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[古代“中风”的内涵及《千金要方》小续命汤治疗脑梗死与脑出血]

[Conotation of ancient "stroke" and Qianyin Yaofang Xiaoxuming Decoction treating cerebral infarction and cerebral hemorrhage].

作者信息

Xiong Xing-Jiang

机构信息

Guang'anmen Hospital,China Academy of Chinese Medical Sciences Beijing 100053,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2020 Jun;45(12):2725-2734. doi: 10.19540/j.cnki.cjcmm.20200316.501.

Abstract

Xiaoxuming Decoction is the ancient classic herbal formulae for the treatment of stroke. Before the Han and Tang Dynasties, Xiaoxuming Decoction was highly praised by doctors of all dynasties as the "No.1 prescription of internal medicine". However, it was gradually declined in later generations and even abandoned by doctors of all dynasties. The reason why Xiaoxuming Decoction was anybody to care for it and the changes of physicians' understanding of the pathogenesis of "stroke" in the ancient times. In ancient times, the connotation of stroke was very extensive, including facial neuritis, acute cerebral infarction, acute cerebral hemorrhage, sequelae of cerebral hemorrhage, unexplained weakness of limbs, cervical spondylosis, acute myelitis, acute radiculitis, Guillain Barre syndrome, multiple sclerosis, myasthenia gravis, motor neuron disease, dermatomyositis, hypokalemic paralysis peripheral neuritis. According to studies, in the treatment of cerebral infarction and cerebral hemorrhage, Xiaoxuming Decoction can significantly shorten the course of acute stage and promote the recovery of hemiplegia, and its mechanism is consistent with the treatment principle of modern medicine for cerebrovascular diseases. In addition, this prescription is forbidden for patients with red face, fast heart rate, high blood pressure, blocked stool, red tongue, yellow fur, rapid pulse string or strong pulse string, and strong pulse on the wrist.

摘要

小续命汤是治疗中风的古代经典方剂。在汉唐以前,小续命汤被历代医家推崇为“内科第一方”。然而,后世却逐渐衰落,甚至被历代医家弃用。小续命汤被冷落的原因与古代医家对“中风”病机认识的变迁有关。古代中风内涵十分广泛,包括面神经炎、急性脑梗死、急性脑出血、脑出血后遗症、不明原因肢体无力、颈椎病、急性脊髓炎、急性神经根炎、格林巴利综合征、多发性硬化、重症肌无力、运动神经元病、皮肌炎、低钾性麻痹、周围神经炎等。据研究,在治疗脑梗死和脑出血方面,小续命汤能显著缩短急性期病程,促进偏瘫恢复,其作用机制与现代医学治疗脑血管病的原则相符。此外,面红、心率快、血压高、大便干结、舌红、苔黄、脉弦数或脉弦有力、腕部脉强者禁用本方。

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