破瘀醒神法治疗脑出血的实验研究进展

Progress of Experimental Research on the Treatment of the Intracerebral Hemorrhage by the Method of Breaking Blood Stasis and Awakening the Mind

摘要: 脑出血(intracerebral hemorrhage, ICH)是指非外伤性脑实质内血管破裂引起的出血，占脑卒中的20%~30%，在急性期病死率高达30%~40%。其病理机制复杂，目前治疗手段主要是对症处理，包括吸氧镇静、使用高渗脱水药、降压药、止血药及亚低温治疗等，具有外科干预指征的患者可行外科治疗。但尚缺乏能显著改善预后的治疗手段。在中医学中，脑出血属于“出血性中风”范畴，“瘀血”是该病发生发展过程的关键因素。在我国“八五”攻关期间，以国医大师任继学教授为代表，确立了以破血化瘀、泄热醒神、豁痰开窍为内涵的“破瘀醒神法”。具体来说，任继学教授自拟了“破瘀醒神汤”。在此基础上，任继学教授对经典著作熟读深思，结合丰富的临床经验，提出了“脑髓理论”，其团队在此理论指导下提出了髓虚毒损的病机，增加了破瘀醒神法的理论内涵，促进其新的发展。具体来说，课题组自拟了“脑出血方”(又称“益髓破血方”)。本文通过汇总对破瘀醒神汤、脑出血方(益髓破血方)的实验研究发现破瘀醒神法治疗脑出血作用涉及减轻脑水肿、减轻炎症反应、抑制细胞凋亡和调节细胞自噬。本文对破瘀醒神法治疗脑出血的实验研究进行综述，以期为中医药治疗脑出血方案提供参考。

Abstract: Intracerebral hemorrhage (ICH) refers to the non-traumatic rupture of blood vessels in the brain parenchyma, accounting for 20% to 30% of stroke, and the fatality rate is as high as 30% to 40% in the acute stage. Its pathological mechanism is complex. At present, the main treatment methods are symptomatic treatment, including oxygen inhalation and sedation, hypertonic dehydration drugs, antihypertensive drugs, hemostatic drugs, and mild hypothermia therapy. Surgical treatment is feasible for patients with surgical intervention indications. However, there is still a lack of treatment methods that can significantly improve the prognosis. In traditional Chinese medicine, the intracerebral hemorrhage belongs to the category of “hemorrhagic stroke”, and “blood stasis” is the key factor in the process of this disease. During my country’s “Eighth Five-Year Plan” research period, represented by Professor Ren Jixue, a master of traditional Chinese medicine, the “method of breaking blood stasis and awakening the mind” with the connotation of breaking blood and removing blood stasis, dissipating heat and rejuvenating the mind, and eliminating phlegm and opening resuscitation was established. Specifically, Professor Ren Jixue made his own “Broken Blood Stasis and Awoken the Mind Decoction”. On this basis, Professor Ren Jixue has read and thought deeply about classic works, combined with rich clinical practice, and put forward the “brain theory”. Under the guidance of this theory, his team proposed the pathogenesis of marrow deficiency and toxin damage, and developed the theory of breaking blood stasis and rejuvenating spirit. Connotation, promote its new. Specifically, the research group drafted its own “brain prescription” (also known as “marrow-benefiting and blood-breaking prescription”). This article summarizes the experimental research of Broken Blood Stasis and Awoken the Mind Decoction and Naochuxue prescription (Yisuipoxue prescription) and finds that breaking blood stasis and awakening the mind treatment of brain involves reducing brain edema, reducing inflammatory reaction, inhibiting apoptosis and regulating autophagy. This article summarizes the experimental studies on the treatment of brain with the method of breaking blood stasis and awakening the mind, in order to provide reference for the treatment of brain with traditional Chinese medicine.