从“伤-生-显”分期探析中风病发病机制及治未病策略

基于中医学未病先防理念，提出应注重时间在中风病发生过程中的作用，根据正邪变化及脏腑生理，从健康状态到中风病发病的过程以时间为轴可分为“伤-生-显”3个阶段，应针对不同阶段的特点分期进行预防。提出正气损伤期为中风病萌芽之时，以随时间积累的正气损伤、脏腑损耗为病机，应以未病养生为主要策略，从饮食、情志、锻炼等方面顾护正气，防其损伤；病邪内生期为疾病发展阶段，以风火痰瘀之邪内生为主，应该防病调护，采用食疗等方法祛除内邪并改善体质；症状显露期提示中风先兆，宜见微知治，以治为防，防治结合，采取针灸、药物等方法及时治疗，以防其进一步发展为中风。

Exploration of Pathogenesis and Strategies of "Treating Disease Before It Arises" onStroke Based on Staging of "Injury-Generation-Manifestation"

Abstract： Based on the concept of prevent disease before it arises in Chinese medicine， this articleproposes that attention should be paid to the role of time in the process of stroke occurrence. Based on thechanges of healthy qi and pathogenic qi， as well as the physiology of zang-fu organs， the process fromhealth status to stroke onset can be divided into three stages based on time axis： "injury-generationmanifestation"，and the prevention should be carried out in stages according to the characteristics ofdifferent stages. It is proposed that the period of injury to the healthy qi is at the beginning of stroke，withthe accumulation of injury to healthy qi and loss of zang-fu organs over time as the pathogenesis. The mainstrategy should be to carry out health preservation before illness，taking into account factors such as diet，emotions， and exercise to protect healthy qi and prevent its injury. The endogenous period of pathogenicfactors is the stage of disease development， with wind， fire， phlegm， and blood stasis as the mainpathogenic factors； the disease prevention and regulation should be carried out， and methods such asdietary therapy should be used to eliminate internal pathogens and improve constitution. The symptomexposure period indicates the omen of stroke， so it is advisable to treat with a few symptoms， taketreatment as prevention， combine prevention and treatment， and take acupuncture and moxibustion，medicine and other methods for timely treatment to prevent it from further developing into stroke.