老年痴呆历代治法演变考

Research on Evolution of Treatment Methods of Senile Dementia in Past Dynasties

老年痴呆是一种随着年龄增长发病率成倍增长的神经系统变性疾病,严重影响老年人的生存质量。中医认识本病历史悠久,从先秦至明清时期,历代医家对本病不断进行探索和研究,治疗方法在不同的历史时期呈现出不同的特点。先秦两汉时期的《黄帝内经》为后世防治该病奠定了理论基础,其中蕴含了老年痴呆以补为主、兼顾调理气血和情志的治疗思想;晋隋时期重视补心,唐代的补养心肾法对后世影响深远;宋金元时期提出心脾两虚致忘说,发展了补益心脾法并逐渐确立起祛痰的理念;明清时期推出痴呆专论和脑主记忆说,治疗方法更加灵活多样,分型、分期论治及关注预后等治疗理念的树立使得治疗老年痴呆的理法方药体系渐趋成熟。

Senile dementia is a degenerative disease of the nervous system that increases exponentially with age,seriously affecting the quality of life of the elderly.Traditional Chinese Medicine has a long history of understanding this disease.From the pre-Qin period to the Ming and Qing dynasties,physicians of the past dynasties continuously explored and studied senile dementia,and the treatment methods showed different characteristics in different historical periods.The Inner Canon of Huangdi in the pre-Qin and Han dynasties laid a theoretical foundation for later generations to prevent and treat Senile dementia.It contains the treatment thinking of senile dementia focusing on replenishment,taking into account the conditioning of Qi and blood and emotions.The Jin and Sui Dynasty paid attention to replenishing the heart,while the method of tonifying the heart and kidney in the Tang Dynasty had a profound impact on later generations.During the Song,Jin and Yuan Dynasties,the theory of the deficiency of the heart and the spleen was put forward,while the method of replenishing the heart and the spleen was developed,and the concept of expectoration was gradually established.The theory of dementia and the theory of brain governing memory were introduced during the Ming and Qing Dynasties,and the treatment methods were more flexible and diversified,and the establishment of treatment concepts such as classification,treatment by stage,and attention to prognosis have made the system of principles,methods,and prescriptions for senile dementia’s mature.