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基于“血脉理论”指导心脑合病的病因病机及辨证论治

【作者】 张健

【导师】 杨关林;

【作者基本信息】 辽宁中医药大学 , 中西医结合, 2011, 硕士

【摘要】 心脑血管疾病现已成为严重危害人类健康的重大疾病,其高死亡率和高致残率是一个全球性的挑战和重负。导师杨关林教授从事临床、教学、科研二十余年,对血管性疾病进行了深入的临床与实验研究,在大量临床实践中,杨师发现现代人胸痹并发中风的患者较常见,并以此为基础,结合临床研究的最新进展,创新性的提出了“心脑合病”的概念。杨师从中医整体观出发,以中医“血脉理论”为指导,以中医古代文献为依据,对心脑疾病间的内在联系进行了具体的分析和探讨,并对其病因病机及辨证论治进行了深入的研究,杨师认为心脑病变(中风病、冠心病)虽有在脑、在心的不同,但二者同属血管性疾病,是全身性血管病变在不同器官的表现,二者致病因素具有高度一致性,概括起来都与肝脾肾脏腑功能失调有关,以血脉为共同病变部位,以血脉瘀阻为共同病理基础。二者病因、病位、病理基础及病机演变高度一致,只是发病的部位、先后不同,而最终在同一个体并存是病程发展的必然结局。因此,对心脑合病的治疗应针对疾病发展不同阶段的主要病因病机,并视其标本虚实,辨证施治,使二者在临床治疗上相互渗透,相互促进。本文进一步深化了对中风病和冠心病病因病机及辨证论治的认识,丰富了心脑血管病的中医治疗内涵,开创了运用中医血脉理论指导心脑血管疾病预防研究的新思路。

【Abstract】 Cardiovascular and cerebrovascular diseases have long been life threatening diseases. Also, due to their high rate of patient fatality and disability, they are both well known global medical challenge. Professor Yang Guanlin has spent decades on the clinical and experimental study of vascular diseases. Base on a large number of clinical practice and research, Yang discovers that Chest in patients with stroke is more common in the modern times, and at the basic of this, Yang is the first in the field to propose the concept of "heart and brain disease combined" in The People’s Republic of China. From the concept of holism in TCM and using " blood-vessels theory "of TCM as a guide, Yang analysis and discusses specifically the intrinsic linkages between Heart and brain disease. First of all, although cardiovascular and cerebrovascular disease (stroke, coronary heart disease) affect different human tissues, they both qualify as vascular diseases. Secondly, these two diseases cause the systematic vascular lesions in the performance of different organs, but there is high consistency between the risk factors of these two diseases. Therefore, Yang concludes that the occurrences of heart and brain disease are both related to dysfunction in liver, spleen and kidney. To be more specific, blood-vessel is the common disease location and therefore, blood-vessels stasis is the common pathology. Causes, disease location, pathology and pathogenesis of both diseases display highl consistency. The only differences are of the site of disease, the order of occurrence. Unfortunately,the co-existence of the diseases in the same individual is the inevitable outcome of progression of the disease. Therefore, the treatment of cardiovascular and cerebrovascular disease should be combined and targeted at the major cause and pathogenesis of different stages of development of the disease, depending on the Biao and Ben, deficiency and excess. Treatment should be administrated according to the differentiation of disease. This article further deepens the understanding of etiology, pathogenesis and the treatment of stroke and coronary heart disease. Furthermore, this article enriched the content of TCM treatment of cerebrovascular disease, and creates new ideas for the prevention and research of cardiovascular diseases under the guidance of blood-vessels theory of TCM.

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