Russian stroke tradition

Lead: Ischemic stroke, also known as cerebral infarction or ischemic stroke, is a cerebrovascular disease with high incidence and extremely common clinical symptoms, which leads to ischemic and hypoxic necrosis of some brain tissues, thus causing necrosis and apoptosis of corresponding nerve cells. Traditional Chinese medicine is called stroke, and its clinical features are often sudden fainting, unconsciousness, hemiplegia, numbness of the skin, mouth and eyes askew and other symptoms.

First, ischemic stroke is changeable in condition and complicated in symptoms. The basic pathogenesis of ischemic stroke is yin-yang imbalance.

1, overview

Ischemic stroke often has sudden onset, changeable condition and rapid progress, and its symptoms and signs are also complex and diverse. It has the characteristics of high morbidity, high disability rate, high recurrence rate and high mortality rate, which is extremely harmful to people's health and seriously affects people's quality of life. At present, with the continuous improvement of people's daily living standards, people's average life expectancy has been continuously improved, and China has gradually entered an aging society, and the incidence of ischemic stroke in China has increased year by year.

At present, the western medicine treatment of ischemic stroke in society mostly adopts thrombolysis, anticoagulation, antiplatelet aggregation, improving cerebral circulation, protecting cranial nerves, etc., which aims at improving circulation, scavenging oxygen free radicals, nourishing nerves, etc., but the curative effect is not very ideal for the characteristics of high disability rate and high recurrence rate of ischemic stroke. In recent years, the treatment of ischemic stroke with the thought of Fuyang school has achieved good clinical effect.

2. Theoretical exploration

The academic thought of Fuyang School comes from the "Chongyang Thought" in the classic medical book Huangdi Neijing, which is reflected in Zhang Zhongjing's Treatise on Febrile Diseases. The movement and change of Yin and Yang is the most basic form of movement between heaven and earth, which constitutes the origin of life and the foundation of saving lives.

Zhongjing is a master of medical theory, method, prescription and medicine. His book Treatise on Febrile Diseases is also called the ancestor of prescriptions, and many prescriptions emphasize the importance of protecting Yang Qi. There are only 1 13 prescriptions in Treatise on Febrile Diseases, among which there are 24 prescriptions with dried ginger, 34 prescriptions with aconite and 43 prescriptions with cassia twig, which embodies the idea of treating Chongyang. The most basic viewpoint of Fuyang School is the viewpoint that "Yang dominates and Yin obeys".

The second is the principle of supporting yang, that is, "those who are ill with yang should support yang and suppress yin;" If the disease is in yin, exchange yang for yin. "Fire belongs to Yang, and the pole is made of fire, that is, the pole is made of Yang. The essence of human life lies in taking yang as the foundation, and the basis of treatment legislation also lies in using yang to eliminate internal yin evil, which is particularly important to the human body.

Traditional Chinese medicine believes that the basic pathogenesis of stroke is yin-yang imbalance, qi-blood imbalance and direct attack on the brain, which is related to internal injuries of seven emotions, improper diet, excessive body fat and turbid phlegm. Common diseases include wind, fire, phlegm, blood stasis, qi and deficiency. The symptoms in the acute stage are mainly empirical, and the symptoms in the later stage are mostly mixed with excess and deficiency. In the long-term clinical practice, Dr. Hu Yueqiang and other Fuyang doctors found that yang deficiency is of great significance in the pathogenesis of ischemic stroke.

Based on the concept of "Yang governs Yin's obedience" and the yin-yang noumenon structure of "internal yang and vulva", it is considered that yang deficiency is the root of ischemic stroke, that is, the view of "Yang deficiency is the foundation", and it is further proposed that stroke should be treated as a secondary treatment, that is, clearing up Jiao Yangming first to make yang heat have a way out; Secondly, strengthen the spleen and stomach, so that the center turns; Then the Lord will warm Jiao Yuanyang to ensure that the stroke can be cured.

3. Clinical treatment

Based on the concept of supporting yang, the method of warming and supporting yang is used to treat ischemic stroke, which has many applications in clinical diagnosis and treatment Fuyang recipe combined with aspirin was used to treat patients with cerebral infarction, and it was found that it could significantly reduce the level of hs-CRP and improve the symptoms of neurological deficit.

Patients with cerebral infarction are mostly caused by qi deficiency, spleen and kidney deficiency, phlegm and blood stasis blocking collaterals. Therefore, the method of supporting yang, strengthening spleen and tonifying kidney, warming meridians and dredging collaterals is used to treat patients with acute cerebral infarction, so as to achieve the purpose of strengthening the body resistance and eliminating evil, and its clinical effect is remarkable. The method of supplementing qi and supporting yang was used to treat patients with ischemic stroke. It was found that it can obviously improve the neurological function of patients, improve their daily living ability and reduce the clinical mortality. Acupuncture and moxibustion supporting yang and strengthening body resistance in the treatment of patients with ischemic stroke has also proved its exact clinical effect.

Second, the process of understanding the name of stroke in past dynasties, and different views on the disease in different eras need to be understood.

Traditional Chinese medicine has experienced a long and long historical process in understanding the name of stroke. Before the Han Dynasty, in the pre-Qin era when a hundred schools of thought contended, various academic thoughts were in full bloom. But as far as doctors are concerned, from the existing literature records, we can find that there was no systematic understanding and naming concept of stroke in the medical field at that time, but there were related symptom descriptions and similar records of stroke.

1, understanding of the etiology and pathogenesis of stroke from pre-Qin to Tang and Song Dynasties

There is a saying in Huangdi Neijing and Su Wenfeng Lun that "wind is the cause of all diseases, and when it changes, it is the cause of all diseases", and its article Su Wen Gu Kong Lun also says that "wind is the cause of all diseases". As the first pathogenic factor of human body, pathogenic wind is changeable in nature and diverse in pathogenic forms, so many early doctors will

"On Su Wenfeng" said: "Wind hurts people, or because of deficiency heat, or because of heat ... or because of dryness, or because of wind"; The above article holds that the symptoms of stroke such as dryness and wind are caused by exogenous pathogenic wind entering the stomach, or being born in the body, or being born in the camp, or entering the viscera. At the same time, the deficiency of vital qi, weakness of zang-fu organs, dysfunction of zang-fu organs, and insufficient metabolism of qi and blood in ying and Wei are also important factors, which lead to the decline of human body's external defense ability, unstable external defense and the existence of pathogenic factors alone.

On the basis of inheriting predecessors' viewpoints, Zhang Zhongjing constantly improved the viewpoint of "exogenous pathogenic wind", and then pushed it to a commanding height, that is, put forward the viewpoint of "endogenous deficiency and pathogenic wind in the middle". Zhongjing believed that stroke was caused by the loss of vital qi, the decline of viscera function, the emptiness of blood vessels and meridians, the instability of defensive surface, and the wind and pathogenic wind taking advantage of it, which led to the disease.

This view makes it clear that the invasion of exogenous pathogenic wind is of great significance to the occurrence of stroke and has a great influence on later physicians. At the same time, according to the severity of stroke, Zhongjing divided it into different types, such as meridians, viscera and viscera, which further deepened people's understanding of the disease and started people's research on the classification and grading of stroke.

2. Understanding of the etiology and pathogenesis of stroke in Jin and Yuan Dynasties.

In the Jin and Yuan Dynasties, with the further development of society and the continuous improvement of medical level, people's understanding of stroke was further deepened. Compared with before the Tang and Song Dynasties, the viewpoint of exogenous wind began to decrease gradually, while the viewpoint of endogenous wind began to be put forward by some doctors, and the viewpoint of endogenous wind began to be debated from different levels, and the academic field contended, among which Liu, Liu, Liu and Liu were four representatives.

Liu is a representative figure of "cold door", and he advocates that "six qi can turn into fire". Under the guidance of his academic thought, he put forward the viewpoint that stroke is actually "five emotions turning into fire" and "extreme heat generating wind", which initiated the theory of wind evil in the middle wind and made an important step towards the research and development of the etiology and pathogenesis of stroke.

Hejian believes that the occurrence of stroke is based on heat and marked by wind. In the final analysis, those who say wind evil still have to say heat evil. All six qi can be turned into fire, and fire is heat. When it is hot, it will lead to wind, which will rush to the brain and meridians, leading to diseases. At the same time, the five ambitions are too extreme, the emotions are out of control, the heart is very strong, and the kidney water is insufficient.

Kidney water can not help heart fire, heart fire can not be restrained, and heart fire can also lead to stroke and hemiplegia. Spleen and stomach are the acquired foundation of human body and the source of qi and blood biochemistry. When the spleen and stomach are injured, the source of qi and blood biochemistry will be deficient, the viscera will be damaged, and the vital qi will be insufficient, which will cause various pathogenic impurities to accumulate in the body and block blood vessels. If it lasts for a long time, it will have a stroke.

3. Understanding of the etiology and pathogenesis of stroke in Qing Dynasty.

During the Ming and Qing Dynasties, the academic thought of evil wind developed further, and people deepened the theory of internal wind on the basis of inheriting the views of predecessors, among which a large number of excellent physicians emerged. Jing Yue said: Non-wind is a disease, which is what people usually call a stroke. Its symptoms are mostly sudden fainting and unconsciousness.

Its etiology is caused by internal injury, deficiency of qi and blood, and decline of viscera function, rather than exogenous wind evil, which obviously abandons the viewpoint of exogenous wind theory of stroke. Li Zhongzi, another physician at the same time, after summing up his long-term clinical experience, divided the viscera in stroke into closed syndrome and separated syndrome, further clarified and refined the classification of stroke diseases, which provided help for future generations to further study stroke.

The liver is a general's official, and it's just dirty. Its body is yin and yang is used, and the liver stores blood. The liver is nourished by the yin blood of the liver. If yin and blood are insufficient, yin and yang are unbalanced, and liver yang is hyperactive. But the liver and kidney are homologous, and the essence and blood alternate, and the liver blood is nourished by the yin essence of the kidney. Liver and blood deficiency, kidney yin deficiency, water without wood, but the fire moves to the wild, and the deficiency fire gets angry, which is more likely to lead to yang hyperactivity and wind, resulting in stroke.

In Qing Dynasty, Wang Qingren believed that stroke was caused by qi deficiency and blood stasis. We know that "Qi is handsome for blood", and the normal operation of blood in blood vessels needs the promotion and fixation of Qi. However, due to the lack of vitality and healthy qi, the promotion function of qi will inevitably decline, qi deficiency can not maintain the normal operation of blood, blood circulation is slow and weak, and blood stasis will occur for a long time. Stagnation of blood stasis, obstruction of blood vessels, empty veins, dysfunction of human organs, skin, meridians and other functions, and finally stroke.

Conclusion: Stroke is the first of the four difficult diseases in ancient China. In the process of understanding the etiology and pathogenesis of stroke, doctors in past dynasties put forward various theories on the pathological mechanism of stroke according to their long-term clinical understanding of the disease and the experience of predecessors. Before the Tang and Song Dynasties, the etiology of stroke was mainly based on the theory of "external wind", and after the Tang and Song Dynasties, it was mostly based on the theory of "internal wind". Up to now, it is generally believed that deficiency, fire, wind, phlegm, blood and qi are combined to cause disease.