| 引用本文: |
周德生,胡华,张雪花,刘利娟,陈瑶,高晓峰.基于神机气化理论辨治感性脑病[J].湖南中医药大学学报,2020,40(8):922-928[点击复制] |
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| 基于神机气化理论辨治感性脑病 |
| 周德生,胡华,张雪花,刘利娟,陈瑶,高晓峰 |
| (湖南中医药大学第一附属医院神经内科, 湖南 长沙 410007;湖南中医药大学第一附属医院集团衡阳县医院, 湖南 衡阳 421200;湖南省脑科医院精神科, 湖南 长沙 410007) |
| 摘要: |
| 感性脑病以感性反应症状为主要临床表现，跨科于精神病、神经病、心身疾病等领域，或者是某些内、外、妇、儿科疾病的特殊类型。感性脑病以气病、形病、神病同时存在并互相影响为共同病机，感性反应症状是由神机气化不及、太过、紊乱而产生的，往往不同类别、不同程度感性反应组合外显。神机障碍与脏腑、奇恒府、官窍等形体结合，表现为神明障蔽、神明藏匿、神明显露、神明混乱等。通过病毒性脑炎继发癫痫性精神病、多发梗死性血管性痴呆、小儿抽动症3个医案，阐述了辨治感性脑病的临床思路：正确诊断，治本兼顾脑病治气与脑病治脏；控制感性反应症状，治标在于调神养神；正视慢病长疗程，重视心身整体护理；建立个体化方案，跨学科整合论治；根据研究进展，积极采用新方法新手段。 |
| 关键词: 感性脑病 感性反应 神志病 病毒性脑炎继发癫痫性精神病 多发梗死性血管性痴呆 |
| DOI：10.3969/j.issn.1674-070X.2020.08.003 |
| 投稿时间：2020-06-27 |
| 基金项目:国家自然科学基金资助项目（81874463）；湖南省科技厅科技创新平台与人才计划——中医脑病临床研究中心（2017SK4005）；湖南省中医药管理局资助项目（201824）；湖南省级财政中医药项目——名院工程（rsk-010-13[006-09]）；湖南中医药大学校级科研基金（ZYYDX201730）；中医内科学重大疾病防治及成果转化——教育部重点实验室开放基金（ZYNK201609）；湖南省科技厅重点专项（2017SK2111）。 |
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| Differentiation and Treatment of Perceptual Encephalopathy Based on Spiritual Mechanism and Qi Transforming Theory |
| ZHOU Desheng,HU Hua,ZHANG Xuehua,LIU Lijuan,CHEN Yao,GAO Xiaofeng |
| (Department of Neurology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Hengyang County Hospital, The First Affiliated Hospital Group of Hunan University of Chinese Medicine, Hengyang, Hunan 421200, China;Department of Psychiatry, Hunan Provincial Brain Hospital, Changsha, Hunan 410007, China) |
| Abstract: |
| Perceptual encephalopathy which makes perceptual reaction symptoms as the main clinical manifestations, cross departments in the fields of psychosis, neuropathy, psychosomatic diseases, or some special types of internal medicine, surgery, gynecology, and pediatric diseases. The common pathogenesis of perceptual encephalopathy is that the Qi disease, physical diseases and spiritual diseases exist at the same time and affect each other. The symptoms of perceptual reaction are caused by insufficient, overreaction and disorder of Qi transformation. They are often manifested in different types and degrees of perceptual reaction combinations. The combination of the obstacle of spiritual mechanism and the body such as the Zang-fu, the extraordinary Fu-organ, orifice, etc., is manifested in the blocking of spiritual mechanism, the hiding of spiritual mechanism, the revealing of spiritual mechanism, and the disorder of spiritual mechanism. Through 3 medical cases of epileptic psychosis secondary to viral encephalitis and multiple cerebral infarction vascular dementia to tourette's syndrome, this paper expounded the clinical thinking of treating perceptual encephalopathy. The diagnosis should be correct, and the root causes is treated by focusing both Qi and viscera of encephalopathy; the symptoms of perceptual reaction are controlled, and the symptoms are treated by regulating and nourishing the spirit; the long course of treatment for chronic disease should be faced, and attention should be paid to the whole body and mind nursing; the individualized programs should be established, and interdisciplinary treatment is integrated; according to the research progress, new methods and means should be actively adopted. |
| Key words: perceptual encephalopathy perceptual response mental illness epileptic psychosis secondary to viral encephalitis multiple cerebral infarction vascular dementia |
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