肥人多中风病因及致病机制探讨

Etiology and Pathogenesis of Obese People Being Susceptible to Stroke

根据肥人多中风的经典认识及中风“关口前移”“重心下移”的流行病学特点,明晰肥胖致中风的病因病机,提示减少肥胖能有效防治中风。系统梳理了肥人多中风的历代文献研究,指出饮食失节、多逸少动、情志内伤、年龄增长及药物损伤等是导致肥胖的常见病因,上述因素可单独致病亦能交互为害,致脏腑失和,气化失司,卫气郁滞,膏脂堆积,凝液为痰,滞血为瘀,日久化火,形成湿热、痰热、瘀热等邪气,耗气伤阴,伤脉损络,引发消渴、脉胀、脉积等病证,成为中风发病夙根。卫气失常贯穿于肥人中风的各个病机环节,脏腑气化失调,痰瘀遁脉成积,是中风发病的核心环节。

According to the classic understanding of obese people being susceptible to stroke and the epidemiological characteristics of“younger age of stroke onset”and“the increasing incidence of rural low-income people”,the etiology and pathogenesis of obesity causing stroke are clarified,and it is suggested that reducing obesity can effectively prevent stroke.This paper systematically reviewed the literature studies on obese people being susceptible to stroke,and pointed out that improper diet,more rest and less activity,internal injury of emotions,aging,and drug injury are common causes of obesity.The above factors can cause disease alone or can interact with each other causing disharmony of zang-fu organs,loss of qi transformation,stagnation of defensive qi,accumulation of fat,condensate as phlegm,stagnation of blood as stasis,transforming into fire with the passing of time,forming damp-heat,phlegm-heat,stasis-heat and other pathogenic qi,consuming qi and damaging yin,damaging vessels and collaterals,leading to consumptive thirst,pulse swelling,and pulse accumulation,etc.which become the root cause of stroke.Disharmony of defensive qi runs through every pathogenesis of obese people with stroke.Imbalance of visceral qi transformation and intermingled phlegm and blood stasis accumulating in blood vessels are the core parts of stroke.