Stage-based syndrome differentiation and treatment of Alzheimer’s disease from the perspective of "combining diseases in modern medicine and TCM patterns"

LI Fuyao; SHI Jing; TIAN Jinzhou

doi:10.3969/j.issn.2095-6606.2023.03.016

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Stage-based syndrome differentiation and treatment of Alzheimer’s disease from the perspective of "combining diseases in modern medicine and TCM patterns"

Theoretical Exploration | 更新时间：2023-06-06

- Stage-based syndrome differentiation and treatment of Alzheimer’s disease from the perspective of "combining diseases in modern medicine and TCM patterns"
  增强出版
- Modern Chinese Clinical Medicine Vol. 30, Issue 3, Pages: 83-87(2023)
- 作者机构：
  
  北京中医药大学东直门医院　北京　100700
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2095-6606.2023.03.016
  CLC： R259
- Published：30 May 2023，
  
  Received：10 November 2022，
- 稿件说明：
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LI Fuyao, SHI Jing, TIAN Jinzhou. Stage-based syndrome differentiation and treatment of Alzheimer’s disease from the perspective of "combining diseases in modern medicine and TCM patterns". [J]. Modern Chinese Clinical Medicine 30(3):83-87(2023)
DOI：

LI Fuyao, SHI Jing, TIAN Jinzhou. Stage-based syndrome differentiation and treatment of Alzheimer’s disease from the perspective of "combining diseases in modern medicine and TCM patterns". [J]. Modern Chinese Clinical Medicine 30(3):83-87(2023) DOI： 10.3969/j.issn.2095-6606.2023.03.016.

摘要

阿尔茨海默病(Alzheimer’s disease，AD)是一种神经退行性疾病，主要特点为认知功能损害。中医典籍中虽无此病名，但早已有相关记载，具有丰富的理论源流及临床经验积累。现代相关研究也提出了补肾、化痰、活血等多种不同治法。但是对于AD这一动态进展的疾病，中医治疗策略也应“病证结合”，有针对性的动态分期辨治：从疾病本身特点看，AD本身核心病机为肾虚，早期显著、贯穿全程，中期因痰、瘀、火等实邪进展，晚期恶化于毒盛正衰；从个体化辨证施治角度看，除了运用脏腑辨证对整体分型辨治外，更可结合“五脏藏神”针对认知、精神、行为症状进行深度辨识。基于此，本文从“病证结合”角度提出AD中医诊治的四个层次：①补肾为基础，尽早启动、贯穿全程；②化痰、祛瘀、泻火、解毒固脱分期论治；③脏腑辨证，整体施治；④“五脏藏神”理论治脏以调神。

Abstract

Alzheimer’s disease (AD) is a neurodegenerative disease characterized by cognitive impairment. Although the term cannot be found in traditional Chinese medicine (TCM) classics

the disease has long been recorded

providing a solid theoretical foundation and rich clinical experience. In the modern era

various TCM treatment methods have also been put forward for it

including supplementing the kidney

dissolving phlegm

and invigorating blood.However

for AD

a dynamically progressing disease

the principle of "combining diseases in modern medicine and TCM patterns" should be adopted

and stage-based syndrome differentiation and treatment in a targeted manner is key. In terms of disease characteristics

the core and throughout pathogenesis is kidney deficiency

especially in the early stage. With the disease progression

excess pathogens like phlegm

blood stasis

and fire stand out in the middle stage. In the late stage

the exuberance of toxin with decline of healthy qi accelerates the deterioration of the patient’s conditions. As for individualized syndrome differentiation

the theory of "five viscera storing spirit" can be applied for in-depth identification of cognitive

psychological and behavioral symptoms in addition to finding the overall pattern based on

zang

pattern differentiation. This study puts forward a four-level TCM therapy of AD from the perspective of "combining diseases in modern medicine and TCM patterns" : 1) supplementing the kidney as early as possible and throughout the stages; 2) adopting the method of resolving phlegm

dispelling stasis

purging fire

removing toxin and preventing collapse at different stages; 3) taking a global approach based on syndrome differentiation of

zang

viscera; 4) adopting the theory of "five viscera storing spirit" for cognitive

psychological and behavioral symptoms.

关键词

阿尔茨海默病病证结合肾虚病机级联假说五脏藏神脏腑辨证

Keywords

Alzheimer’s diseasecombining diseases in modern medicine and TCM patternskidney deficiencypattern cascade hypothesisfive viscera storing spiritssyndrome differentiation of zang-fu viscera

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