基于“风胜则动”探讨续命汤在中风后肢体运动障碍中的应用

Exploring the Application of Xuming Decoction in Post-Stroke Limb Movement Disorders Based on the Principle of "Wind Prevailing and Causing Movement"

  • 摘要: 中风后肢体运动障碍是中风后常见功能障碍。《古今录验》续命汤为张仲景主治“中风痱,身体不能自收”的重要方剂,后世对其多有化裁和收录,其中以《备急千金要方》小续命汤最为常用。随着中风病“内风论”的发展,续命汤类方以其多用风药, 与“内风”医理难通而逐渐被批判甚至弃用。论文基于“风胜则动”及“内风乃身中阳气之变动”等观点,提出续命汤“引风助动”理论。认为“风即为气”,中风初起风阳暴亢, 风胜则动, 发为卒中;中风之后阳气已虚, 风败而静, 四肢不用。而麻黄、桂枝等风药尚有生风助动、振颓启废、激动阳气、调和营卫、升降气机等作用。续命汤组方以风药之用为主,配合温阳益气,生风以激动阳气,振颓启废; 补阳以引风助动,益气生血; 解肌以调和营卫,疏利四肢; 复枢以调脏腑之轴,畅通气机,促进中风后肢体运动功能的恢复, 为续命汤临床应用提供理论依据。

     

    Abstract: Post-stroke limb movement disorder is a common functional disorder after stroke. Xuming Decoction in Ancient and Modern Records of the Proven is an important prescription of Zhang Zhongjing for treating "stroke prickly heat, the body cannot hold itself". It has been modified and recorded in many later generations, among which Xiaoxuming Decoction in Important Formulas Worth a Thousand Gold Pieces for Emergency is the most commonly used. With the development of the "internal wind theory" of stroke, the prescriptions of Xuming Decoction were gradually criticized and even abandoned because they often used "wind drugs" and were difficult to understand the medical theory of "internal wind". Based on the viewpoints of "wind prevailing and causing movement" and "internal wind being the change of yang qi in the body", the paper proposes the theory of "inducing wind to promote movement" of Xuming Decoction and believes that "wind is qi". At the beginning of stroke, wind-yang is violently hyperactive, and wind prevails and causes movement, resulting in stroke; after stroke, yang qi is weak, wind is defeated and static, and limbs are unable to use. However, "wind drugs" such as Ephedra sinica Stapf and Cinnamomum aromaticum Nees have the functions of generating wind and promoting movement, revitalizing the decadent and the useless, exciting yang qi, harmonizing the ying and wei, and raising and lowering qi. The Xuming Decoction is mainly composed of "wind drugs", which warms the yang and replenishes the qi, generates wind to excite yang qi, and revitalizes the weak; replenishes the yang to induce wind and promote movement, replenishes qi and generates blood; relieves muscles to harmonize the ying and wei, and dredges the limbs; restores the pivot to regulate the axis of the internal organs, unblocks the qi, and promotes the recovery of limb motor function after stroke, providing a theoretical basis for the clinical application of Xuming Decoction.

     

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