基于缺血性脑卒中后肠损及脑探讨脑卒中从肠论治的针刺思路

Acupuncture treatment ideas for ischemic stroke by regulating intestinal function following“intestinal injuries affecting the brain”after ischemicstroke

缺血性脑卒中发作后,脑部损伤会影响肠道功能,而肠道功能失常又会进一步加重脑部损伤,形成病理上互相干扰的恶性循环。中医两千年前即有脑肠相关的医学论述,现代脑肠轴理论又证实胃肠道与脑之间存在涉及神经、内分泌、免疫等多方面联系的双向调节系统,本文旨在从肠腑的角度出发,分别从津液代谢、气机升降、神明调控、经脉荣通等方面阐述肠腑功能失用加重脑损的中医机理,探讨在这种双向互相影响下“肠损及脑”对针灸治疗缺血性脑卒中从肠论治的指导思路。

After an ischemic stroke,brain injuries will affect intestinal function,and intestinal dysfunction will further aggravate brain injuries,forming a pathologically interfering vicious circle.Two thousand years ago,there were medical discourses related to the brain-gut in traditional Chinese medicine.The modern brain-gut axis theory has confirmed that there is a two-way regulatory system between the gastrointestinal tract and the brain that involves nerves,endocrine,immunity and other aspects.From the perspective of viscera and bowels,this article explainsthe mechanism of intestinal dysfunction aggravating brain injuries in terms of body fluid metabolism,lifting and lowering movements of qi,Shenmingregulation,meridian rongtong,etc.,and explores the effect of“intestinal injuriesaffecting the brain”by acupuncture treatment under this two-way mutual influence.