中医体质学说在中风病一级预防中的理论研究
摘要
中风病又名卒中,是一种以突然昏仆,不省人事,半身不遂,口舌踻斜;或不经昏仆,仅以半身不遂,口舌歪斜,言语不利,偏身麻木为主要表现的病症,是现代中医临床常见疾病。一般来说,相当于西医学的急性脑血管疾病出现上述症状者。中风病以其发病急骤,变化难测,病情危重,后遗症多而列风劳臌隔四大难症之首,自远古以来就受到医家重视,是历代医籍中论述最多、理论观念争执最繁杂的疾病之一。
正是由于中风病复杂难治,预后多不理想,所以若能够在发病之前,就采取措施以阻止中风的发生无疑是最理想的,因此历代医家都非常重视对中风病预防的研究。在这方面做了一些论述,其中不乏真知灼见,直到今天仍值得我们在开展中风病预防工作时研究借鉴并发扬光大。中医预防强调“治未病”,主张从整体观念出发,坚持辨证施治,注重人体脏腑阴阳气血的调衡,充分发挥人的自主健康能力,其作用涵盖了中风病病前、病中和病后的所有层面,具有系统、全面的优势。现代临床研究也证明,使用中医药预防中风病具有较好的效果,因而受到广泛的关注。
但是,对比现代预防医学在中风病预防方面取得的成就,中医学对中风病预防的研究和临床实践,越来越表现出一定的差距,主要表现在以下几个方面:
首先是对中风病危险因素认识的局限性。现代预防医学认为中风病的危险因素分为不可干预因素和可干预因素两类。前者包括年龄、性别、种族等;后者包括高血压、糖尿病、心血管疾病、血脂异常、动脉硬化等疾病以及抽烟、酗酒等不健康的生活方式。在这种认识的指导下,现代预防医学通过危险因素筛查,可以确定中风患病的高危人群,并对高危人群所具有的危险因素开展有针对性的干预和治疗。如通过药物控制血压,积极治疗糖尿病和心血管疾病;通过药物和饮食调控血脂,改善动脉硬化等;通过宣教,帮助人们改良生活方式,戒烟限酒等等。这些对中风危险因素的认识明确客观,采取的干预措施操作性强,较为规范,便于采用。反观传统的中医学,对中风病危险因素的论述从文献中可以看到的,涉及年龄、性别以及不良生活方式和饮食习惯等,所以更多地强调通过养生保健来防止中风病的发生,而对可能引起中风的各种基础疾病的认识则是空白。
其次是未病先防思想空洞化。现代医学提出三级预防理论,对疾病分别进行病前、病中及愈后的处理。其中一级预防也称对因预防,是指对引起疾病的各种危险因素开展预防工作。中医预防理论中的未病先防思想与西医的一级预防理论从概念上差别不大,但如上所述,对疾病的危险因素认识的差距就较为明显。由于这种差距的存在,所以中医未病先防工作,仅仅局限于对中风先兆证的认识治疗以及养生保健,并不包括对基础疾病的治疗。而随着现代影像技术、实验室检验技术的发展,医学界对中风先兆证日益深刻,已经把它归入中风病二级预防范畴。这样,所谓未病先防,其实仅剩下养生保健的内容。养生保健固然重要,但传统中医学的养生方法并不强调“危险人群-适宜的养生方法-降低患病风险”这一模式,养生方法的针对性不强,较为笼统,在现代社会紧张的工作压力和快捷的生活节奏之下,容易造成危险人群的依从性不强,使养生保健方法起不到应有的作用。综上所述,未病先防思想虽然是我们的祖先最早提出的预防思想,曾为保证人类健康做出过巨大贡献,但是在现代社会,正逐步被空洞化。
针对以上中医预防理论的不足,如何加以弥补,使之重新焕发生机和活力,是摆在我们每一个中医人面前的重要课题。而随着中医体质学说的发展和对现代预防医学的借鉴,这个课题的解决已渐露曙光。
现代医学预防理论的发展虽然取得了辉煌的成就,但是也存在一些明显的缺陷。主要表现在对疾病的认识往往依赖于生化指标检测和影像等技术的发展,不能象中医学那样,以符合系统理论的观点来认识疾病;又如普遍成本较高,难以满足中风病预防的长期性要求,等等。但是现代医学一级预防理论中对中风病危险因素的认识却给了我们极大的启发。如果中医学能够象现代医学那样发现并干预决定中风发病的更为本质的因素,不就能够真正使未病先防的理念落到实处了吗?
要实现这个目标,传统中医学的辨证论治体系明显力所不逮,因为辨证论治的着眼点在于证,而中风发病前,虽然有一个内伤积损的过程,但是其证候即使表现出来,也未必与中风发病时的证候相同,而且证候表现的时间相对短暂,对证治疗难以触及疾病的实质。这大概就是传统中医文献中,论及预防,必谈养生,而不强调利用方药开展疾病预防的主要原因。
上个世纪七十年代末以来,中医体质学说研究逐渐兴起,使中医学对疾病本质的认识有了新的深化。中医体质学说是中医基础理论的组成部分,本于传统中医学的辨证论治体系,同时又跳出了“辨证”的框框,把疾病的发生、各种证候的发展以及预后转归等等临床事件更多地归因于人的体质。中医体质学说定义的体质是一种体现了人的结构、功能和心理相统一的状态。这种状态源于先天,故在相当长的时间里可以保持稳定;同时又成于后天,在一定条件的干预下,会发生变化。人的体质状态可以通过对机体脏腑功能、阴阳气血等方面的观察来衡量和描述。基于以上认识,中医体质学说主张人在体质健康的条件下,不会或不易发生疾病,即使发生疾病,往往预后良好。但在多数情况下,人的体质是不平衡的,表现出各种偏性,这种偏性就会决定疾病的发生和变化,反过来疾病也会对体质的偏性造成影响。因此预防和治疗的目的都是保证体质状态平衡无偏,而基本方法,则是通过辨识体质,了解其偏性并加以干预以促使其回到平衡状态。
利用体质学说开展中风病预防,就是通过对导致中风发病的危险因素进行中医体质学辨识,并通过改善体质,从根本上阻止这些危险因素对机体的侵害而得以实现。因而更深刻、更具有针对性。中医体质学说倡导的“治未病”理论包含了丰富的三级预防思想,特别强调一级预防。因此,在中风病的预防中日益显现出其科学价值。
研究目的
通过文献研究,对中医学预防中风病传统理论和方法进行反思,结合现代预防医学对中风病预防的认识,对以往利用中医体质学说进行中风病预防的实践进行总结,尝试依照体质学的原则,为中风病一级预防提供具有可操作性的方案。
研究方法
1.搜集资料
以我校图书馆馆藏资料为基础,辅以网上检索和个人购买的图书。资料来源有如下五个方面:
1.1今人点校出版的中医典籍丛书或类书。如《明清名医全书大成》、《中国古今医案类编》、《近代中医珍本集》、《常见病证中医文献专辑》、《黄帝内经研究大成》、《传世藏书·子库·医部·第六册》,等等,均列入参考文献范围。有些丛书或类书的内容有所重复,正可相互参校。
1.2单行本的医经、医话和医案。如《黄帝内经素问校注》、《灵枢经》、《金匮要略译释》、《千金要方》、《千金翼方》、《医贯》、《卫生宝鉴》、《冉雪峰医著全集》、《医学衷中参西录》、《金匮翼》、《增评医学心法》、《雪雅堂医案附:类中秘旨》、《医学真传》、《孟河四家医籍》、《风劳臌膈四大证治》、《医学心悟》、《金元四大家医学全书》、《张山雷医集》、《张聿青医案》,等等。
1.3现代和当代出版的中风研究和中医体质学说方面的专著。如《近代中医名家论治中风病荟萃》、《当代名医证治汇粹》、《中国名老中医专家学术经验集》、《近代中医流派经验选集》、《清代名医医术荟萃》、《中医体质学》、《中国历代医论选讲》、《中医百家医论荟萃》、《中风病防治研究》、《古今医家诊治中风经验及发挥》、《中医体质学》、《人体体质学——理论、应用和发展》、《中国脑血管病防治指南》,等等。
1.4信息量巨大的电子出版物。如《中华医典》、《文渊阁四库全书电子版》。对部分难以找到原始文献的古代医书来说,这也不失为一种补救的办法。
1.5 CNKI、万方、VIP等国内权威的期刊全文数据库和论文数据库。下载近14年来有关中医防治和研究中风的主要论文400余篇,作为本论文写作的重要参考文献。
2.资料研究内容
选择具有代表性的历代医家之医论医案以及现代医学的部分资料进行归纳和总结,分成三个子专题进行论述,一是中医学中风预防理论的总结和反思,二是中医体质学说理论和实践的总结,三是利用体质学说开展中风一级预防的实践总结和理论探索。
研究结果:
1.中风预防理论和实践的总结与反思
以中医学关于中风病病因病机学说的演化为纲,系统整理了从古至今中风病预防的理论和实践,并在篇后小结中对中风病预防理论和实践的不足之处进行了阐发。
中风病因病机学说的演变大体经历了四个阶段,一是《内经》阶段,二是外风说阶段,三是内风说提出,但医家内外风兼采阶段,四是独重内风阶段。在这四个阶段中,对中风病预防的认识各有特点,总的说来呈现逐渐丰富的趋势。《内经》时期,医家对中风病的病因病机认识已经较为全面,以外风认识为主,但非常重视体内因素对发病的作用,很多理论成为后世内凤医家立论的基础。但是基于《内经》多理论探讨,少临床记录的特点,这个时期对中风病预防的认识较为丰富,但除了摄养辟邪外,很少其他的预防方法。外风说时期对中风病因病机的认识偏重于“内虚邪中”,在这种理论的指导下,中风病的防治偏重于疏风散邪,也有通过养生或针灸等方法改变“内虚”状态的记述,但显然并未得到重视。金元医家提出了“内风致中”的理论,开启了探讨体内因素在中风发病中的作用的新篇章,但是从那时起直到清代中期,绝大多数医家是内外风说兼采以内风为重,即同时肯定内风和外风在中风发病中的作用。在这种病因病机认识的指导下,产生的中风病预防思想基本同时包括了对外风的抵御疏散以及对内风致病因素的处理和干预,但是这种处理和干预往往发生在中风发病后,属于既病防变的范畴。近现代以来,随着中医学对脑的生理病理的认识逐渐加深,大多数医家全面摒弃了中风病的外风认识,独重内风,在此思想指导下,产生的中风病预防理论,也是重点改善体内环境,平熄内风。
在总结了中风病预防理论和方法之后,笔者认为,参考现代医学在预防中风方面的成就,传统中医学存在着明显的缺陷和不足。主要包括:(1)对中风病危险因素的认识不够;(2)未病先防思想空洞化。所以中医的中风病预防只能局限于既病防变,也就是西医学的二级预防,不能在未病先防即一级预防方面发挥更大的作用。
2.全面归纳和总结了中医体质学说的研究进展。
包括:(1)中医体质学说的发展源流,总体上呈现体质学思想与临床实践的结合日趋紧密;(2)中医体质学说的基本观点和方法,对上世纪七十年代末以来的中医体质学说的研究状况和主要成果进行回顾和总结,介绍了辨识体质防治疾病的基本方法;(3)中医体质学说在疾病预防中的应用,从中医预防理论以及现代医学预防理论的角度,分别论述了中医体质学说在疾病预防特别是未病先防和一级预防中的作用。
3.总结和探索:利用中医体质学说开展中风一级预防的理论和实践
介绍了现代医学对中风病的一级预防成果,利用中医体质学说的观点和方法,对现代医学关于中风病危险因素的认识、现代人群的体质特征、老年人的体质特征等问题,择要进行诠释,综合文献提出中风病的好发体质类型。在此基础上总结和探索利用体质学说,辨识人群体质进行中风病危险因素筛查,进而针对这些危险因素总结和研究具体的预防方案,从而使中风病未病先防的理念真正落到实处。
结论
1.传统中医学预防中风病的理论和实践既有科学合理的成分,也存在与当代社会特点不相适应的缺陷和不足,这些缺陷和不足主要表现在:
(1)对中风病的危险因素认识不够,没有认识到眩晕等(类现代高血压)疾病在中风发病过程中的作用;
(2)不能真正落实未病先防理念,即对于中风发病的预防不力。
2.当代中医体质学说对疾病预防特别是未病先防具有特殊重要的意义。
3.运用中医体质学说的理论和方法,可以:
(1)通过诠释现代医学的概念,深化对中风发病危险因素的认识;
(2)为中风病未病先防开拓了新的干预范围;
(3)根据体质特点,确定有针对性的养生保健方案;
(4)在中医预防医学与现代预防医学之间构筑起交流的平台
最终认为利用当代中医体质学说开展中风病的治疗以及预防,是未来中风病预防工作的发展方向之一。
Apoplexy has another name called stroke,is a kind of disease with stupor and falling down suddenly and senselessly,hemiplegia,oblique mouth and tongue. Or without stuporand falling down suddenly,just with hemiplegia,crooked mouth and tongue,speaking unsmoothly,and half of the body numbly.It is a clinical common disease of Traditional Chinese Medicine nowadays.Generally speaking,it equals to acute cerebral vascular disease with symptoms above approximately in Western medicine.Apoplexy disease is the head of four difficult diseases in the ancient times for having the characters of abrupt invasion,being difficult to forecast its changes,serious condition and various sequela.Since the ancient times,it has been paid most attention by medical scientists.And it has been one of the disease witch discussed most frequently and raised most miscellaneous disputes in the historical medical books.
Just because apoplexy is complicated to cure while having unsatisfactorily prognosis,if it could be prevent from emergence before its invasion by taking measures,it will be most ideal undoubtedly.So medical scientists had paid much attention to researching the preventing theories and methods and made a lot of argumentation in this respect since ancient times on.There are so much penetrating and correct judgement among them,and deserves to study and develop while we carry out the jobs of prophylaxis of apoplexy today.The prophylaxis of Traditional Chinese Medicine focuses on "Curing not disease ",and advocates proceeding from the concept of viewing the situation as a whole,insists on identifying symptoms for remedy,pay attention to adjusting the situation of human internal organs,negative and positive,qi and blood to maintain the state of hamony.give full play to people's independent health ability,before its function has contained apoplexy,the disease neutralized all aspects after being ill,have systems,overall advantage.Modern clinical research proves too,use traditional Chinese medicine to prevent apoplexy from having better results,therefore receive the extensive concern.
However,compare with modern preventive medicine and prevent the achievement that the respect is made at apoplexy,traditional Chinese medicine demonstrates certain disparity more and more to research that apoplexy prevents and clinical practice,mainly shown in the following several aspects: It is to hitting the limitation that the critically ill dangerous factor of wind realizes at first.Modern preventive medicine thinks the dangerous factor of apoplexy is divided into and can't intervene the factor and can intervene two kinds of factors.The former includes age,sex,race,etc.;And then person including last disease,fat of blood unusual,arteriosclerosis,etc.disease and smoke,unhealthy life style of getting drunk etc.at blood pressures high, candy urine disease,energies.Under the guidance of this kind of understanding, modern preventive medicine sifts checking through the dangerous factor,can confirm the high-risk group that apoplexy is ill,and launch pointed intervention and treat to the dangerous factor that the high-risk group have. If control blood pressure through the medicine,treat diabetes and cardiovascular vessel disease actively;Adjust and control the fat of blood through medicine and diet,improve arteriosclerosis,etc.;Through the propaganda and education,help people to improve the life style,give up smoking wine of limit,etc..The understanding of dangerous factor of apoplexy is clear and objective,the intervening measure taken is operational and strong, comparatively standardize,it is easy to adopt.Review traditional traditional Chinese medicine,can see to hitting the argumentation of the critically ill dangerous factor of wind from the literature,involve age,sex,bad life style and eating habit,etc.,so put emphasis on preventing the occurrence of apoplexy by health care more,it is blanks to causing the understanding of different basic diseases of apoplexy.
Secondly it is the not disease that defends the thought cavity first.It propose prevention theory tertiary medical sciences modern,it separately last disease disease,at disease and treatment after healing.Among them first class prevention calls and prevents correctly too,mean that launches the work of preventing from to various dangerous factors which causes disease.Chinese medicine prevent theory disease defend thought first and first class prevention theory of Western medicine difference strong at concept,butas stated above,the disparity realized to the dangerous factor of disease is comparatively obvious.Because of the existence of this kind of disparity, so the Chinese medicine not disease defends working first,only confine treatment and health care to the understanding of apoplexy omen card,exclude the treatment of the basic disease.And with the development of modern image technology,laboratory inspection technology,the medical circle is deep day by day to the apoplexy omen card,have already included it in second prevention category of apoplexy.Like this,the so-called not disease is defended first, in fact only have a content of health care left.Health care is no doubt important,but the traditional traditional Chinese medicine health care method does not emphasize "the dangerous crowd-suitable health care method-reduce the ill risk" This mode,the pertinence of the method is not strong that keeps in good health,comparatively generally,under modern society's tense working pressure and swift rhythm of life,it is apt to cause the compliance of the dangerous crowd not strong,make the method of health care ineffectual.In sum,not the disease has defended the thought first it is the prevention thought that our ancestor puts forward first,once made enormous contribution in order to guarantee human health,but in the modern society,quilt cavity progressively.
Prevent the deficiency of the theory to the above-mentioned Chinese medicine, how remedy,make it radiate vigour anotherly,it is the important subject in front of our every Chinese medicine person.And with the development of the physique theory of Chinese medicine and reference of modern preventive medicine,the settlement of this subject has already revealed the dawn gradually.
Modern medical science has prevented the development of the theory and made the brilliant achievement,but there are someobvious defects.Mainly display the development often depending on technology such as detection and image of biochemical index in the understanding of disease,can't know disease for the view which accords with the systematic theory like traditional Chinese medicine;The and for example general cost is relatively high,it is difficult to meet the chronic requirement that apoplexy prevents,wait a moment.But the first class prevention theory of modern medical science has given us great inspiration in hitting the understanding of the critically ill dangerous factor of wind.If traditional Chinese medicine can be found and intervened more essential factor that apoplexy of decision have illness coming on like modern medical science,can not really make the not idea that the disease has been defended first fulfill?
Should realize this goal,the dialectical theory of traditional traditional Chinese medicine manages the obvious strength of the system and does not capture,because the starting point thatthe dialectical theory manages lay in the card,and before apoplexy has illness coming on,though a internal injury accumulated the course decreased,but its card is waited even show,it is the same that the card when may not have illness coming on with apoplexy either is waited,and it is relatively transient that the card waits the time to display,it is difficult to touch the essence of disease to verify the treatment. This is probably in literature of traditional Chinese medicine,touch upon and prevent,must talk about keeping in good health,and the main reason not putting emphasis on utilizing square medicine to launch the prevention from suffering from the diseases.
Last century was since the end of the seventies,the physique theory of Chinese medicine has been studied and risen gradually,make the essential understanding to disease of traditional Chinese medicine have new promotion. The physique theory of Chinese medicine is a component of the basic theory of Chinese medicine,originally manage the system in the dialectical theory of traditional traditional Chinese medicine,while jumpedout "Dialectical "Circle,the disease one emergence,various card development and prognosis that wait transfer to if belonging to,wait a moment for there aren't incidents clinical.The physique that the physique theory of Chinese medicine defines is a kind of state with unified structure,function and psychology which reflects the person.This kind of state comes from being congenital,so can remain stable during quite a long time;While will become it the day after tomorrow,under the intervention of certain condition,will change.People's physique state can be weighed and described through observation of respects such as organism internal organs function,negative and positive qi and blood,etc..Because of the above-mentioned understanding,the physique theory of Chinese medicine maintains people are under the condition of the physical health,disease that will not be or not inci(?)t,even disease takes place, often the prognosis is good.But under most s(?)uations,people's physique is uneven,demonstrate various bias,this kind of(?)as will determine taking place and change of disease,disease will cause infl(?)ce on the bias of the physique conversely.So prevent and therapeutic purpos(?)is all to guarantee the state equilibrium of physique is not partial,and b(?)sic tool,understand its bias and intervene in order to impel it to get ba(?)to equilibrium state through distinguishing the physique.
Utilize the physique theory to prevent apopl(?)y,but through to leading to the fact the dangerous factor that apoplexy has illness coming on learns to distinguish the physique of Chinese medicine,pass the physique of improving, prevent the infringement of the organism of these dangerous factors and can realize fundamentally.Therefore is deeper,mo(?)e pointed.The physique theory of Chinese medicine was advocated "Cure the not disease" The theory includes the abundant tertiary prevention thought,especially emphasize first class prevention.So,display its scientific value in the prevention of apoplexy day by day.
Purpose:
Study through the literature,prevent traditional theory of of apoplexy and method to review to traditional Chinese medicine,combine the understanding that apoplexy is prevented of modern preventive medicine,summarize practice that utilized the physique theory of Chinese medicine to prevent apoplexy in the past,the principle trying to be studied according to the physique,offer for first class prevention of of apoplexy and have effective schemes.
Methods:
1.collecting the materials
Based on materials in storage of library of our school,complementing with searching in the Internet and books purchased The source of the materials includes five respects the following:
1.1 The series of books or reference books of the ancient TCM which reviewed and proofreaded by moderns.
1.2 The ancient classical medicine books,medical commentaries and medical anamneses in the form of single-article pamphlet.
1.3 The monographs of researching in apoplexy and physique theory of TCM which published in Modern and contemporary.
1.4 The electronic publications with enormous information.
1.5 The full text databases of periodicals and theses with domestical authoritative such as CNKI,Wanfang,VIP,etc.I have downloaded more than 400 sorts theses about preventing and curing and studying apoplexy in Chinese medicine of the past 14 years,as the important references of writing of this thesis.
2.Research contents of the materials
Choose medicine that cures the family representative successive dynasties to talk about some materials of the medicine case and modern medical science to sum up and summarize,divided into three sub special topics and described, first,traditional Chinese medicine apoplexy prevents summary and introspection of the theory,second,the summaries of the Chinese medicine physique theory theory and practice,third,utilize the physique theory to launch practice summarizing and theory study that the first grade of apoplexy prevents.
Results:
1.Apoplexy prevents summary and introspection of the theory and practice About apoplexy disease cause of disease getting ill key link of turning into of theory,system put apoplexy theory and practice that disease prevent from from ancient times to the present in order with traditional Chinese medicine, and has prevented the weak points of the theory and practice from elucidating to apoplexy in the brief summary after the page.
Go through on the four period of stage on the whole development of theories,first,"in pass" stage,second,other wind say stage,third,interior wind say,propose,cure house internal and external wind and concurrently adopt stage,fourth,the heavy interior windstage alone.Among four period of stage, all understanding that apoplexy is prevented have characteristic,appear abundant trend gradually generally speaking."in through" period,cure house the causes of disease of disease for apoplexy have the ill to know more more comprehensively,beyond know wind to main fact,but it pay much attention to factors internal for function that have illness coming on,a lot of theories become later age on the foundation of curing family's argument of interior wind.But because of "in through" many for theory for discussion,iris clinical for characteristic that record to be the little,there is the getting more abundant comparatively the understanding that apoplexy is preventeds this period,but besides conserving one's health and exorcising evil spirits,few other prevention methods.The understanding of the saying period is ill to the cause of disease of apoplexy machine of other wind overweights" In empty and evil inside",Under the guidance of this kind of theory,the prevention and cure of apoplexy overweights and expells wind scatteredly and evilly, change through methods such as keeping in good health or acupuncture and moxibustion,etc.too "Empty inside" The recording and narrate of the state, but has not been obviously paid attention to.The family has proposed the gold dollar's curing" In the interior wind causes" Theory,it open it is at apoplexy new page of function while having illness coming on since it is internal without being probed into for factor,but from then on until will it be middle period Qing Dynasty,overwhelming majoritycure house whether internal and external wind say and concurrently adopt less than wind in weight, i.e.certainly wind and function in apoplexy has illness coming on of other wind at the same time.Under the guidance knowing in this kind of cause of disease is ill machine,apoplexy produced has prevented the thought and basically included resisting evacuating and treatment and intervention that the internal wind cause the cause of disease to be plain of foreign wind at the same time,but the treatment and intervene,take place until apoplexy have illness coming on often,it is already category that disease preapre for an unfavorable turn of events to be.Since modern times,as the understanding of physiological pathology of the brain of traditional Chinese medicine is strengthened gradually,the great majority cure the other wind that the family has abandoned apoplexy in an all-round way to know,the heavy interior wind alone,under the guidance of this thought,apoplexy produced prevents the theory,improve internal milieu especially too,flat wind while putting out. After summarizing apoplexy and preventing theory and method,I think,consult the modern medical achievement in preventing apoplexy,traditional traditional Chinese medicine is obvious defect and deficiency.Mainly include: (1)It is not enough to hitting understanding of the critically ill dangerous factor of wind;(2)Not the disease has defended the thought cavity first. So apoplexy of Chinese medicine is prevented and can only be confined to the disease preapres for an unfavorable turn of events,second prevention of studying in Western medicinethat that is to say,can't defend first grade promptly to prevent the respect from playing a greater role at the not disease first.
2.Have summed up and summarized the research progress of the physique theory of Chinese medicine in an all-round way.
Including:(1)The development source and course of the physique theory of Chinese medicine,the combination studying the thought and clinical practice is becoming closer that the physique appears generally;(2)Basic concept and method of the physique theory of Chinese medicine,studying the state and main achievement to review and summarize to Chinese medicine physique theory since the end of the seventies of last century,have recommended distinguishing the basic tool of preventing and curing disease of the physique;(3)The application of Chinese medicine in the prevention from suffering from the diseases of physique theory,in term of preventing the theory and modern medical science from preventing the theory in Chinese medicine,expounded the fact separately the physique theory of Chinese medicine is defended in the prevention from suffering from thediseases especially not disease first and the function in first class prevention.
3.Summarize and explore:Utilize the physique theory of Chinese medicine to launch the theory and practice of first class prevention of apoplexy Introduce modern medical science to the first class prevention achievement of apoplexy,utilize view and method of the physique theory of Chinese medicine, about hitting questions such as understanding,physique characteristic,the elderly's physique characteristic of modern crowd of the critically ill dangerous factor of wind,etc.to modern medical science,should annotate to select,it was good that the comprehensive literature proposed apoplexy and disease to send physique type.Summarize and explore that utilizes the physique theory on this basis,the critically ill dangerous factor of wind is sifted and checked in distinguishing crowd's physique and going on,then direct against these dangerous factors and summarize and study the concrete prevention scheme,thus not enabling apoplexy,the idea that the disease has been defended first has been really fulfilled.
Conclusion:
1.The traditional Chinese medicine theory and practice of preventing apoplexy have compositions with rational science,exist in conformity with contemporary social characteristic defect and deficiency,defect these and enough to show mainly:
(1)It is not enough to know to the dangerous factor of apoplexy,has not realized thatdizzy(a kind of modern hypertension)Role in course of having illness coming on of apoplexy of disease;
(2)Can't implement disease defend idea first,do one's best for the prevention that apoplexy has illness coming on really.
2.The contemporary physique theory of Chinese medicine defends having the important meaning first specially to the prevention from suffering from the diseases especially not disease.
3.Use theory and method of the physique theory of Chinese medicine,all right:
(1)Through annotating the concept of modern medical science,deepen and have illness coming on to apoplexy the understanding of the dangerous factor;
(2)It is apoplexy and and not disease that have defended opening up the new intervention range first;
(3)According to the physique characteristic,confirm the pointed scheme of health care;
(4)Construct the platform exchanged between preventive medicine of Chinese medicine and modern preventive medicine Think finally that utilizes the contemporary physique theory of Chinese medicine to launch the treatment and prevention of apoplexy,it is one of the developing direction of the apoplexy prevention work in future.
正是由于中风病复杂难治,预后多不理想,所以若能够在发病之前,就采取措施以阻止中风的发生无疑是最理想的,因此历代医家都非常重视对中风病预防的研究。在这方面做了一些论述,其中不乏真知灼见,直到今天仍值得我们在开展中风病预防工作时研究借鉴并发扬光大。中医预防强调“治未病”,主张从整体观念出发,坚持辨证施治,注重人体脏腑阴阳气血的调衡,充分发挥人的自主健康能力,其作用涵盖了中风病病前、病中和病后的所有层面,具有系统、全面的优势。现代临床研究也证明,使用中医药预防中风病具有较好的效果,因而受到广泛的关注。
但是,对比现代预防医学在中风病预防方面取得的成就,中医学对中风病预防的研究和临床实践,越来越表现出一定的差距,主要表现在以下几个方面:
首先是对中风病危险因素认识的局限性。现代预防医学认为中风病的危险因素分为不可干预因素和可干预因素两类。前者包括年龄、性别、种族等;后者包括高血压、糖尿病、心血管疾病、血脂异常、动脉硬化等疾病以及抽烟、酗酒等不健康的生活方式。在这种认识的指导下,现代预防医学通过危险因素筛查,可以确定中风患病的高危人群,并对高危人群所具有的危险因素开展有针对性的干预和治疗。如通过药物控制血压,积极治疗糖尿病和心血管疾病;通过药物和饮食调控血脂,改善动脉硬化等;通过宣教,帮助人们改良生活方式,戒烟限酒等等。这些对中风危险因素的认识明确客观,采取的干预措施操作性强,较为规范,便于采用。反观传统的中医学,对中风病危险因素的论述从文献中可以看到的,涉及年龄、性别以及不良生活方式和饮食习惯等,所以更多地强调通过养生保健来防止中风病的发生,而对可能引起中风的各种基础疾病的认识则是空白。
其次是未病先防思想空洞化。现代医学提出三级预防理论,对疾病分别进行病前、病中及愈后的处理。其中一级预防也称对因预防,是指对引起疾病的各种危险因素开展预防工作。中医预防理论中的未病先防思想与西医的一级预防理论从概念上差别不大,但如上所述,对疾病的危险因素认识的差距就较为明显。由于这种差距的存在,所以中医未病先防工作,仅仅局限于对中风先兆证的认识治疗以及养生保健,并不包括对基础疾病的治疗。而随着现代影像技术、实验室检验技术的发展,医学界对中风先兆证日益深刻,已经把它归入中风病二级预防范畴。这样,所谓未病先防,其实仅剩下养生保健的内容。养生保健固然重要,但传统中医学的养生方法并不强调“危险人群-适宜的养生方法-降低患病风险”这一模式,养生方法的针对性不强,较为笼统,在现代社会紧张的工作压力和快捷的生活节奏之下,容易造成危险人群的依从性不强,使养生保健方法起不到应有的作用。综上所述,未病先防思想虽然是我们的祖先最早提出的预防思想,曾为保证人类健康做出过巨大贡献,但是在现代社会,正逐步被空洞化。
针对以上中医预防理论的不足,如何加以弥补,使之重新焕发生机和活力,是摆在我们每一个中医人面前的重要课题。而随着中医体质学说的发展和对现代预防医学的借鉴,这个课题的解决已渐露曙光。
现代医学预防理论的发展虽然取得了辉煌的成就,但是也存在一些明显的缺陷。主要表现在对疾病的认识往往依赖于生化指标检测和影像等技术的发展,不能象中医学那样,以符合系统理论的观点来认识疾病;又如普遍成本较高,难以满足中风病预防的长期性要求,等等。但是现代医学一级预防理论中对中风病危险因素的认识却给了我们极大的启发。如果中医学能够象现代医学那样发现并干预决定中风发病的更为本质的因素,不就能够真正使未病先防的理念落到实处了吗?
要实现这个目标,传统中医学的辨证论治体系明显力所不逮,因为辨证论治的着眼点在于证,而中风发病前,虽然有一个内伤积损的过程,但是其证候即使表现出来,也未必与中风发病时的证候相同,而且证候表现的时间相对短暂,对证治疗难以触及疾病的实质。这大概就是传统中医文献中,论及预防,必谈养生,而不强调利用方药开展疾病预防的主要原因。
上个世纪七十年代末以来,中医体质学说研究逐渐兴起,使中医学对疾病本质的认识有了新的深化。中医体质学说是中医基础理论的组成部分,本于传统中医学的辨证论治体系,同时又跳出了“辨证”的框框,把疾病的发生、各种证候的发展以及预后转归等等临床事件更多地归因于人的体质。中医体质学说定义的体质是一种体现了人的结构、功能和心理相统一的状态。这种状态源于先天,故在相当长的时间里可以保持稳定;同时又成于后天,在一定条件的干预下,会发生变化。人的体质状态可以通过对机体脏腑功能、阴阳气血等方面的观察来衡量和描述。基于以上认识,中医体质学说主张人在体质健康的条件下,不会或不易发生疾病,即使发生疾病,往往预后良好。但在多数情况下,人的体质是不平衡的,表现出各种偏性,这种偏性就会决定疾病的发生和变化,反过来疾病也会对体质的偏性造成影响。因此预防和治疗的目的都是保证体质状态平衡无偏,而基本方法,则是通过辨识体质,了解其偏性并加以干预以促使其回到平衡状态。
利用体质学说开展中风病预防,就是通过对导致中风发病的危险因素进行中医体质学辨识,并通过改善体质,从根本上阻止这些危险因素对机体的侵害而得以实现。因而更深刻、更具有针对性。中医体质学说倡导的“治未病”理论包含了丰富的三级预防思想,特别强调一级预防。因此,在中风病的预防中日益显现出其科学价值。
研究目的
通过文献研究,对中医学预防中风病传统理论和方法进行反思,结合现代预防医学对中风病预防的认识,对以往利用中医体质学说进行中风病预防的实践进行总结,尝试依照体质学的原则,为中风病一级预防提供具有可操作性的方案。
研究方法
1.搜集资料
以我校图书馆馆藏资料为基础,辅以网上检索和个人购买的图书。资料来源有如下五个方面:
1.1今人点校出版的中医典籍丛书或类书。如《明清名医全书大成》、《中国古今医案类编》、《近代中医珍本集》、《常见病证中医文献专辑》、《黄帝内经研究大成》、《传世藏书·子库·医部·第六册》,等等,均列入参考文献范围。有些丛书或类书的内容有所重复,正可相互参校。
1.2单行本的医经、医话和医案。如《黄帝内经素问校注》、《灵枢经》、《金匮要略译释》、《千金要方》、《千金翼方》、《医贯》、《卫生宝鉴》、《冉雪峰医著全集》、《医学衷中参西录》、《金匮翼》、《增评医学心法》、《雪雅堂医案附:类中秘旨》、《医学真传》、《孟河四家医籍》、《风劳臌膈四大证治》、《医学心悟》、《金元四大家医学全书》、《张山雷医集》、《张聿青医案》,等等。
1.3现代和当代出版的中风研究和中医体质学说方面的专著。如《近代中医名家论治中风病荟萃》、《当代名医证治汇粹》、《中国名老中医专家学术经验集》、《近代中医流派经验选集》、《清代名医医术荟萃》、《中医体质学》、《中国历代医论选讲》、《中医百家医论荟萃》、《中风病防治研究》、《古今医家诊治中风经验及发挥》、《中医体质学》、《人体体质学——理论、应用和发展》、《中国脑血管病防治指南》,等等。
1.4信息量巨大的电子出版物。如《中华医典》、《文渊阁四库全书电子版》。对部分难以找到原始文献的古代医书来说,这也不失为一种补救的办法。
1.5 CNKI、万方、VIP等国内权威的期刊全文数据库和论文数据库。下载近14年来有关中医防治和研究中风的主要论文400余篇,作为本论文写作的重要参考文献。
2.资料研究内容
选择具有代表性的历代医家之医论医案以及现代医学的部分资料进行归纳和总结,分成三个子专题进行论述,一是中医学中风预防理论的总结和反思,二是中医体质学说理论和实践的总结,三是利用体质学说开展中风一级预防的实践总结和理论探索。
研究结果:
1.中风预防理论和实践的总结与反思
以中医学关于中风病病因病机学说的演化为纲,系统整理了从古至今中风病预防的理论和实践,并在篇后小结中对中风病预防理论和实践的不足之处进行了阐发。
中风病因病机学说的演变大体经历了四个阶段,一是《内经》阶段,二是外风说阶段,三是内风说提出,但医家内外风兼采阶段,四是独重内风阶段。在这四个阶段中,对中风病预防的认识各有特点,总的说来呈现逐渐丰富的趋势。《内经》时期,医家对中风病的病因病机认识已经较为全面,以外风认识为主,但非常重视体内因素对发病的作用,很多理论成为后世内凤医家立论的基础。但是基于《内经》多理论探讨,少临床记录的特点,这个时期对中风病预防的认识较为丰富,但除了摄养辟邪外,很少其他的预防方法。外风说时期对中风病因病机的认识偏重于“内虚邪中”,在这种理论的指导下,中风病的防治偏重于疏风散邪,也有通过养生或针灸等方法改变“内虚”状态的记述,但显然并未得到重视。金元医家提出了“内风致中”的理论,开启了探讨体内因素在中风发病中的作用的新篇章,但是从那时起直到清代中期,绝大多数医家是内外风说兼采以内风为重,即同时肯定内风和外风在中风发病中的作用。在这种病因病机认识的指导下,产生的中风病预防思想基本同时包括了对外风的抵御疏散以及对内风致病因素的处理和干预,但是这种处理和干预往往发生在中风发病后,属于既病防变的范畴。近现代以来,随着中医学对脑的生理病理的认识逐渐加深,大多数医家全面摒弃了中风病的外风认识,独重内风,在此思想指导下,产生的中风病预防理论,也是重点改善体内环境,平熄内风。
在总结了中风病预防理论和方法之后,笔者认为,参考现代医学在预防中风方面的成就,传统中医学存在着明显的缺陷和不足。主要包括:(1)对中风病危险因素的认识不够;(2)未病先防思想空洞化。所以中医的中风病预防只能局限于既病防变,也就是西医学的二级预防,不能在未病先防即一级预防方面发挥更大的作用。
2.全面归纳和总结了中医体质学说的研究进展。
包括:(1)中医体质学说的发展源流,总体上呈现体质学思想与临床实践的结合日趋紧密;(2)中医体质学说的基本观点和方法,对上世纪七十年代末以来的中医体质学说的研究状况和主要成果进行回顾和总结,介绍了辨识体质防治疾病的基本方法;(3)中医体质学说在疾病预防中的应用,从中医预防理论以及现代医学预防理论的角度,分别论述了中医体质学说在疾病预防特别是未病先防和一级预防中的作用。
3.总结和探索:利用中医体质学说开展中风一级预防的理论和实践
介绍了现代医学对中风病的一级预防成果,利用中医体质学说的观点和方法,对现代医学关于中风病危险因素的认识、现代人群的体质特征、老年人的体质特征等问题,择要进行诠释,综合文献提出中风病的好发体质类型。在此基础上总结和探索利用体质学说,辨识人群体质进行中风病危险因素筛查,进而针对这些危险因素总结和研究具体的预防方案,从而使中风病未病先防的理念真正落到实处。
结论
1.传统中医学预防中风病的理论和实践既有科学合理的成分,也存在与当代社会特点不相适应的缺陷和不足,这些缺陷和不足主要表现在:
(1)对中风病的危险因素认识不够,没有认识到眩晕等(类现代高血压)疾病在中风发病过程中的作用;
(2)不能真正落实未病先防理念,即对于中风发病的预防不力。
2.当代中医体质学说对疾病预防特别是未病先防具有特殊重要的意义。
3.运用中医体质学说的理论和方法,可以:
(1)通过诠释现代医学的概念,深化对中风发病危险因素的认识;
(2)为中风病未病先防开拓了新的干预范围;
(3)根据体质特点,确定有针对性的养生保健方案;
(4)在中医预防医学与现代预防医学之间构筑起交流的平台
最终认为利用当代中医体质学说开展中风病的治疗以及预防,是未来中风病预防工作的发展方向之一。
Apoplexy has another name called stroke,is a kind of disease with stupor and falling down suddenly and senselessly,hemiplegia,oblique mouth and tongue. Or without stuporand falling down suddenly,just with hemiplegia,crooked mouth and tongue,speaking unsmoothly,and half of the body numbly.It is a clinical common disease of Traditional Chinese Medicine nowadays.Generally speaking,it equals to acute cerebral vascular disease with symptoms above approximately in Western medicine.Apoplexy disease is the head of four difficult diseases in the ancient times for having the characters of abrupt invasion,being difficult to forecast its changes,serious condition and various sequela.Since the ancient times,it has been paid most attention by medical scientists.And it has been one of the disease witch discussed most frequently and raised most miscellaneous disputes in the historical medical books.
Just because apoplexy is complicated to cure while having unsatisfactorily prognosis,if it could be prevent from emergence before its invasion by taking measures,it will be most ideal undoubtedly.So medical scientists had paid much attention to researching the preventing theories and methods and made a lot of argumentation in this respect since ancient times on.There are so much penetrating and correct judgement among them,and deserves to study and develop while we carry out the jobs of prophylaxis of apoplexy today.The prophylaxis of Traditional Chinese Medicine focuses on "Curing not disease ",and advocates proceeding from the concept of viewing the situation as a whole,insists on identifying symptoms for remedy,pay attention to adjusting the situation of human internal organs,negative and positive,qi and blood to maintain the state of hamony.give full play to people's independent health ability,before its function has contained apoplexy,the disease neutralized all aspects after being ill,have systems,overall advantage.Modern clinical research proves too,use traditional Chinese medicine to prevent apoplexy from having better results,therefore receive the extensive concern.
However,compare with modern preventive medicine and prevent the achievement that the respect is made at apoplexy,traditional Chinese medicine demonstrates certain disparity more and more to research that apoplexy prevents and clinical practice,mainly shown in the following several aspects: It is to hitting the limitation that the critically ill dangerous factor of wind realizes at first.Modern preventive medicine thinks the dangerous factor of apoplexy is divided into and can't intervene the factor and can intervene two kinds of factors.The former includes age,sex,race,etc.;And then person including last disease,fat of blood unusual,arteriosclerosis,etc.disease and smoke,unhealthy life style of getting drunk etc.at blood pressures high, candy urine disease,energies.Under the guidance of this kind of understanding, modern preventive medicine sifts checking through the dangerous factor,can confirm the high-risk group that apoplexy is ill,and launch pointed intervention and treat to the dangerous factor that the high-risk group have. If control blood pressure through the medicine,treat diabetes and cardiovascular vessel disease actively;Adjust and control the fat of blood through medicine and diet,improve arteriosclerosis,etc.;Through the propaganda and education,help people to improve the life style,give up smoking wine of limit,etc..The understanding of dangerous factor of apoplexy is clear and objective,the intervening measure taken is operational and strong, comparatively standardize,it is easy to adopt.Review traditional traditional Chinese medicine,can see to hitting the argumentation of the critically ill dangerous factor of wind from the literature,involve age,sex,bad life style and eating habit,etc.,so put emphasis on preventing the occurrence of apoplexy by health care more,it is blanks to causing the understanding of different basic diseases of apoplexy.
Secondly it is the not disease that defends the thought cavity first.It propose prevention theory tertiary medical sciences modern,it separately last disease disease,at disease and treatment after healing.Among them first class prevention calls and prevents correctly too,mean that launches the work of preventing from to various dangerous factors which causes disease.Chinese medicine prevent theory disease defend thought first and first class prevention theory of Western medicine difference strong at concept,butas stated above,the disparity realized to the dangerous factor of disease is comparatively obvious.Because of the existence of this kind of disparity, so the Chinese medicine not disease defends working first,only confine treatment and health care to the understanding of apoplexy omen card,exclude the treatment of the basic disease.And with the development of modern image technology,laboratory inspection technology,the medical circle is deep day by day to the apoplexy omen card,have already included it in second prevention category of apoplexy.Like this,the so-called not disease is defended first, in fact only have a content of health care left.Health care is no doubt important,but the traditional traditional Chinese medicine health care method does not emphasize "the dangerous crowd-suitable health care method-reduce the ill risk" This mode,the pertinence of the method is not strong that keeps in good health,comparatively generally,under modern society's tense working pressure and swift rhythm of life,it is apt to cause the compliance of the dangerous crowd not strong,make the method of health care ineffectual.In sum,not the disease has defended the thought first it is the prevention thought that our ancestor puts forward first,once made enormous contribution in order to guarantee human health,but in the modern society,quilt cavity progressively.
Prevent the deficiency of the theory to the above-mentioned Chinese medicine, how remedy,make it radiate vigour anotherly,it is the important subject in front of our every Chinese medicine person.And with the development of the physique theory of Chinese medicine and reference of modern preventive medicine,the settlement of this subject has already revealed the dawn gradually.
Modern medical science has prevented the development of the theory and made the brilliant achievement,but there are someobvious defects.Mainly display the development often depending on technology such as detection and image of biochemical index in the understanding of disease,can't know disease for the view which accords with the systematic theory like traditional Chinese medicine;The and for example general cost is relatively high,it is difficult to meet the chronic requirement that apoplexy prevents,wait a moment.But the first class prevention theory of modern medical science has given us great inspiration in hitting the understanding of the critically ill dangerous factor of wind.If traditional Chinese medicine can be found and intervened more essential factor that apoplexy of decision have illness coming on like modern medical science,can not really make the not idea that the disease has been defended first fulfill?
Should realize this goal,the dialectical theory of traditional traditional Chinese medicine manages the obvious strength of the system and does not capture,because the starting point thatthe dialectical theory manages lay in the card,and before apoplexy has illness coming on,though a internal injury accumulated the course decreased,but its card is waited even show,it is the same that the card when may not have illness coming on with apoplexy either is waited,and it is relatively transient that the card waits the time to display,it is difficult to touch the essence of disease to verify the treatment. This is probably in literature of traditional Chinese medicine,touch upon and prevent,must talk about keeping in good health,and the main reason not putting emphasis on utilizing square medicine to launch the prevention from suffering from the diseases.
Last century was since the end of the seventies,the physique theory of Chinese medicine has been studied and risen gradually,make the essential understanding to disease of traditional Chinese medicine have new promotion. The physique theory of Chinese medicine is a component of the basic theory of Chinese medicine,originally manage the system in the dialectical theory of traditional traditional Chinese medicine,while jumpedout "Dialectical "Circle,the disease one emergence,various card development and prognosis that wait transfer to if belonging to,wait a moment for there aren't incidents clinical.The physique that the physique theory of Chinese medicine defines is a kind of state with unified structure,function and psychology which reflects the person.This kind of state comes from being congenital,so can remain stable during quite a long time;While will become it the day after tomorrow,under the intervention of certain condition,will change.People's physique state can be weighed and described through observation of respects such as organism internal organs function,negative and positive qi and blood,etc..Because of the above-mentioned understanding,the physique theory of Chinese medicine maintains people are under the condition of the physical health,disease that will not be or not inci(?)t,even disease takes place, often the prognosis is good.But under most s(?)uations,people's physique is uneven,demonstrate various bias,this kind of(?)as will determine taking place and change of disease,disease will cause infl(?)ce on the bias of the physique conversely.So prevent and therapeutic purpos(?)is all to guarantee the state equilibrium of physique is not partial,and b(?)sic tool,understand its bias and intervene in order to impel it to get ba(?)to equilibrium state through distinguishing the physique.
Utilize the physique theory to prevent apopl(?)y,but through to leading to the fact the dangerous factor that apoplexy has illness coming on learns to distinguish the physique of Chinese medicine,pass the physique of improving, prevent the infringement of the organism of these dangerous factors and can realize fundamentally.Therefore is deeper,mo(?)e pointed.The physique theory of Chinese medicine was advocated "Cure the not disease" The theory includes the abundant tertiary prevention thought,especially emphasize first class prevention.So,display its scientific value in the prevention of apoplexy day by day.
Purpose:
Study through the literature,prevent traditional theory of of apoplexy and method to review to traditional Chinese medicine,combine the understanding that apoplexy is prevented of modern preventive medicine,summarize practice that utilized the physique theory of Chinese medicine to prevent apoplexy in the past,the principle trying to be studied according to the physique,offer for first class prevention of of apoplexy and have effective schemes.
Methods:
1.collecting the materials
Based on materials in storage of library of our school,complementing with searching in the Internet and books purchased The source of the materials includes five respects the following:
1.1 The series of books or reference books of the ancient TCM which reviewed and proofreaded by moderns.
1.2 The ancient classical medicine books,medical commentaries and medical anamneses in the form of single-article pamphlet.
1.3 The monographs of researching in apoplexy and physique theory of TCM which published in Modern and contemporary.
1.4 The electronic publications with enormous information.
1.5 The full text databases of periodicals and theses with domestical authoritative such as CNKI,Wanfang,VIP,etc.I have downloaded more than 400 sorts theses about preventing and curing and studying apoplexy in Chinese medicine of the past 14 years,as the important references of writing of this thesis.
2.Research contents of the materials
Choose medicine that cures the family representative successive dynasties to talk about some materials of the medicine case and modern medical science to sum up and summarize,divided into three sub special topics and described, first,traditional Chinese medicine apoplexy prevents summary and introspection of the theory,second,the summaries of the Chinese medicine physique theory theory and practice,third,utilize the physique theory to launch practice summarizing and theory study that the first grade of apoplexy prevents.
Results:
1.Apoplexy prevents summary and introspection of the theory and practice About apoplexy disease cause of disease getting ill key link of turning into of theory,system put apoplexy theory and practice that disease prevent from from ancient times to the present in order with traditional Chinese medicine, and has prevented the weak points of the theory and practice from elucidating to apoplexy in the brief summary after the page.
Go through on the four period of stage on the whole development of theories,first,"in pass" stage,second,other wind say stage,third,interior wind say,propose,cure house internal and external wind and concurrently adopt stage,fourth,the heavy interior windstage alone.Among four period of stage, all understanding that apoplexy is prevented have characteristic,appear abundant trend gradually generally speaking."in through" period,cure house the causes of disease of disease for apoplexy have the ill to know more more comprehensively,beyond know wind to main fact,but it pay much attention to factors internal for function that have illness coming on,a lot of theories become later age on the foundation of curing family's argument of interior wind.But because of "in through" many for theory for discussion,iris clinical for characteristic that record to be the little,there is the getting more abundant comparatively the understanding that apoplexy is preventeds this period,but besides conserving one's health and exorcising evil spirits,few other prevention methods.The understanding of the saying period is ill to the cause of disease of apoplexy machine of other wind overweights" In empty and evil inside",Under the guidance of this kind of theory,the prevention and cure of apoplexy overweights and expells wind scatteredly and evilly, change through methods such as keeping in good health or acupuncture and moxibustion,etc.too "Empty inside" The recording and narrate of the state, but has not been obviously paid attention to.The family has proposed the gold dollar's curing" In the interior wind causes" Theory,it open it is at apoplexy new page of function while having illness coming on since it is internal without being probed into for factor,but from then on until will it be middle period Qing Dynasty,overwhelming majoritycure house whether internal and external wind say and concurrently adopt less than wind in weight, i.e.certainly wind and function in apoplexy has illness coming on of other wind at the same time.Under the guidance knowing in this kind of cause of disease is ill machine,apoplexy produced has prevented the thought and basically included resisting evacuating and treatment and intervention that the internal wind cause the cause of disease to be plain of foreign wind at the same time,but the treatment and intervene,take place until apoplexy have illness coming on often,it is already category that disease preapre for an unfavorable turn of events to be.Since modern times,as the understanding of physiological pathology of the brain of traditional Chinese medicine is strengthened gradually,the great majority cure the other wind that the family has abandoned apoplexy in an all-round way to know,the heavy interior wind alone,under the guidance of this thought,apoplexy produced prevents the theory,improve internal milieu especially too,flat wind while putting out. After summarizing apoplexy and preventing theory and method,I think,consult the modern medical achievement in preventing apoplexy,traditional traditional Chinese medicine is obvious defect and deficiency.Mainly include: (1)It is not enough to hitting understanding of the critically ill dangerous factor of wind;(2)Not the disease has defended the thought cavity first. So apoplexy of Chinese medicine is prevented and can only be confined to the disease preapres for an unfavorable turn of events,second prevention of studying in Western medicinethat that is to say,can't defend first grade promptly to prevent the respect from playing a greater role at the not disease first.
2.Have summed up and summarized the research progress of the physique theory of Chinese medicine in an all-round way.
Including:(1)The development source and course of the physique theory of Chinese medicine,the combination studying the thought and clinical practice is becoming closer that the physique appears generally;(2)Basic concept and method of the physique theory of Chinese medicine,studying the state and main achievement to review and summarize to Chinese medicine physique theory since the end of the seventies of last century,have recommended distinguishing the basic tool of preventing and curing disease of the physique;(3)The application of Chinese medicine in the prevention from suffering from the diseases of physique theory,in term of preventing the theory and modern medical science from preventing the theory in Chinese medicine,expounded the fact separately the physique theory of Chinese medicine is defended in the prevention from suffering from thediseases especially not disease first and the function in first class prevention.
3.Summarize and explore:Utilize the physique theory of Chinese medicine to launch the theory and practice of first class prevention of apoplexy Introduce modern medical science to the first class prevention achievement of apoplexy,utilize view and method of the physique theory of Chinese medicine, about hitting questions such as understanding,physique characteristic,the elderly's physique characteristic of modern crowd of the critically ill dangerous factor of wind,etc.to modern medical science,should annotate to select,it was good that the comprehensive literature proposed apoplexy and disease to send physique type.Summarize and explore that utilizes the physique theory on this basis,the critically ill dangerous factor of wind is sifted and checked in distinguishing crowd's physique and going on,then direct against these dangerous factors and summarize and study the concrete prevention scheme,thus not enabling apoplexy,the idea that the disease has been defended first has been really fulfilled.
Conclusion:
1.The traditional Chinese medicine theory and practice of preventing apoplexy have compositions with rational science,exist in conformity with contemporary social characteristic defect and deficiency,defect these and enough to show mainly:
(1)It is not enough to know to the dangerous factor of apoplexy,has not realized thatdizzy(a kind of modern hypertension)Role in course of having illness coming on of apoplexy of disease;
(2)Can't implement disease defend idea first,do one's best for the prevention that apoplexy has illness coming on really.
2.The contemporary physique theory of Chinese medicine defends having the important meaning first specially to the prevention from suffering from the diseases especially not disease.
3.Use theory and method of the physique theory of Chinese medicine,all right:
(1)Through annotating the concept of modern medical science,deepen and have illness coming on to apoplexy the understanding of the dangerous factor;
(2)It is apoplexy and and not disease that have defended opening up the new intervention range first;
(3)According to the physique characteristic,confirm the pointed scheme of health care;
(4)Construct the platform exchanged between preventive medicine of Chinese medicine and modern preventive medicine Think finally that utilizes the contemporary physique theory of Chinese medicine to launch the treatment and prevention of apoplexy,it is one of the developing direction of the apoplexy prevention work in future.
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