呆病防治的理论源流

Theoretical origin and development of prevention and treatment of dementia

本文采用文献梳理方法,以呆病及其核心症状为主线,将古代医籍中的零金碎玉串联成文,从病名演变、病机更新、脉证并治等方面,勾勒出我国呆病防治的理论源流。我国认识呆病的历史有2000多年,从西汉时期《黄帝内经》首见"善忘"症状名和"肾藏志"理论,到东汉时期《伤寒论》提出"本有久瘀血,故令喜忘"新说及其脉证并治,为呆病的诊治奠定了理论基础。后世传承之中更有创新,如明代晚期《景岳全书》首创"痴呆证"疾病名并提出"扶正"治法,清代早期《辨证录》又名"呆病"并设立"呆病门六则"专篇和"治痰"大法,丰富了呆病的诊治理论和方法。延至当今,从20世纪末的呆病"辨证施治"方案,到21世纪初的呆病"证候级联假说"及其"序贯疗法",已形成独具中医学特色的呆病防治方案。

With the method of document combing,this article takes dementia and its core symptoms as a main line,and outlines the theoretical source of the prevention and treatment of dementia in our country from the aspects of disease name evolution,pathogenesis renewal,and pattern-differentiation and treatment in our country.Dementia was first recognized in our country 2,000 years ago.From the first mention of“forgetful”symptom and the theory of“Kidneys storing Zhi(i.e.memory)”in the Huangdi Neijing in the Western Han Dynasty,to theory of“Prolonged blood stasis making people forgetful”in the Shang Han Lun in the Eastern Han Dynasty,all these have laid a solid theoretical foundation for the diagnosis and treatment of dementia.There are more innovations in the inheritance by later generations.For example,in the late Ming Dynasty,Jing Yue Quan Shu pioneered the name of“Dementia Syndrome”and proposed the treatment method of“Strengthening Qi”for it.In the early Qing Dynasty,Bian Zheng Lu referred to it as“dementia disease”and elaborated on it in the special part of“The Six Chapters of Dementia Disease”and the“Treating Phlegm to treat dementia”therapy.These have enriched the theories and methods of diagnosis and treatment for dementia disease.Extended to the present day,from the“differentiation and treatment”protocol of dementia disease at the end of the last century to the“pattern cascade hypothesis”and“sequential therapy”of Alzheimer’s disease at the beginning of this century,the prevention and treatment system for the dementia disease with unique Chinese medicine characteristics has been formed.