基于“元阳虚衰、痰瘀阻窍”理论探讨血管性痴呆辨经论治

Discussion on Syndrome Differentiation and Treatment of Vascular Dementia based on the Theory of “Deficiency and Decline of Yuanyang and Obstruction of Orifices by Phlegm and Blood Stasis”

辨证论治为中医治疗疾病的基本原则,基于辨证论治的基础上,针灸治疗疾病时常采用辨经论治。血管性痴呆为脑血管疾病引起的病症之一,在经络辨证思想的指导下,从血管性痴呆的病机角度下展开了研究分析,总结程红亮教授基于“辨经论治”理论治疗血管性痴呆的经验,概括程红亮教授以“辨经”为“论治”的核心,其病位在脑、在督脉、与脏腑相关,“脑-督脉-脏腑相关”实质是以督脉为桥梁,构建起脑-督脉-脏腑三者之间的联系。因此,本病的发生是多脏腑功能失调所致,从局部或一脏一经论治是不够的。但目前针灸治疗该病大多集中在辨证论治,经络辨经取穴尚未形成体系。在此基础上,程红亮教授提出“元阳虚衰、痰瘀阻窍”是血管性痴呆的主要病机,治疗时以督脉为纲领,与心经、肾经、任脉有机联系,以“通督任”为首要治疗思路,“化痰瘀”为重要治疗手段,针、灸、药三者并用综合治疗,可有效改善患者的认知功能,进一步提高了临床疗效。

Syndrome differentiation and treatment is the basic principle of traditional Chinese medicine in the treatment of diseases.On the basis of syndrome differentiation and treatment,acupuncture and moxibustion often adopts syndrome differentiation and treatment in the treatment of diseases.Vascular dementia is one of the diseases caused by cerebrovascular diseases.Under the guidance of the thought of meridian differentiation,this paper carried out research and analysis from the perspective of the pathogenesis of vascular dementia,summarized Professor CHENG Hongliang’s experience in treating vascular dementia based on the theory of “syndrome differentiation and treatment”,and summarized that Professor CHENG Hongliang takes “syndrome differentiation” as the core of “treatment”,and its disease is located in the brain,in the governor vessel and related to the Zang Fu organs,The essence of “brain governor vessel viscera correlation” is to build the connection between brain governor vessel viscera by taking governor vessel as a bridge.Therefore,the occurrence of this disease is caused by the dysfunction of multiple viscera,and it is not enough to treat it from local or one viscera.However,at present,acupuncture treatment of this disease mostly focuses on syndrome differentiation and treatment,and the selection of meridians and acupoints has not yet formed a system.On this basis,CHENG Hongliang proposed that “deficiency and failure of Yuanyang and obstruction of orifices by phlegm and blood stasis” are the main pathogenesis of vascular dementia.During the treatment,the governor’s pulse is taken as the program,which is organically connected with the heart meridian,kidney meridian and Ren meridian.With “Tongdu Ren” as the primary treatment idea and “resolving phlegm and blood stasis” as an important treatment method,the combination of acupuncture,moxibustion and medicine can effectively improve the cognitive function of patients and further improve the clinical curative effect.