王永炎教授对中风病"阳(气)虚化风"的病机认识

本文就王永炎教授提出"阳(气)虚化风"的中风发病新机制的意象诊疗过程、历代相关研究、风的概念的诠释和西医学相关疾病基础及机制几方面进行阐述。王永炎教授通过长期临床实践,发现部分患者在中风病发病之初即表现为气虚甚则阳虚为主的征象,症见肢体松懈瘫软、精神萎靡不振、面色白光白、劳则更甚等;常规治疗效果不佳,而用益气温阳法治疗后改善显著,根据临床病证现象及证治效验的观察,在"以象为素,以素为候,以候为证"的意象诊疗过程中总结出中风病"阳(气)虚化风"的发病新机制。其不同于历代医家气虚或阳虚中风的理论,而是在中医理论及临床疗效支持的基础上,依据其临床基础疾病及相应血流动力学改变,结合西医学缺血性脑血管病的特点对其发病机制进行探讨。中风病"阳(气)虚化风"论的提出是从疾病和证候、治疗与验证的过程中形成的中风病发生新机制,是对中风病急性期以"风火痰瘀"为核心证候病机的补充完善。

Professor Wang Yongyan's theory of "yang(qi)deficiency generating wind"for the mechanism of stroke

This paper elaborated on "yang(qi)deficiency generating wind"as the stroke pathogenesis, proposed by Professor Wang Yongyan,from the following aspects:diagnosis & treatment,previous re-search,interpretation of wind in TCM,and understanding of this disease in Western medicine.From long-term clinical practice,Professor Wang Yongyan found that at the beginning of the stroke onset,qi defi-ciency even yang deficiency symptoms were commonly present in some patients,including flaccid limbs, lassitude,and pale complexion,which were aggravated upon physical exertion.Boosting qi and supple-menting yang appears to be more effective than usual treatment methods.Professor Wang proposed this new pathogenesis theory from an imaging diagnostic process of "identifying causes from manifestations,i-dentifying symptoms from causes,and identifying pattern from symptoms".Differing from the previous views of "qi deficiency or yang deficiency inducing stroke"held by ancient TCMpractitioners,Professor Wang's theory is based on both clinical practice and TCMtheory with reference to corresponding changes of hemodynamics and pathogenesis of ischemic cerebrovascular disease in Western medicine.The theory, yang(qi)deficiency generating wind,was developed as a new pathogenesis of stroke from the disease, symptoms,treatment,and clinical validation,so as to supplement and improve the core pathogenesis,"wind,fire,phlegm and blood stasis"for the acute phrase of stroke.