基于“一气周流”论治缺血性脑卒中后遗症

Treatment on Sequelae of Ischemic Stroke Based on“Qi Circumfluence”Theory

“一气周流”由黄元御提出,在此基础上,他认为中风主要是由水寒土湿、木郁生风所致,且血分虚者病在左侧、气分虚者病在右侧,分别予桂枝乌苓汤、黄芪姜苓汤治疗。结合“一气周流”理论及临床实践,可将“一气周流”理论用于缺血性脑卒中后遗症论治。临床上,缺血性脑卒中后遗症患者气血双虚的情况更为典型,故治疗上可将桂枝乌苓汤与黄芪姜苓汤有机结合。另外在用药方面,主张使用引经药,如引诸药入脑的天麻、川芎;同时提倡酌用地龙、水蛭等虫类药以助搜风破积、走窜化瘀之功。附验案一则。

“Qi Circumfluence”was proposed by HUANG Yuanyu.On this basis,he believed that the stroke was mainly caused by the cold,dampness and wind transformed from wood constraint.Patients with blood deficiency disease,the location was on the left side,were treated with Guizhi Wuling Decoction(桂枝乌苓汤),while patients with qi deficiency disease,the location was on the right side,treated with Huangqi Jiangling Decoction(黄芪姜苓汤).The theory of“Qi Circumfluence”can be applied to the treatment of sequelae of ischemic stroke.In clinic,qi and blood deficiency occur in most of patients suffering from sequelae of ischemic stroke,so the treatment can organically combine Guizhi Wuling Decoction with Huangqi Jiangling Decoction.In addition,in terms of medication,it is advocated to use channel ushering drug,such as Tianma(Gastrodiae Rhizoma)and Chuanxiong(Chuanxiong Rhizoma),which take drugs into the brain.At the same time,it is advocated to use insect drug such as Dilong(Pheretima)and Shuizhi(Hirudo)to help dispelling wind and breaking the accumulation.A case is attached.