基於缺血性中風“體病同治”策略探討杜蛭丸臨床再定位

唐仕歡１　常夢麗１　張晶晶１　楊洪軍２

（１中國中醫科學院中藥研究所，北京，１００７００；２中國中醫科學院醫學實驗中心，北京，１００７００）

【摘要】中風是當今多發重大疾病，降低該病的發病率、致殘率和複發率是臨床的重要課題。中成藥應用是中風防治的有效手段之一，但中成藥品類繁多，臨床適應證寬泛，應用“中醫理論臨床實踐基礎研究”三維整合技術可以實現中成藥臨床再定位及其評價，挖掘品種的組方內涵和特點，進一步明確其臨床定位和優勢，為更好地發揮其臨床價值具有現實意義。本文總結中風的病因病機認識，提出體質虛損是缺血性中風發病前提，並貫穿整個發病軸，在發病前期、急性發作期、恢復期、後遺症期均存在，僅是凸顯程度不同，氣虛血瘀是發病核心病機，“體病同治”是有效防治策略。在此基礎上，以中成藥杜蛭丸為範例，分析該品種的組方特點，發現符合“體病同治”的防治策略，在中醫理論指導下分析其臨床再定位，並提出進一步的研究思路與路徑。基於中醫理論、臨床實踐、基礎研究有機結合，將實現品種的臨床再定位和評價，為中風防治和中成藥的臨床再定位研究提供示範。

【關鍵詞】缺血性中風；體病同治；杜蛭丸；臨床再定位

Clinical Re-orientation of DuZhi Wan in Treating Ischemic Stroke Based on the Strategy of “ Simultaneous Treatment of Constitution and Disease”

Tang Shihuan1 , Chang Mengli1 ,Zhang jingjing1 ,Yang Hongjun2

(1 Institute of Chinese Materia Medica, China Academy of Traditional Chinese Medical Sciences, Beijing 100700,China;2Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700,China)

Abstract

Stroke is a major disease with high incidence rate nowadays. It is an important clinical project to reduce the incidence rate, mortality rate, and recurrence rate of stroke. The application of Chinese patent medicines is one of the effective methods to treat and prevent stroke, but there are many complex varieties of Chinese patent medicines, which have a wide range of clinical indications. The application of three-dimensional integration technology of “ traditional Chinese medicine(TCM) theory-clinical practicebasic research” can achieve clinical re-orientation and re-evaluation, explore the connotations and characteristics, and further specify clinical re-orientation and advantages of Chinese patent medicines, which has practical significance for better exerting the clinical value. Summarizing the pathogenesis and mechanism of stroke, this study proposed that deficient constitution was the pathogenic premise of stroke and ran through the whole pathogenic stages with different degrees such as the premorbid stage, acute attack stage, recovery stage, and sequelae stage. Qi deficiency and blood stasis were the core mechanism of stroke. The strategy of “ simultaneous treatment of constitution and disease” was effective to treat and prevent stroke. This study took DuZhi Wan, a Chinese patent medicine, as an example to analyze the prescription characteristics of DuZhi Wan corresponding to the strategy of “ simultaneous treatment of constitution and disease” . The clinical re-orientation of DuZhi Wan was analyzed under the guidance of TCM theory, and the research idea and path were further proposed. The combination of TCM theory, clinical practice, and basic research will realize the clinical re-orientation and evaluation of varieties of Chinese patent medicines, which provides a demonstration for the prevention and treatment of stroke and the clinical re-orientation of Chinese patent medicines.

Keywords

Ischemic stroke; Simultaneous treatment of constitution and disease; DuZhi Wan; Clinical re-orientation