作者：胡海洋，刘庆华，程发峰

单位：

北京中医药大学中医学院

Units：

School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China

关键词：

认知障碍; 卒中后认知障碍; 五脏一体观; 中医病机; 辨证论治;

Keywords：

Cognition disorders; Post-stroke cognitive impairment; Holism of Five Viscera; Pathogenesis (TCM) ; Syndrome differentiation and treatment

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.150

Funds：

国家自然科学基金资助项目（81973789）

摘要：

中医学重视整体观念，认为五脏作为有机整体，在生理、病理上联系密切、相互影响。卒中后认知障碍（PSCI）的病位虽在脑，但其发病与五脏均相关，其中心、肾乃病机之关键，肝、脾、肺三脏亦与之密切相关。为了弥补西医疗法的不足、改善PSCI的临床治疗效果，笔者基于“五脏一体观”理论，分别从五脏的角度探讨了PSCI的病机及辨证论治，并指出心脉失养者应养心调血以安神、肾精虚衰者应补肾填精以益智、肝气郁结者应疏肝解郁以开结、肺虚痰阻者应益肺化痰以降浊、脾虚湿困者应健脾祛湿以充五脏，五脏和则气血调达、髓充神明、认知功能得以恢复。这为临床防治PSCI提供了新的思路和方法。

Abstract：

Traditional Chinese medicine attaches great importance to the concept of wholeness, believing that the five viscera, as an organic whole, are closely related and mutually influence each other physiologically and pathologically. Although the location of post-stroke cognitive impairment (PSCI) is in the brain, its incidence is related to the five viscera, and the heart and kidney are the key to the pathogenesis, and the three viscera of the liver, spleen and lung are also closely related to it. In order to make up for the shortcomings of western medical methods and improve the clinical treatment effect of PSCI, the author discusses the pathogenesis and dialectical treatment of PSCI from the perspective of five viscera based on the theory of "Holism of Five Viscera" , and points out that the patients with heart and pulse loss should nourish the heart and regulate the blood to calm the mind, the patients with kidney essence deficiency and decline should nourish the kidney and fill the essence to improve the brain, the patients with liver Qi stagnation should ease the liver and relieve depression to open the knot, the patients with lung deficiency and phlegm should strengthen the lung and reduce phlegm to reduce turbidity, the patients with spleen deficiency and dampness should strengthen the spleen and remove dampness to fill the five viscera, and the harmony of the five viscera promotes the regulation of Qi and blood, replenishes the soul, and restores cognitive function. This provides a new idea and method for clinical prevention and treatment of PSCI.

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