从概念解析和疾病诊疗探讨楼英对中风后失语理论的构建

Exploring LOU Ying’s Construction of the Theory of Post-stroke Aphasia from Concept Analysis and Disease Treatment

[目的]探讨明代医家楼英对中风后失语理论的构建,以期为中医药临床提供参考。[方法]运用传统医史文献的整理方法,认真研读楼英《医学纲目》中关于中风后失语的论述并加以分析理解,从而总结归纳楼英在中风后失语病因病机、分类、鉴别诊断、治则治法和用药等方面的特色经验。[结果]楼英提出,“外感风邪,内有营卫气血亏虚”是中风后失语的病因病机,其病位在里。根据病情严重程度不同,分为言謇语涩和完全不能言语。在诊断上,应与其他原因引起的发音障碍和痿证相鉴别。治疗上以“祛邪扶正,以通为用”为治则,“内外并用,多法齐施”为手段,“博采众长,随证加减”为用药特色。[结论]楼英在充分继承先贤理论精华的基础上,初步构建了中医药治疗中风后失语的理论体系,值得后世借鉴。

[Objective]To discuss the construction of the theory of post-stroke aphasia by the Ming Dynasty physician LOU Ying,with a view to provide reference for the clinical practice of traditional Chinese medicine.[Methods]Using the method of organizing traditional medical historical documents,LOU Ying’s discussion on post-stroke aphasia in Yixue Gangmu is carefully studied and analyzed,so as to summarize LOU Ying’s characteristic experience on the etiology and pathogenesis of post-stroke aphasia,as well as classification,differential diagnosis,treatment rules and methods and the use of medication.[Results]LOU Ying suggested that“external wind and internal deficiency of Qi and blood”was the etiology of post-stroke aphasia,which was located in the inside of the body.According to the severity of the disease,aphasia was categorized as speech outburst and total inability to speak.Diagnosis should be differentiated from other causes of dysarthria and impotence.The treatment was based on the principle of“eliminating pathogenic factors and reinforcing healthy Qi,unblocking Qi and blood to function well as a means”,the means of“using internal and external methods together”,and the medication feature of“using a wide range of skills,and adding and subtracting according to the syndrome”.[Conclusion]On the basis of fully inheriting the theoretical essence of the sages of the previous generations,LOU Ying had initially constructed a theoretical system of Chinese medicine for the treatment of post-stroke aphasia,which was worthy of reference for future generations.