【作者】 田财军；

【导师】 张洪斌； 刘持年；

【作者基本信息】 山东中医药大学 ， 中医内科学， 2008， 博士

【摘要】 多发性硬化(multiple sclerosis，MS)是发生于中枢神经系统的慢性自身免疫性疾病，以中枢神经系统炎症性、多发性白质脱髓鞘病变和小血管旁单核细胞浸润为主要特征，可累及轴索和出现神经元丢失。临床特点是反复发作的神经功能障碍，临床表现复杂多样，发病年龄较早，复发率、致残率高，缺乏有效治疗手段，已成为研究热点。目前中医对多发性硬化的研究，以临床观察和实验研究为主，初步涉及病因病机探讨与临床研究总结、反思。尚未形成完备的辨证论治体系，整体观念不足，在将多发性硬化作为独立疾病，把握其基本病机方面存在缺陷，临床治疗局限于随症治之，忽略了多发性硬化中医病机的特殊性，以致多发性硬化的研究进展缓慢。在导师指导小组悉心指导下，本研究系统复习多发性硬化研究文献，归纳其临床特征，应用中医理论认识其辨证范畴、病因病机、辨证论治、转归预后。揭示内毒致损的机理。通过动物实验，初步检验其有效性。研究显示，肉苛作为多发性硬化的中医病名具备可行性；多发性硬化病在脑髓，涉及五脏而以肺脾肾为要；病理因素主要为内生浊毒；毒邪入液，脑髓损伤，神机失常为基本病机：脏腑损而难复，痰瘀浊毒相依，伏于气血为复发之因。治法以清、消、和、补为主。脏腑辨证为主，营卫辨证、气血津液辨证、体用辨证作为补充。动物实验以泰元饮预防性治疗实验性自身免疫性脑脊髓炎，初步验证解毒治法的有效性。通过初步构建多发性硬化中医辨证论治体系，探索了中医药治疗多发性硬化的机理与疗效评价的动物实验研究方法，为今后的进一步研究奠定了基础。更多还原

【Abstract】 Multiple sclerosis (MS) is a chronic autoimmune disorder disease betiding the central.nervous systemlt is characterized mainly by inflaming, multiple demyelinationalpathological changes of the white matter of the central nervous system and monocytesocking around small blood vessels, also may involving axon and happening occurring ofthe lose of the neurons. It’s clinical character is repeated paroxysm of disability of thenerval function. Clinical manifestations are varied and complicated. MS is a diseasecoming, on in the early-aged with a high incidence of recrudescing and deformity and beinga research hotspot.The research of MS in the traditional Chinese medicine (TCM) chiefly focuses on theclinical observation and experimental research. Now, and primarily involves the probing of thepathological factors and mechanism and summarizing and reflecting of the clinical research. Itstill doesn’ t formed an integrated system of differentia treatment and short of whole conception.Lacuna exists in the grasping of basic pathological mechanism when taking MS as anindependent disease. Clinical treatment limits to the simple focusing on the symptom and ignoresparticularities of the TCM pathological mechanism of MS. It brings on the slowly progresses inthe researching of MS.Under the dovoted guidance of the tutor direction group, my study reviewed the researchliterature of the MS systematically, summed up its’ clinical manifestations, get reach ofits’ differentia category, pathological factors and mechanism, differentia treatment,development and prognosis. Expose the mechanism of damage resulting from inner-toxin andprove the validity by virtue of animal experiments.Study shows that it is feasible that intramuscular knurl could be taked as the synonymy of the MS. MS occurs in encephala, involving five internal organs especially involving thelung, spleen and kidney. The major pathological factors is the toxin produced in the bodybrains damage and mental abnormity. The recrudescence factor is the tangle and secreting of thephlegm, blood stasis and toxin in the qi and blood. The treatments base chiefly on cleating,eliminating, reconciling and supplementing.Base on the Zang-fu differentia, complemented by ying-wei differentia, qi-blooddifferentia, ti-yong differentia. Chiefly build up the system of treatment differentia, and groundthe further research and treatment for the future.更多还原