| 引用本文: |
刘佳茜, 李涛, 杨一帆, 杜楠, 王嘉, 冯延, 杨俊豪, 闫咏梅.从“痰瘀痹阻、毒损脑络”探讨帕金森病“筋急肉怠”的病机内涵及治疗[J].湖南中医药大学学报,2026,46(8):1668-1674[点击复制] |
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| 从“痰瘀痹阻、毒损脑络”探讨帕金森病“筋急肉怠”的病机内涵及治疗 |
| 刘佳茜,李涛,杨一帆,杜楠,王嘉,冯延,杨俊豪,闫咏梅 |
| (陕西中医药大学, 陕西 咸阳 712046;陕西中医药大学第一临床医学院, 陕西 咸阳 712000;陕西省中医脑病学重点实验室, 陕西 咸阳 712000) |
| 摘要: |
| 帕金森病（PD）作为一种严重威胁老年人健康的神经系统变性疾病，其肌强直与运动迟缓分属中医学“筋急”与“肉怠”范畴。传统辨治多重责于肾虚髓减，然痰瘀痹阻贯穿病程始终，为病势缠绵之关键。本文立足于《黄帝内经》相关理论，从“筋急肉怠”证候入手，系统阐释PD之病机演变：以肝脾气化失司为本，痰瘀痹阻为标，继而郁久化毒、毒损脑络，终致神机失用，从而揭示其“本虚标实、由阻致损”的动态病机内涵。基于此，进一步总结岐黄学者闫咏梅教授以化痰祛瘀、解毒通窍、舒筋止颤为核心的辨治思路及方药运用经验，以期为PD的中医辨治建立从理论到实践一以贯之的完整框架。 |
| 关键词: 帕金森病|筋急肉怠|痰瘀痹阻|肝脾失调|病机探讨|中医辨治 |
| DOI：10.3969/j.issn.1674-070X.2026.08.019 |
| 投稿时间：2026-01-15 |
| 基金项目:国家中医药管理局岐黄学者支持项目（国中医药人教函﹝2022﹞6号）；陕西省中医脑病学重点实验室项目（KF202313）；2025年度研究生质量提升工程专项项目（CXSJ202515）。 |
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| Pathogenetic implications and treatment of "sinew tension and muscle sluggishness" in Parkinson's disease from the perspective of “obstruction by phlegm and blood stasis and toxin-induced damage to the brain collaterals” |
| LIU Jiaqian, LI Tao, YANG Yifan, DU Nan, WANG Jia, FENG Yan, YANG Junhao, YAN Yongmei |
| (Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712046, China;First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712000, China;Shaanxi Key Laboratory of TCM Encephalopathy, Xianyang, Shaanxi 712000, China) |
| Abstract: |
| Parkinson's disease (PD) is a neurodegenerative disorder that poses a serious threat to the health of the aging population. Its rigidity and bradykinesia correspond respectively to the Chinese medicine concepts of "sinew tension" and "muscle sluggishness". Traditional pattern differentiation and treatment have largely emphasized kidney deficiency and marrow depletion; however, obstruction by phlegm and blood stasis persists throughout the disease course and constitutes a key contributor to its protracted progression. Drawing on relevant theories in the Huang Di Nei Jing (Huangdi's Classic of Medicine) and taking the pattern of "sinew tension and muscle sluggishness" as the entry point, this paper systematically elucidates the pathogenetic evolution of PD: dysfunction of qi transformation in the liver and spleen constitutes the root, while obstruction by phlegm and blood stasis constitutes the manifestation; prolonged stagnation subsequently transforms into toxin, which damages the brain collaterals and ultimately impairs spirit activities. This progression reveals a dynamic pathogenetic implication characterized by "deficiency at the root and excess at the manifestation, with obstruction leading to damage." On this basis, the paper further summarizes the pattern differentiation and treatment approach of Professor YAN Yongmei, a Qihuang Scholar, together with her experience in the use of formulas and medicinals. Her approach centers on transforming phlegm and eliminating stasis, removing toxins and opening the orifices, and relaxing the sinews and arresting tremor. The aim is to establish a coherent framework linking theory with practice for the TCM pattern differentiation and treatment of PD. |
| Key words: Parkinson's disease|sinew tension and muscle sluggishness|obstruction by phlegm and blood stasis|disharmony between the liver and spleen|pathogenesis exploration|pattern differentiation and treatment in Chinese medicine |
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