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章薇.试论中风“五位三要”中医康复诊治体系的构建[J].湖南中医药大学学报,2023,43(11):1956-1962[点击复制] |
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| 试论中风“五位三要”中医康复诊治体系的构建 |
| 章薇 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 国家致力于提高应对重大疾病的中医医疗服务体系的建设。中风(脑卒中)属于重大疾病,思考和构建多学科融合的中风中医康复诊疗体系,对发挥中医优势、提高康复效率有积极的现实意义。基于中医药优势专科特点、中风全病程康复规律,利用归纳法,思考中风"五位三要"中医康复诊治体系的构建。五位包括分期、病机、治疗、技术、工作模式5个方面,每个方面包含3个要素,即"三期三论三观三合三跨",具体如下:病程上分"三期"(急性期、恢复期、后遗症期),疾病分"五层"(未病、欲病、新病、盛病、病愈/未愈),病机上重"三论"(中风与"心脑相关论"、缺血性中风与"痰瘀互结论"、出血性中风与"风火相激论"),治疗策略上倡"三观"(早治观、分治观、和衡观),外治技术上重"三合"(针灸、推拿、康复融合),工作模式上创"三跨"(跨学科融合、跨科室辐射、跨区域指导)。构建中风"五位三要"的中医康复诊治体系,为规范中风的中医康复体系提供一定的借鉴与思路。 |
| 关键词: 中风 中医康复 诊治体系 病程 病机 治疗策略 |
| DOI：10.3969/j.issn.1674-070X.2023.11.004 |
| 投稿时间：2023-10-05 |
| 基金项目:国家中医药管理局高水平一流建设学科建设项目；国家临床创新平台项目；湖南省重点研发计划（2023SK2049）。 |
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| Construction of "Five Aspects and Three Essentials" rehabilitation diagnosis and treatment system for stroke |
| ZHANG Wei |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| China has been committed to constructing a TCM service system for major diseases, and stroke is one of them. Hence, it is of positive practical significance to consider and construct a multidisciplinary integrated TCM rehabilitation diagnosis and treatment system for stroke, so as to leverage the advantages of TCM and improve rehabilitation efficiency. In view of the characteristics of TCM advantageous specialties as well as the law of rehabilitation throughout the whole course of stroke, the inductive method has been applied to contemplating the construction of TCM rehabilitation diagnosis and treatment system for stroke based on the theory of "Five Aspects and Three Essentials". Accordingly, the "Five Aspects" are stages, pathogenesis, treatment, techniques, and working models, and each of them involves three elements, namely, "three stages, three theories, three perspectives, three integrations, and three crossovers". The specifics are as follows:there are "three stages" (acute, recovery, and sequela stages) in terms of disease course, "five levels" (health, pre-disease, early stage of disease, progressed stage of disease, and recovery/unrecovery) in terms of disease itself, and "three key theories" (the "heart-brain correlation theory" for stroke, the "intertwined phlegm and blood stasis theory" for ischemic stroke, and the "mutually agitated wind and fire theory" for hemorrhagic stroke) in terms of pathogenesis. Consequently, "three perspectives" (perspectives from treating early, treating differentially, and treating harmoniously) should be advocated in terms of treatment strategies, "three integrations" (integrations of acupuncture, tuina, and rehabilitation) should be emphasized regarding to external treatment techniques, and "three crossovers" working patterns (cross-disciplinary integration, cross-departmental cooperation, and cross-regional guidance) should be created. Therefore, this article provides some reference and ideas for standardizing TCM rehabilitation system of stroke by constructing a "Five Aspects and Three Essentials" TCM rehabilitation diagnosis and treatment system for stroke. |
| Key words: stroke TCM rehabilitation diagnosis and treatment system disease course pathogenesis treatment strategy |
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