从络虚毒损探讨症状性颅内动脉粥样硬化性狭窄因机治法

Discussion on the etiology,pathogenesis and treatment of symptomatic intracranial atherosclerotic stenosis from“collateral deficiency and toxin damage”

毒损脑络与毒损脉络是现代阐释中风病发生发展的重要学说,其"毒邪可破坏形体,损伤脑络"之论在对症状性颅内动脉粥样硬化性狭窄(简称症状性脑动脉狭窄)发病的认识中亦具有重要意义。通过阐释本病正气虚的发病基础,详述火毒、浊毒等毒损证素对脑血管狭窄的影响,分析"络虚—络滞—络损"病理演变过程,总结络虚毒损是症状性脑动脉狭窄的核心病机;治疗以扶正、解毒与通络分阶段并行,细分补气解毒与清热解毒之别,强调分期治疗,为临床治疗该病提供新的思路与方法。

Toxin damaging the brain collaterals and toxin damaging the vessels and collaterals are important modern interpretations of the occurrence and development of stroke.The theory that"toxins can destroy the physique and damage the brain collaterals"also plays an important role in the pathogenesis of symptomatic cerebral artery stenosis.This paper explains the disease occurrence from healthy qi deficiency,analyzes the influence of fire toxin,turbid toxin and other toxin damages on cerebral vascular stenosis,as well as the pathological development from"collateral deficiency"to"collateral stagnation"and further to"collateral damage".It was concluded that"collateral deficiency and toxin damage"is the core pathogenesis of symptomatic intracranial atherosclerotic stenosis(symptomatic cerebral artery stenosis).Parallel treatment of strengthening the deficiency,eliminating toxins,and dredging collaterals should be applied at specific stages.Invigorating qi and eliminating toxins should be distinguished from clearing heat and eliminating toxins.Besides,stage-tailored treatment should also be emphasized,which may provide reference for clinical treatment of the disease.