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1.广东药科大学,广州 510006
2.中国中医科学院 西苑医院 国家中医心血管病临床医学研究中心,北京 100091
3.中国中医科学院 西苑医院,北京 100091
Received:06 May 2022,
Published Online:27 July 2022,
Published:05 November 2022
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刘凤岚,朱梦梦,王青等.心血管病继发认知障碍与心脑同治的中医药防治策略[J].中国实验方剂学杂志,2022,28(21):179-184.
LIU Fenglan,ZHU Mengmeng,WANG Qing,et al.Traditional Chinese Medicine Prevention and Treatment Strategy of Cognitive Impairment Secondary to Cardiovascular Disease and Simultaneous Treatment of Heart and Brain[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(21):179-184.
刘凤岚,朱梦梦,王青等.心血管病继发认知障碍与心脑同治的中医药防治策略[J].中国实验方剂学杂志,2022,28(21):179-184. DOI: 10.13422/j.cnki.syfjx.20222194.
LIU Fenglan,ZHU Mengmeng,WANG Qing,et al.Traditional Chinese Medicine Prevention and Treatment Strategy of Cognitive Impairment Secondary to Cardiovascular Disease and Simultaneous Treatment of Heart and Brain[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(21):179-184. DOI: 10.13422/j.cnki.syfjx.20222194.
心血管病患者继发认知障碍是老年人群的常见并病,严重危害患者健康,影响长期生存质量,心血管病可导致血管内皮损伤,脑灌注不足,脑部病变,继而引起认知障碍,心血管危险因素也会增加患者继发认知障碍的风险,积极寻求早期诊断及中西医结合防治方法尤为重要。中医基于“整体观念”提出“心脑相通”,心脑相通共主神明,心伤可累及脑,导致神志异常,是心血管病继发认知障碍的病因。后世医家基于“异病同治”和心脑相通,提出“心脑同治”。“心脑同治”包含两种含义,一为不同疾病归同一病因病机,可用同一方法治疗;二为异病共存,针对相同危险因素进行治疗。该文系统探讨了心血管疾病继发认知障碍的中医病因病机及心脑同治的防治策略,认为气血不足是基础,瘀毒互结阻脉、损窍是关键,调畅气血,活血解毒通脉、通窍为其主要治法,以期丰富“心脑同治”的理论内涵,为中医药防治心血管病继发认知障碍提供新的思路。
Cognitive impairment secondary to cardiovascular disease is a common complication in the elderly population, which seriously threatens the health of patients and affects the long-term quality of life. Cardiovascular diseases can lead to vascular endothelial injury, cerebral hypoperfusion, and brain lesions, and then cause cognitive impairment. Cardiovascular risk factors also increase the risk of secondary cognitive impairment in patients. It is particularly important to seek for early diagnosis and traditional Chinese medicine (TCM) and western medicine prevention and treatment. Based on the "holistic concept", TCM puts forward the theory of "the connection of heart and brain". The heart and brain are connected and both are in charge of mental activities. Heart injury affects the brain, resulting in abnormal consciousness, which is considered to be the pathogenesis of cognitive impairment secondary to cardiovascular disease in TCM. Later generations of doctors propose the theory of "simultaneous treatment of the heart and the brain" on the basis of "treating different diseases with the same treatment" and "the connection of heart and brain". The theory contains two meanings. One is that different diseases can be treated by the same method because of the same etiology and pathogenesis. The other is the coexistence of different diseases and the treatment should be targeted to the same risk factors. This paper systematically discussed the TCM pathogenesis of cognitive impairment secondary to cardiovascular disease and the prevention and treatment strategy of "simultaneous treatment of the heart and the brain". In this paper, the deficiency of qi and blood was the foundation, and the interaction of blood stasis and poison and the obstruction of the pulse and the loss of the body were the key factors. Activating blood, detoxifying arteries, and connecting the orifices were the main treatment method for the disease. This paper is expected to enrich the connotation of "simultaneous treatment of the heart and the brain", and provide new ideas for the prevention and treatment of cognitive impairment secondary to the cardiovascular disease with TCM.
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