从《黄帝内经》脾藏意及香入脾理论探讨痴呆的中医治疗

Analysis of TCM treatment of dementia with aromatic Chinese herbs based on the theory of“spleen housing ideas”and“aromatics acting on the spleen”in Huangdi Neijing

《黄帝内经》中有"脾藏意"及"香入脾"理论。以"呆"为关键词,对历代相关的医案进行统计后发现,中医治疗痴呆以调理脾胃的方剂使用最多(29.72%),其次是开窍醒神方剂(21.62%);在使用的192味药物中,频次最高的前10位依序为半夏、甘草、石菖蒲、茯苓、郁金、茯神、远志、当归、栀子、生地黄,其中石菖蒲、郁金、当归也属于古代本草记载的芳香药范畴。临床治疗痴呆一病,调理脾胃及善用芳香药或许是提升疗效的重要环节之一,这也是中医经典理论与临床实践经验相互结合的一个体现。

In Huangdi Neijing(Huangdi's Internal Classic),there are the theories of“spleen housing ideas”and“aromatics acting on the spleen”.Based on statistical analysis of case records about dementia in ancient dynasties,the present research discovers that prescriptions to treat dementia by regulating the spleen and stomach accounted for the most(29.72%),followed by those inducing resuscitation(21.62%).Among the 192 Chinese medicinal herbs in the prescriptions,the top ten most frequently used were Banxia(Pinellia Rhizome,Rhizoma Pinelliae),Gancao(Liquorice Root,Radix et Rhizoma Glycyrrhizae),Shichangpu(Grassleaf Sweetflag Rhizome,Rhizoma Acori Tatarinowii),Fuling(Indian Bread,Poria),Yujin(Turmeric Root Tuber,Radix Curcumae),Fushen(Indian Bread with Hostwood,Sclerotium Poriae Pararadicis),Yuanzhi(Thin-leaf Milkwort Root,Radix Polygalae),Danggui(Chinese Angelica,Radix Angelicae Sinensis),Zhizi(Cape Jasmine Fruit,Fructus Gardeniae),and Shengdi(Rehmannia Root,Radix Rehmanniae).Among them,Shichangpu,Yujin and Danggui fall into the category of aromatic herbs in ancient times.Therefore,the authors argue that in the clinical treatment of dementia,regulating the spleen and stomach and making good use of aromatic herbs may be key to improving the curative effect,which is also a good example of the integration of traditional Chinese medicine theory and clinical practice.