从中西医结合视角探讨大秦艽汤治疗“内中风”

Discussion on Treatment of“Exogenous Wind”by Daqinjiao Decoction from Perspective of Integration Traditional and Western Medicine

大秦艽汤是金代刘完素创制的治疗中风名方,中风的病因存在内风、外风之争,刘完素虽是内风说的首倡者,但因大秦艽汤中使用多味风药,后世主流观点仍认为该方主治外风。从玄府学说的角度看,阴血亏虚,玄府失养,虚热内生,热气怫郁,这是内风产生的原因,而大秦艽汤中风药与养血药配伍,正能起到通玄府、行血滞的功效,与内风说相符。现代医学研究表明,大秦艽汤能改善血液流变性,抗凝、抑制血栓形成,与该方养血、通滞的观点吻合,而并无治疗“外风”解热镇痛、祛痰镇咳的疗效。从中西医结合的视角,可还原刘完素本意,揭示大秦艽汤治疗内风的机理。

Daqinjiao decoction is a useful prescription for stroke,which is created by the famous doctor Liu Wansu in the Jin Dynasty.There is a dispute between internal Wind and external Wind in the cause of stroke.Because of the use of multi-flavor Wind medicine in Daqinang decoction,the mainstream view of later generations is still that this prescription is mainly in charge of exogenous Wind,although Liu Wansu is the first advocator of the theory of internal Wind.From the perspective of Xuanfu theory,Yin Blood deficiency,Xuanfu loss of nourishment,deficiency Heat endogenesis and Heat stagnation,is the cause of endogenous Wind.The compatibility of Wind medicines and Blood-nourishing medicines in Daqinjiao decoction can play the effect of opening the Xuanfu and removing Blood stagnation,which is consistent with the theory of endogenous Wind.In modern medical research,Daqinhuang decoction can improve hemorheology,anticoagulate and inhibit thrombosis,which is consistent with the viewpoint of nourishing Blood and dredging stagnation,but has no effect on antipyretic,analgesic,expectorant and antitussive effect of“exogenous Wind”.From the perspective of the integration of traditional Chinese and western medicine,we can restore the original intention of Liu Wansu and reveal the mechanism of Daqinjiao decoction in the treatment of endogenous Wind.