中风病“阴阳为纲、类证辨治”的临床思路探讨

Discussion on Clinical Practice of Wind-strike based on “Yin and Yang as the Principle and Grouped Syndrome for Differentiation and Treatment”

中风病的发生、发展、转归存在一定共通的特性,或呈现某些有规律的变化。认为中风病发生的基础、临床病机转化均与患者的阴阳体质属性相关,即在中风病证候的各个阶段均体现了中医学阴阳理论的基本特征。通过对中医临床"同病类证"的特点分析,指出中风病不同时期临床核心病机多以痰瘀病证为基础,痰瘀闭阻神明清窍是疾病的本质,同时因患者体质阴阳属性的不同,中风病的整个发病及病程转化中存在同病类证即阳类证或阴类证各自的相对稳定性特点。以此为依据总结出中风病"阴阳为纲、类证辨治"的临床辨治方法,即以阴阳属性为总纲,痰瘀为最根本的核心病机,类证辨识指导下的类证同治为组方依据的基本临床思路。

The occurrence,development and prognosis of wind-strike have certain common features or share common rules for the changes.Both the basis of the occurrence and the clinical transformation of the pathogenesis are related to yin and yang constitution of the patients,that is,the basic characteristics under yin and yang theory are reflected at all stages of the wind-strike.According to the features of"grouped syndromes for the same disease",it is proposed that phlegm and stasis syndrome is the basis of the core pathomechanism of wind-strike at all different stages,and phlegm-stasis blocking and obstructing the orifices of mental activity is the root of the disease;due to the different yin and yang constitution of each patient,grouped syndromes in relatively stable condition for the same disease,that is yang group syndromes and yin group syndromes,were presented during the whole pathological changes of wind-strike from occurrence to progression.Therefore,the method of"yin and yang as the principle,and grouped syndromes for differentiation and treatment"is proposed for diagnosing and treating wind-strike in clinical practice,which takes yin and yang as the overall principle,and phlegm-stasis as the root of core pathogenesis,and advocates grouped syndromes differentiation and same treatment for grouped syndromes when providing prescriptions.