从多种辨证方式认识痴呆病机

To understand the pathogenesis of dementia from various ways of syndrome differentiation

痴呆是一种好发于老年群体的疾病,以进行性智能障碍为主要表现,进展隐匿,早期仅以记忆力减退及学习能力下降为表现,随疾病进展逐渐出现认知能力的改变,对患者自身生活质量也有较大影响。本病可从气血津液不同层次,阐述其病机:气机运动失常,则神明失养;气滞血瘀,瘀阻脑络,神志不明;久病则痰浊瘀血形成,髓海失养则智力损害。并以经络理论为基础,从督脉、少阳及三阳经论述其病机转归。通过体质不同认识痴呆发病机制,及先天与后天对痴呆的病机影响,区分痴呆与“癫”“狂”的病机异同,以鉴别三者,从而为中医治疗痴呆病提供一定的辨治思路。

Dementia is a disease that usually occurs prone int he elderly,with progressive intellectual impairment as the main manifestation,and its progress is often hidden.In the early stage,only memory loss and learning ability decline,but cognitive ability gradually changes along with disease progression,which also has a great impact on patients’quality of life in the course of the disease.This disease can be explained from different levels of qi,blood and body fluid,and its pathogenesis is explained as follows:if the movement of qi is abnormal,the spirit will lose nourishment;if qi stagnation and blood stasis,blood stasis blocking brain collateral,causing unconsciousness.Long illness forming phlegm turbidness and blood stasis,marrow sea loss of nourishment causing intellectual damage.Based on the meridian theory,the pathogenesis of the disease was discussed from the governor meridian,Shaoyang and three yang channels.Through different physical conditions to understand the pathogenesis of dementia,and the impact of congenital and nurture on the pathogenesis of dementia,the pathogenesis similarities and differences between dementia and‘depressive psychosis’and‘manic psychosis’are recognized to identify the three.Therefore,it provides some ideas for the treatment of dementia in traditional Chinese medicine.