从“煎厥”探析可逆性后部脑白质综合征中医病机

On Pathogenesis of Reversible Posterior White Matter Syndrome in Traditional Chinese Medicine from Perspective of“Jianjue”

目的探析可逆性后部脑白质综合征(reversible posterior leukoencephalopathy syndrome,RPLS)的中医病机,以期为中医辨治急重症提供理论依据。方法依据《素问·生气通天论篇第三》描述“煎厥”与RPLS临床表现极为相似及吻合,基于“煎厥”发于“阳气耗”“阴精亏”及“脏精绝”,分别从“脏腑”“阴阳”及“虚实”等方面分析RPLS中医病位及病机。结果中医理论认为二者病位均在肝肾,中医病机均属本虚标实,本虚为肝肾阴虚、肝阳上亢,标实为痰湿、瘀血内阻。结论用“煎厥”理论认识RPLS的病机,为中医药参与防治危急重症提供理论支撑。

Objective To explore the TCM pathogenesis of reversible posterior white matter syndrome(RPLS),in order to provide theoretical basis for TCM syndrome differentiation and treatment.Methods According to the description of"Jianjue"in the third chapter of Suwen·Qitongtian Lun,the clinical manifestations of"Jianjue"and RPLS were very similar and consistent.The location and pathogenesis of TCM were analyzed from the aspects of"Zang-Fu organs","Yin and Yang"and"deficiency and excess".Results It is considered that the location of both diseases is in the liver and kidney,and the pathogenesis of TCM belongs to the deficiency of the origin and the excess of signs.The deficiency of the origin is the deficiency of liver and kidney Yin and the hyperactivity of liver Yang,and the signs include phlegm dampness,blood stasis and internal obstruction.Conclusion-Understanding the pathogenesis of RPLS with the theory of"Jianjue"provides theoretical support for the participation of TCM in the prevention and treatment of critical illness.