脑桥中央髓鞘溶解症中医诊疗思路探讨

本文整理及讨论脑桥中央髓鞘溶解症的中医病因病机及治疗思路,为临床进一步研究做参考。笔者认为脑桥中央髓鞘溶解症早期发病以厥证为主,后期向偏枯转变。病因病机早期为阳气亏耗、气机逆乱,后期多见正虚邪中。治疗上可分先兆期、早期、后期3期辨证施治。先兆期注意防病调控,对症治疗,以阻断疾病发展为目的;早期发病以扶阳固脱,醒脑开窍为主,尽快调整患者阴阳气血回复平衡;后期以扶阳调神为法,促进患者功能康复。治疗过程尤应注重扶阳及调神,方法上采用内外相辅,针药结合。

Discussion on TCM Diagnosis and Treatment of Central Pontine Myelinolysis

This article aims to summarize and discuss the etiology,pathogenesis and treatment of central pontine myelinolysis in Traditional Chinese medicine(TCM)in order to provide reference for further clinical research.It suggested that the central pontine myelinolysis was similar to the syncope syndrome in TCM in the early onset,then turned into partial decrepitude in the later stage.On the analysis of pathogenesis,it found that qi disorder happened early,while the evil dominated in the later stage.The whole course could be divided into 3 stages:the precursor stage,the early stage,and the later stage.In the precursor stage,attention should be paid to the prevention and control of the disease,and symptomatic treatment should be taken to block the development of it.In the early stage,adjust the balance of Yin,Yang,Qi and blood as soon as possible.And in the later stage,the treatment should be promoting the functional recovery of patients with the method of regulating the spirit and protecting yang.During the course,Shen and Yang are the nucleus of the therapy.In the method,internal and external supplements are used,combined with acupuncture and medicine.