“脑脾同治”理论超早期介入治疗中风病临床撷英

Clinical Experience of Ultra Early Interventional Therapy for Stroke Based on the Theory of “Concurrent Treatment of Brain and Spleen”

[目的]探讨并总结黄汝成教授运用"脑脾同治"理论超早期介入治疗中风病的临床经验。[方法]通过跟师学习,整理相关病例资料,从中风病的关键病理因素、"脑脾同治"理论的机理内涵、"脑脾同治"理论的临床运用等三大方面展开,分析总结黄汝成教授运用"脑脾同治"理论超早期介入治疗中风病的临床经验,并附一则医案。[结果]黄汝成教授在祛瘀生新法的基础上,结合对中风病关键病理因素"瘀"的认识,强调须发挥"后天之本"在中风病早期治疗中的重要作用,将"治脾"贯穿其中,通过醒脾开郁行气、运脾消积化痰、补脾扶正生新等治疗原则促使"瘀"的祛除并推助生新,从而形成了"脑脾同治"的重要理论,丰富了祛瘀生新法的内容。治疗上针药结合,辨证施治,灵活加减,取得良好的疗效。所举隅之医案,黄汝成教授辨证为痰瘀内阻证,治法以活血化瘀通络、运脾化痰消积,具体以祛瘀生新煎及针法作为底加减,针药联合,在溶栓后超早期进行中医介入治疗,取得较好效果。[结论]黄汝成教授基于祛瘀生新法,结合自己的临床经验,提出"脑脾同治",丰富了祛瘀生新法的内容,临床上取得良好效果,值得借鉴。

[Objective] To analyze and summarize Professor HUANG Rucheng’s clinical experience of ultra early interventional therapy for stroke based on the theory of "concurrent treatment of brain and spleen". [Methods] Through learning from Professor HUANG Rucheng and sorting out relevant case data,Professor HUANG Rucheng’s clinical experience of ultra early interventional therapy for stroke based on the theory of "concurrent treatment of brain and spleen" was summarized from three aspects: The key pathological factor of stroke, the concrete mechanism of "concurrent treatment of brain and spleen"theory, and the clinical application of "concurrent treatment of brain and spleen" theory. And one case was attached for analysis. [Results] Based on the method of dispelling stasis and promoting regeneration, Professor HUANG Rucheng combines the understanding of the key pathological factor "stasis" of stroke, and stresses that the "acquired source" should play an important role in the early treatment of stroke, and "treating the spleen" should run through it. Through the treatment principles of invigorating the spleen, activating depression and promoting Qi, transporting the spleen, eliminating accumulation and resolving phlegm, tonifying the spleen, strengthening health and promoting regeneration, it promotes the elimination of "stasis" and the promotion of "new generation", thus forming an important theory of "concurrent treatment of brain and spleen", enriching the content of the method of dispelling stasis and promoting regeneration. For the aspect of treatment, the combination of acupuncture and medicine, syndrome differentiation,flexible addition and subtraction have achieved good curative effect. In the medical case attached, Professor HUANG Rucheng considered the syndrome type was the internal obstruction of phlegm and blood stasis,the treatment principles were promoting blood circulation, removing blood stasis,dredging collaterals, transporting the spleen, resolving phlegm,and eliminating accumulation precisely, based on the Quyu Shengxin decoction combined with acupuncture therapy, traditional Chinese medicine intervention therapy was applied in the ultra early stage after thrombolysis, which had achieved good results. [Conclusion] Based on the method of dispelling stasis and promoting regeneration, Professor HUANG Rucheng combines her own clinical experience and proposes the theory of "concurrent treatment of brain and spleen", it enriches the content of the method of dispelling stasis and promoting regeneration, and achieves good clinical results, which is worthy of reference.