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从"脑气络-病络"理论探析癫痫发作的病机及治疗OA北大核心CSTPCD

Discussion on the pathogenesis and treatment of epilepsy from the theory of "brain's qi collateral-abnormal collateral"

中文摘要英文摘要

癫痫是由脑部神经元过度放电导致的中枢神经系统疾病,具有突然性、反复性及自限性的发作特点.脑气络与脑神经网络在结构及功能方面具有高度相关性和内在一致性,以脑气络结构功能异常导致脑气络不通为核心的"脑气络-病络"病机理论能够较全面地阐释癫痫发作的相关中医病机及疾病演变规律,具有重要的临床价值.本文以癫痫发作特点为切入点,基于"脑气络-病络"理论,认为痰气郁滞、脑气络动风、痰瘀互结滞损脑络,以及脑气络双向流通的结构功能特性是癫痫发作呈现突然性、反复性、自限性的关键因素.根据"络以通为用"理论,提出理气通络法应作为本病的治疗原则贯穿治疗全程,针对不同病理变化辅以化痰、祛瘀之法,同时,结合脏腑辨证,重视癫痫发作的伴随症状,调畅脑气络使风息痫止,以期为癫痫的中医证治提供参考.

Epilepsy is a disease of the central nervous system caused by excessive neuronal discharges in the brain,characterized by sudden,recurrent and self-limited onset. The brain's qi collateral and the brain neural network are highly correlated and internally consistent in terms of structure and function. The theory of "brain's qi collateral-abnormal collateral",which is centered on the structural disorder and dysfunction of brain's qi collateral leading to the poor circulation of brain's qi collateral,can comprehensively explain the related pathogenesis of epilepsy and the law of disease evolution,so it has important clinical value. Taking the pathogenic characteristics as an entry point and based on the theory of "brain's qi collateral-abnormal collateral",this paper argues that phlegm and qi stagnation,wind in the brain's qi collateral,and phlegm and blood stagnation damaging the brain's collaterals,as well as the structural and functional characteristics of brain's qi collateral that circulate bi-directionally are the key factors for epilepsy to present sudden,recurrent,and self-limited characteristics. According to the therapeutic principle of "Collaterals need to be unobstructed to function normally",it is proposed that the method of regulating the qi and collaterals should be used as the basic treatment principle throughout the treatment. In addition,the method of resolving phlegm and eliminating blood stasis is supplemented for different pathological changes,while combining the syndrome differentiation of zang-fu viscera and attaching importance to the accompanying symptoms of epileptic seizures,to regulate the brain's qi collateral to achieve the effects of wind quenching and epileptic arrest. This is to provide reference for the treatment of epilepsy in traditional Chinese medicine.

孙田烨;王凯悦;阎明源;黎莉莉;刘金民

北京中医药大学东方医院 北京 100078北京中医药大学东直门医院

中医学

癫痫脑气络病络发作特点病机

epilepsybrain's qi collateralabnormal collateralpathogenic characteristicspathogenesis

《北京中医药大学学报》 2024 (008)

1043-1048 / 6

国家自然科学基金项目(No.81774277);国家中医药管理局京津冀中医药协同发展项目(No.GZY-GCS-2017-0);北京中医药大学基本科研业务费项目(No.2020-tsxk-001) National Natural Science Foundation of China(No.81774277)

10.3969/j.issn.1006-2157.2024.08.002

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