中医临床研究2025，Vol.17Issue(25)：126-131,6.DOI:10.3969/j.issn.1674-7860.2025.25.019
基于"肝-胃-冲-心"气逆探讨张锡纯脑充血的辨治
The diagnosis and treatment of cerebral congestion from ZHANG Xichun based on the theory of Qi counterflow of"liver-stomach-Chong meridian-heart"
摘要
Abstract
ZHANG Xichun is one of the representative figures of the integrated school of traditional Chinese medicine and Western medicine in modern China.Based on the essential knowledge in Lingshu(《灵枢》)and Suwen(《素问》),he integrated the essence of traditional Chinese medicine and Western medicine.Yixue Zhongzhong Canxi Lu(《医学衷中参西录》)is a summary of the clinical experience of ZHANG Xichun on the fusion of traditional Chinese medicine and Western medicine.In the book,there was a unique approach to the diagnosis and treatment of cerebral congestion.Based on the disruption of Qi(气)circulation of the liver,stomach,Chong meridian,and heart,the core pathogenesis of"blood disorder follows Qi disorder"of cerebral congestion was revealed in the book.That is,when Qi circulates normally,blood flows smoothly;when Qi circulation of the liver,stomach,Chong meridian,and heart organs is disrupted,blood in the blood vessels will rise and block the cerebral meridians.ZHANG Xichun classified cerebral congestion into three pathological stages:cerebral congestion,cerebral hemorrhage,and cerebral hemorrhage,which respectively correspond to modern hypertension,pre-cerebral hemorrhage,and hemorrhagic stroke.A pathogenesis chain of visceral Qi counterflow initiated by liver Qi hyperactivity and reverse,with the coordinated action of stomach Qi stagnation,Chongqi(冲气)upward reverse,and heart fire upward burning was established,which profoundly revealed the pathological evolution rule of cerebral hypertension,vascular damage,and rupture caused by cerebral collateral damage after the reverse of blood with upward Qi.In this study,based on the medical cases in Yixue Zhongzhong Canxi Lu and the theory of Qi counterflow,the connotations of the three methods of"normalizing counterflow,unblocking organs,and inducing blood"are systematically analyzed in the treatment of cerebral congestion.Among them,the method of normalizing counterflow refers to using high dose heavy metal and stone such as Zheshi(Haematitum),Longgu(Os Draconis)and Muli(Concha Ostreae)to soothe the liver and reduce adversity,and to suppress floating Yang(阳).The principle of unblocking organs involves promoting digestion and lowering gastrointestinal Qi with Dahuang(Radix et Rhizoma Rhei),Baiziren(Semen Platycladi),Taoren(Semen Persicae)and so on.The inducing blood method is to use Niuxi(Radix Achyranthis Bidentatae)primarily to guide blood downward and leads blood to the meridians.The normalizing counterflow method aims to calm the liver and reduce internal heat to treat root cause,the method of unblocking organs aims to promote the circulation of organs and reduce turbidity to intercept the flow,and the method of inducing blood aims to guide blood downward to provide emergency rescue.The three methods jointly form a treatment strategy that addresses both the symptoms and the root cause,providing a reference for the early signs of stroke in modern times and an auxiliary diagnosis and treatment logic of"mutual reference of pulse and syndrome",and offering important inspiration for the early prevention and treatment of stroke in modern times.关键词
脑充血/《医学衷中参西录》/脏腑气逆/镇逆三法Key words
Cerebral congestion/Yixue Zhongzhong Canxi Lu/Visceral Qi reverse/Three methods of normalizing counterflow分类
医药卫生引用本文复制引用
王璐月,王玉勇..基于"肝-胃-冲-心"气逆探讨张锡纯脑充血的辨治[J].中医临床研究,2025,17(25):126-131,6.基金项目
山东省中医药科技项目(M-2022050):疏肝健脾化痰法治疗缺血性脑卒中患者卒中后疲劳的临床研究. （M-2022050）
