血管性痴呆中医病机理论的传承和发扬

Inheritance and Development of Pathogenesis Theory of Vascular Dementia in Traditional Chinese Medicine

血管性痴呆属于中医“呆病”“善忘”等范畴,现代又有“中风痴呆病”的定义,将其与其他呆病区分开来。历代医家认为血管性痴呆病位在脑,肾、脾胃、肝、心、肺等虚损均可致病。病性为本虚标实,本虚以五脏亏虚及气血亏虚为主,邪实以痰、瘀为主。现代医家在此基础上提出“玄府郁阻致病”“络脉虚损致病”及“三焦气化失司致病”的病机理论,补充了血管性痴呆的病机理论,对临床治疗有指导意义。由于血管性痴呆病因病机复杂,临床证型变化多端,中医药因具有多脏腑同调、个性化辨证论治等特点,在血管性痴呆的防治方面显示出优势。在分子层面对血管性痴呆的中医病因病机理论进行阐释并指导临床治疗,是将来中医药防治血管性痴呆研究的重点。

Vascular dementia belongs to the category of“dementia(Dai-bing)”or“amnesia(Shan-wang)”in traditional Chinese medicine(TCM)theory.In contemporary,vascular dementia is defined as“dementia of stroke”,which could be separated from other types of dementia.The TCM clinicians have the consensus that the location of the disease is brain and it could be caused by the deficiency of kidney,spleen and stomach,liver,heart and/or lung.The root pathogenesis of the disease is deficiency of five viscera,qi or blood,while the branch cause is mainly related to the excess of phlegm or static blood.On the basis of this,modern TCM clinicians put forward new pathogenesis theories,namely“Xuan-fu obstruction”,“impairment or deficiency of collaterals”,and“dysfunction of qi transformation in Sanjiao”,supplementing the pathogenesis theory of vascular dementia,which is of clinical guiding significance in its treatment.Vascular dementia has the characteristics of complicated pathogenesis and the variety of clinical syndromes,while TCM could treat different viscera at the same time with personalized syndrome differentiation;therefore TCM has advantages in the prevention and treatment of vascular dementia.Interpretation of TCM pathogenesis theory at the molecular level,which could guide clinical treatment,should be the focus of the research on prevention and treatment of vascular dementia with TCM in the future.