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《中国中医药现代远程教育》[ISSN:1672-2779/CN:11-5024/R]文章信息/InfoTitle:五脏通腑法治疗中风病验案三则 卷期:2024年22卷15期 作者:顾红岩1，苏凤哲2 1北京市通州区梨园卫生院中医科,北京 101100;2北京市通州区中西医结合医院中医科,北京 101100 Author(s):GU Hong-yan1,Su Feng-zhe2 1. Department of Traditional Chinese Medicine,Liyuan Hospital,Tongzhou District,Beijing 101101,China;2．Department of Traditional Chinese Medicine,Beijing Tongzhou District Integrated Hospital of Traditional Chinese and Western Medicine,Beijing 101101,China)Medicine，Beijing 101101，China 关键词中风；五脏通腑法；临床经验 Keywords:troke; the five zang organs dredging fu organs method; clinical experience 摘要:中风患者发生便秘的机率较高，且其严重程度往往与中风的病势转归有较大关系。中风的便秘患者属中医中风腑实证。中风腑实证与五脏相关，非独肠也，采用五脏通腑法治疗效果更佳。五脏通腑法除了下法之外，还应包括化痰祛湿、活血化瘀、益气活血等治法在内。肠道菌群、肠道本身以及参与连接作用的多种神经系统三部分组成了细菌-肠-脑轴，它的发现为“脑病治肠”和下法治疗中风的作用机制找到了理论依据。本文以补肾通腑法、平肝通腑法和健脾通腑法为例，展示了五脏通腑法治疗中风的疗效。
AbstractThe incidence of constipation in stroke patients is high, and the severity of constipation is often related to the prognosis of stroke. Constipation patients with stroke belong to TCM apoplexy fu syndrome. The syndrome of apoplexy is related to the five zang organs, not only the intestines, but also the five zang organs dredging method. In addition to the following methods, the five zang organs dredging fu organs method should also include the methods of removing phlegm and dampness, promoting blood circulation and removing blood stasis, supplementing qi and activating blood circulation.The bacteria gut brain axis is composed of intestinal flora, intestine itself and various nervous systems involved in connection. Its discovery has found a theoretical basis for the mechanism of "brain disease cures intestine" and the following treatment for stroke. Taking the methods of tonifying the kidney and dredging the fu organs, calming the liver and dredging the fu organs, and strengthening the spleen and dredging the fu organs as examples, this paper demonstrates the efficacy of the five zang organs and dredging the fu organs in treating stroke.
中风病是在人体气血亏虚的基础上，因劳倦内伤、忧思恼怒、嗜食肥甘厚味及烟酒等诱发以脏腑阴阳失调，气血逆乱，直冲犯脑，致脑脉痹阻或血溢脑脉之外为基本病机，临床以突然昏仆，半身不遂，口舌㖞斜，言语謇涩或不语，偏身麻木为主症的一种常见病、多发病[1]。中风患者在急性期多用脱水剂，加之长期卧床、饮食失调、用药的副作用等，导致胃肠蠕动减弱或肠道失于濡润发生便秘[2]。大约有48%的中风病人会发生便秘，脑出血患者便秘的发生率可达到66%[3]。便秘的严重程度往往与中风病邪的深浅和后期病情的恢复有很大关系。中风病系五脏气血失和所致，苏凤哲名老中医工作室采用五脏通腑法治疗中风腑实证效果明显，通腑亦应审因辨证，要视五脏虚实，灵活采用五脏通腑法才能取效。
参考文献/References:[1]王永炎,鲁兆麟.中医内科学[M]北京:人民卫生出版社,2015.
[2]张兆蓬.从中医病机角度谈便秘对脑中风患者的影响[J].内蒙古中医药,2010,29 (12): 134.
[3]LI J,YUAN M,LIU Y,etal.Incidence of constipation instroke patients:a systematic review and meta-analysis[J].Medicine,2017,96(25):e7225.
[4]李建香,过伟峰,傅淑平等.基于脑肠互动探讨通腑泻热法治疗中风的机制[J].中医杂志, 2018,59(4) :292-294.
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