1.北京中医药大学,北京市朝阳区北三环东路11号,100029
2.北京中医药大学东方医院
3.中国中医科学院广安门医院
4.中国人民解放军总医院
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收稿:2021-04-15,
修回:2021-06-30,
纸质出版:2021-10-02
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薛静,陈志刚,李楠楠等.从脑髓-脑神-脑气角度分期辨治阿尔茨海默病[J].中医杂志,2021,62(19):1684-1689.
XUE Jing,CHEN Zhigang,LI Nannan,et al.Syndrome Differentiation and Staged Treatment of Alzheimer's Disease from the Perspective of Brain Marrow-Spirit-Qi[J].Journal of Traditional Chinese Medicine,2021,62(19):1684-1689.
薛静,陈志刚,李楠楠等.从脑髓-脑神-脑气角度分期辨治阿尔茨海默病[J].中医杂志,2021,62(19):1684-1689. DOI: 10.13288/j.11-2166/r.2021.19.006.
XUE Jing,CHEN Zhigang,LI Nannan,et al.Syndrome Differentiation and Staged Treatment of Alzheimer's Disease from the Perspective of Brain Marrow-Spirit-Qi[J].Journal of Traditional Chinese Medicine,2021,62(19):1684-1689. DOI: 10.13288/j.11-2166/r.2021.19.006.
认为脑髓根于肾,脑髓损伤是阿尔茨海默病发生的基础,而肾精亏虚、髓海不足为脑髓损伤之根本。提出从脑髓-脑神-脑气角度辨治阿尔茨海默病,其中脑神是脑髓和脑气的外在表现,反映认知、情志等功能;脑气是连接脑髓、脑神的枢纽,脑气逆乱无章,则影响机体的形体官窍而发病。治疗主张分期辨治,平台期以脑髓损伤为主,重在补虚;波动期以脑气机紊乱为主,重在祛内生之邪;下滑期以浊毒损伤脑络、脑神失养为主,重在解毒,兼顾本虚;同时应在疾病的辨治过程中注意痰、瘀、毒等病理产物的有无及兼夹。
Kidney is considered to be the root of brain marrow. The injury of the brain marrow constructs the base of Alzheimer's disease (AD), and is fundamentally induced by kidney essence depletion and marrow sea insufficiency. Therefore, it is proposed to differentiate syndromes and treat AD from the perspective of brain marrow-spirit-
qi
. Brain spirit is the external manifestation of brain marrow and
qi
, reflecting the cognitive and emotional functions. Brain
qi
is the hub that connects the brain marrow and spirit; if there is counter flow and disorder of brain
qi
, the body and orifices will be affected leading to AD. Staged treatment based on syndrome differentiation is suggested; the injury of brain marrow is mainly involved in the plateau phase, and therefore deficiency supplementation method is suggested; the fluctuating phase is mainly affected by disorder of brain
qi
, for which internal pathogen should be dispelled; as the decline phase is characterized by turbid toxin disturbing the brain collaterals, and brain spirit losing nourishment, methods to resolve the toxins should be used and root deficiency should be supplemented simultaneously. Moreover, the presence or absence of pathological products such as phlegm, stasis, toxins and their combinations should be differentiated when giving staged treatment.
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