痴呆病因病机古代文献探源

The Investigation of Ancient Literature on the Etiology and Pathogenesis of Dementia

中医学对“痴呆”的认识源远流长,古代相关文献记载丰富广博,纷繁庞杂,历代医家百家争鸣、各执己见、莫衷一是。为准确把握,系统分析前人对本病的认识历程、治法治则规律、遣方用药原则和辨证论治思想,此文从痴呆名称演变以及年老髓空、肝失疏泄、痰邪内扰、瘀血阻滞、心脾两虚、心肾不交、中风致病等病因病机方面对古代文献中有关痴呆的代表性论述进行梳理和归纳后认为:古代痴呆典籍的记载包含但不限于本病;明清前多从心论治,明清后则从脑论治占主导;古代关于此病治法治则、遣方用药等辨证论治思想的记载,可为中医药防治痴呆提供可能的路径和方法。

The cognition of dementia in traditional Chinese medicine has a long history.The ancient relevant literature records are rich and extensive,and numerous and complicated.Doctors of all ages contend and hold their own opinions.In order to accurately grasp and systematically analyze the previous understanding of the disease,the rule of treatment,the principle of sending prescriptions and the thought of syndrome differentiation and treatment,this paper combs and summarizes the representative discussions on dementia in ancient literature from the aspects of the evolution of dementia name,senile marrow empty,liver failure,phlegm pathogen internal disturbance,blood stasis block,deficiency of both heart and spleen,disharmony of heart and kidney,and pathogenesis of stroke.After accepting it,it is believed that the ancient records of dementia include but are not limited to the disease;before the Ming and Qing Dynasties,the treatment is mainly based on the heart,and after the Ming and Qing Dynasties,the treatment from the brain is dominant;the ancient records on the treatment principles of this disease,sending prescriptions and drugs will provide a possible way and method for the prevention and treatment of dementia with Chinese medicine.