern medical etiology of cerebral edema with the TCM syndrome differentiation and treatment.We believe that the TCM syndrome types of cerebral edema are mainly divided into two categories:excess syndrome and deficiency syndrome.Most patients with the excess syndrome were the syndrome of dampness-heat of liver and gallbladder,syndrome of exuberance of liver yang or both the syndrome of fu viscera obstruction.Most patients with deficiency syndrome belonged to the syndrome of blood stasis due to deficient qi and syndrome of yang deficiency of spleen and kidney.Additionally,corresponding TCM treatment method is expounded.