中风肝阳化风病机缕析

Analysis on Pathogenesis of Liver Yang Transforming Wind of Stroke

肝阳上亢、肝阳化风、肝风扰络损脑属于中风发病不同阶段的病机变化,其发展过程标志着中风病位、病性的变化。①肝气郁结,肝气逆乱,气郁化火,火盛阳旺,火盛伤阴,阴虚阳亢,风阳扰络、损络、入络损脑是肝阳化风不同阶段发生的病机变化,亢阳得以下潜,肝风便能平息;若肝风扰络犯脑,特别是发生络破血溢,或络痹血瘀,纵然风阳平息,但瘀塞或破损之脉络与受损之脑髓多难修复。②肝失疏泄,气机郁结,郁逆化火,肝肾阴虚是肝阳化风的先期病机损害,或者说是肝阳化风的基础病变,大多积久而成并持续存在;气逆阳亢,化风上扰,损脉及脑是肝阳化风致中的核心病机环节;风阳入络,易入难出;风阳损络噬脑,多难修复,乃至殒命。③肝风扰络、损络、入络,进而毁损脑髓是肝阳化风致中的不同病机损害,预后各异。

Hyperactivity of liver yang,liver yang transforming into wind,liver wind harassing the collaterals and damaging the brain belong to the pathogenesis changes in different stages of stroke.The development process marks the changes of the location and disease nature of stroke.①Liver qi depression,liver qi counterflow and disorder,qi depression transforming into fire,exuberant fire and yang hyperactivity,exuberant fire damaging yin,yin deficiency and yang hyperactivity,wind-yang harassing collateral,damaging collateral,entering collateral and damaging brain are pathogenesis changes that occur in different stages of liver-yang transforming into wind.Liver wind can be suppressed when hyperactivity yang is subdued;if liver wind harasses the collaterals and invades the brain,especially if collateral bleeding occurs,or collateral blockage and blood stasis occur,even if wind yang subsides,the stasis or damaged vessels and damaged brain marrow will be hard to repair.②Liver failing to govern free flow of qi,qi depression,qi depression and counterflow transforming into fire,liver and kidney yin deficiency are the early pathological damages of liver yang transforming into wind,or the basic pathological changes of liver yang transforming into wind.Most of them accumulate and persist continuously.Qi counterflow and yang hyperactivity transforming into wind and harassing upward,damaging the vessels and brain are the core pathogenesis in liver yang transforming into wind and inducing stroke;wind yang enters the collaterals,easy to enter and difficult to exit;wind yang damages the collaterals and destroys the brain,which is difficult to repair,and even causes to die.③Liver wind harassing the collaterals,damaging the collaterals,entering the collaterals and then destroying the brain marrow,are different pathological impairment caused by liver yang transforming into wind,and the prognosis is different.