基于关键证候演变规律探讨急性缺血性中风的辨治

Discussion on the Syndrome Differentiation and Treatment of Acute Ischemic Stroke through the Evolution of Key Syndromes

缺血性中风急性期病机错综复杂,证候演变迅速,是该病治疗的关键时期,中医药早期介入可以充分发挥协同治疗优势。急性缺血性中风属本虚标实之证,其关键证候以痰热腑实证最为常见,随着病情发展,脾肾亏虚、气虚或兼血瘀之证渐显,证候演变由实到虚,认识和把握其关键证候演变规律是提高该病疗效的关键。临证时以关键证候演变为主线,遵循"虚则补之,实则泻之"的原则,病证结合序贯治疗急性缺血性中风,能够针对病机本质精准治疗,从而提高临床疗效。

The pathogenesis of the ischemic stroke is complicated,and the syndromes evolve rapidly in the acute phase,which is a critical period for the treatment of the disease,and early intervention of traditional Chinese medicine can give full play to the advantages of synergistic treatment. Acute ischemic stroke belongs to the root deficiency and branch excess,and the most common syndrome is phlegm-heat and bowel excess. As the disease progresses,it is gradually manifested as depletion of spleen-kidney,qi deficiency or blood stasis,indicating the transformation from excess to deficiency syndromes. Therefore,it is critical to understand and hold the evolution principles of the syndromes,by which the therapeutic effect can be improved. In clinical practice,it is suggested to follow the evolution of key syndromes and the principle of"treating deficiency with supplementation,and treating excess with drainage",and to integrate the disease-syndromes combining treatment with sequential treatment,thereby giving precise treatment aimed at the pathogenesis and further enhancing the therapeutic effects.