摘要
疲劳是多系统萎缩(multiple system atrophy,MSA)常见的非运动症状,给患者身体及精神带来了极大负担。中医认为,脑玄府居于上位,主司人体各项生命活动,脑髓充养于脑玄府,为其提供物质基础,脑气运行于脑玄府,代脑行事,主持全身诸脏肢节官窍的行动。本文通过对脑玄府的概念、内在结构及功能关系的认识,结合MSA肾元不足、髓海亏虚、痰瘀停滞等病机特点,认为MSA相关疲劳与肾密切相关,髓消、气乱、玄闭为其核心病机。本病以脑髓消减、玄府不荣为本,脑气紊乱、玄府不通为患。治疗以补肾充髓、温养玄府固其本,调理脑气、宣通玄府复其用。临证当辨别虚实轻重缓急,随症加减化裁,为MSA相关疲劳的中医治疗提供参考。
Fatigue is a prevalent non-motor symptom of multiple system atrophy(MSA),which places a great burden on the patient's physical and mental health.Traditional Chinese Medicine(TCM)believes that the brain xuanfu(pore)is in a superior position,responsible for various life activities of the human body.The brain marrow nourishes the brain xuanfu,casting a material foundation for it.The brain qi runs in the brain xuanfu,acting on behalf of the brain,and oversees the actions of various organs,limbs,and orifices throughout the body.This article,based on the understanding of the concept,internal structure,and functional relationship of the brain xuanfu,combined with the pathological characteristics of MSA such as kidney deficiency,marrow sea deficiency,phlegm stasis stagnation,etc,proposes that MSA-related fatigue is closely associated with the kidney,with marrow depletion,qi disorder,and xuanfu closure as its core pathological mechanisms.This disease is characterized by a decrease in the brain marrow,a lack of prosperity in the xuanfu area,a disturbance in brain qi,and a blockage in the xuanfu area.The treatment aims to tonify the kidney and fill the marrow,warm and nourish the xuanfu,strengthen its foundation,regulate brain qi,and promote the recovery of xuanfu.In clinical practice,it is important to differentiate the severity,urgency,and deficiency-excess patterns of the condition,and adjust accordingly to provide reference for the TCM treatment of MSA-related fatigue.
作者
徐萱
张新宁
赵迪
任珊
贾承儒
苏霁月
田浩
陈志刚
XU Xuan;ZHANG Xinning;ZHAO Di;REN Shan;JIA Chengru;SU Jiyue;TIAN Hao;CHEN Zhigang(Beijing University of Chinese Medicine,Beijing 100029;Dongfang Hospital,Beijing University of Chinese Medicine;Xi'an Hospital of Traditional Chinese Medicine;Xiyuan Hospital,China Academy of Chinese Medical Sciences)
出处
《现代中医临床》
2025年第4期24-28,共5页
Modern Chinese Clinical Medicine
基金
国家自然科学基金面上项目(No.82174328)
北京中医药大学校级项目(No.2020-JYB-ZDGG-119)
国家中医药管理局“十一五”重点专科专病(No.040104001003)。
关键词
多系统萎缩
疲劳
脑玄府
治法
multiple system atrophy
fatigue
brain xuanfu
treatment method
