从瘀论治创伤性脑出血

Treatment of Traumatic Intracerebral Hemorrhage from Blood Stasis

创伤性脑出血属外伤脑络范畴,基本病机为瘀阻脑窍。因此,从瘀论治成为创伤性脑出血的关键治法,具体包括活血化瘀、活血止血、活血行气、活血利水、活血凉血等。基于中医药现代科学内涵,针对创伤性脑出血,活血方药的最终目的在于止血,其作用机制涉及改善血流动力学和血液流变学、修复损伤血管、阻止血脑屏障破坏、减轻脑水肿程度等。立足于中西医结合,构建以病理机制为导向的个体化辨证体系可成为从瘀论治创伤性脑出血的诊疗关键,以期为其基础研究及临床应用提供理论支撑。

Traumatic intracerebral hemorrhage(TICH) belongs to brain injury caused by external force.The basic pathogenesis is blood stasis obstructing brain collaterals. Therefore, treating from removing blood stasis is essential for TICH therapy, including promoting blood circulation for removing blood stasis, activating blood to stop bleeding, activating blood to promote qi flow, activating blood and promoting diuresis, and promoting blood circulation and cooling blood. Based on modern scientific connotation of traditional Chinese medicine and aiming at TICH,the ultimate purpose of blood-activating prescription is to stop bleeding. Its mechanism of action involves improving hemodynamics and blood rheology, repairing damaged blood vessels, preventing blood-brain barrier damage, and reducing the degree of cerebral edema. Focused on integrating Chinese medicine and Western medicine, establishing individualized syndrome typing system combined with pathological mechanism is the key to promote blood circulation to treat TICH, hoping to provide theoretical support for basic research and clinical application for TICH treatment.