Treatment of Minimally Conscious State with Musk Based on "Phlegm，Fire，Blood Stasis，and Deficiency"

SONG Yanbo; SUN Yongkang; LI Mingyuan; WANG Xinzhi

doi:10.13288/j.11-2166/r.2025.02.014

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Treatment of Minimally Conscious State with Musk Based on "Phlegm，Fire，Blood Stasis，and Deficiency"

更新时间：2025-01-13

- Treatment of Minimally Conscious State with Musk Based on "Phlegm，Fire，Blood Stasis，and Deficiency"
- Journal of Traditional Chinese Medicine Vol. 66, Issue 2, Pages: 188-192(2025)
- 作者机构：
  
  1.河南中医药大学第一附属医院脑病中心，河南省郑州市金水区人民路19号，450099
  2.河南中医药大学第一临床医学院
  3.中西医防治重大疾病河南省协同创新中心
  4.焦作市第二人民医院
  5.河南省中医药科学院脑病研究所
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2025.02.014
  CLC：
- Received：11 April 2024，
  
  Revised：2024-05-12，
  
  Published：17 January 2025
- 稿件说明：
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宋研博,孙永康,李明远等.运用麝香从“痰、火、瘀、虚”论治最小意识状态[J].中医杂志,2025,66(02):188-192.

SONG Yanbo,SUN Yongkang,LI Mingyuan,et al.Treatment of Minimally Conscious State with Musk Based on "Phlegm，Fire，Blood Stasis，and Deficiency"[J].Journal of Traditional Chinese Medicine,2025,66(02):188-192.
宋研博,孙永康,李明远等.运用麝香从“痰、火、瘀、虚”论治最小意识状态[J].中医杂志,2025,66(02):188-192. DOI： 10.13288/j.11-2166/r.2025.02.014.

SONG Yanbo,SUN Yongkang,LI Mingyuan,et al.Treatment of Minimally Conscious State with Musk Based on "Phlegm，Fire，Blood Stasis，and Deficiency"[J].Journal of Traditional Chinese Medicine,2025,66(02):188-192. DOI： 10.13288/j.11-2166/r.2025.02.014.

摘要

认为最小意识状态为处于窍闭神匿到窍开神现的边缘状态，但仍属“中风闭证”范畴，病机总属邪气痹阻、窍闭神匿，病理因素为痰、火、瘀三端，风动和水饮可伴随其中，后期多因气血阴阳的耗伤而致虚闭。治疗上以麝香为君，注意配伍及用药缓急；以开窍为法，同时注重祛邪与扶正。痰、火重者以小承气汤开其下窍、以泄热通腑，以麝香配牛黄开其上窍，以醒神导气。痰浊较甚者以白芷暂代麝香，以涤痰汤豁痰开窍，待痰浊渐消再加用麝香。瘀血为主者以通窍活血汤活血通窍，以求血行风自灭，血利则无水患，瘀血除则窍开神现。窍闭体虚者应开窍扶正、标本兼顾，气虚者以补阳还五汤益气扶正，阴虚者以芍药甘草汤合封髓丹养阴柔筋、封固肾中精气，阳虚者以地黄饮子滋阴补阳开窍。

Abstract

Minimally conscious state （MCS） is at the edge between closed and open consciousness， but it still belongs to the category of "wind-strike block" syndrome. The basic pathogenesis of MCS is the obstruction of pathogenic

， orifices closed and spirit hidden， with pathological factors including phlegm， fire， and blood stasis. Wind movement and water retention may also be present， and often leading to deficiency syndrome due to the exhaustion of

， blood，

yin

， and

yang

at later stages. Treatment chooses Shexiang （

Moschus

） as the chief medicinal， emphasizing combination of medicinals and urgency of medication administration； the key therapeutic method is to open the orifices， with focuses on expelling pathogens and reinforcing healthy

. For patients with severe phlegm or fire， use

Xiaochengqi Decoction

（小承气汤） to open the lower orifices， discharge heat and unblock the bowels， combined with Shexiang （

Moschus

） and Niuhuang （

Bovis Calculus

） to open the upper orifices， awaken the spirit and guide

. For patients with turbid phlegm as the predominant， temporarily replace Shexiang （

Moschus

） with Baizhi （

Angelicae dahuricae radix

）， using

Ditan Decoction

（涤痰汤） to eliminate phlegm to open the orifices， when turbid phlegm gradually subsided， Shexiang （

Moschus

） could be added. For patients with blood stasis as the predominant，

Tongqiao Huoxue Decoction

（通窍活血汤） will be u

sed to activate blood and open orifice， if the blood circulates， the endogenous wind will be calmed， the water will be induced， the orifices will open and the consciousness will restore. For patients with closed orifices and body deficiency， the treatment should open the orifices and reinforce healthy

， and consider the root and branch simultaneously；

deficiency syndrome can be addressed with

Buyang Huanwu Decoction

（补阳还五汤） to boost

and reinforce healthy

；

yin

deficiency syndrome can be treated with

Shaoyao Gancao Decoction

（芍药甘草汤） combined with

Fengsui Pill

（封髓丹） to nourish

yin

， soften sinews， and secure kidney essence；

yang

deficiency can be managed by using

Dihuang Yinzi Decoction

（地黄饮子） to enrich

yin

， supplement

yang

， and open the orifices.

关键词

Keywords

references

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