《黄帝内经》象思维视域下的中风病辨治思路探讨

Discussion on Thinking of Diagnosis and Treatment of Stroke from Perspective of Image Thinking in Huang Di Nei Jing

在《黄帝内经》象思维视域下,以肝风统领痰、火、劳累等因素是中风病的核心病机;把握“风”象是治疗中风病的关键要点,同时应重视不同象之间的关系。治疗中风病时,祛邪和扶正的先后顺序曾引起一些医家的争论。叶天士在分析前人著作的基础上,明确提出先祛邪后扶正的观点,对临床有较大的影响。叶天士用药首先以祛邪为主,常用郁金、胆南星祛痰,竹沥、石菖蒲祛火,桂枝解表,附子补虚;扶正则主要应用人参、黄芪、当归等药物。

From perspective of imagery thinking in Huang Di Nei Jing,Phlegm,Fire,fatigue and other factors are related to Liver Wind is the core pathogenesis of stroke.Therefore,grasping the Wind image is the key point in treatment of stroke,and the relationship between different images should be paid attention to.In treatment of apoplexy,the sequence of eliminating pathogenic factors and strengthening the body resistance has caused controversy among some physicians.Based on the analysis of previous works,Ye Tianshi clearly put forward the viewpoint of eliminating the evil factors firstly and strengthening the body's Zheng Qi secondly,which has great influence on clinic.Ye Tianshi's medication is mainly to eliminate pathogenic factors,such as Yujin(radix curcumae)and Dannanxing(arisaema cum bile)can be used to eliminate Phlegm,Zhuli(bamboo juice)and Shichangpu(acorusshi gramineus)can be used to eliminate Fire,Guizhi(ramulus cinnamomi)can be used to relieve exterior syndrome,and Fuzi(aconitum carmichaelii)can be used to tonify deficiency.In strengthening Zheng Qi of man,Renshen(ginseng),Huangqi(astragalus)and Danggui(angelica)and other drugs are mainly used.