从脾胃论治卒中后疲劳
黄雁,钟一萍,詹杰,潘锐焕,陈红霞
摘要(Abstract):
卒中后疲劳是脑卒中发生后常见的并发症,其不仅严重影响患者生活质量,而且极易降低患者参与康复训练的积极性,造成整体康复效果不良。中医药治疗脑卒中具有悠久的历史,对卒中后疲劳有较深入的认识。通过文献检索,经典理论梳理,以及临床经验的总结分析,认为脾胃是五脏六腑之枢、中气乃生命活动之本,脑卒中后疲劳的病机关键在于"脾胃病,中气衰",病证之本属"虚类证"。治疗宜以"补中益气、升阳调气"为法,以黄芪、人参、党参、白术、炙甘草等益气调气之品为要药,从脾胃、中气论治,使辨证执简驭繁,且疗效显著。
关键词(KeyWords): 卒中后疲劳;脾胃;中气;病机
基金项目(Foundation): 国家中医临床研究基地业务建设项目(JDZX2015224);; 国家中医药管理局公共卫生服务补助资金“中医康复服务能力规范化建设项目”
作者(Author): 黄雁,钟一萍,詹杰,潘锐焕,陈红霞
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