董子源 王长德

摘要 探讨缺血性中风急性期中医辨证论治的研究进展。通过对近几年中医辨证论治治疗急性缺血性中风的有关文献进行分析，从病因病机到辨证论治方面阐述缺血性中风急性期的中医治疗进展。缺血性中风急性期中医辨证论治在临床上普遍应用，中西医结合能提高临床疗效。在缺血性中风急性期进行中医辨证论治具有提高临床疗效，减少不良反应等优点，但缺乏客观统一的辨证标准。

关键词 缺血性中风;急性期;辨证论治

Abstract To explore the research progress of TCM syndrome differentiation and treatment of acute ischemic stroke.Through the analysis of relevant literatures on the treatment of acute ischemic stroke by TCM syndrome differentiation and treatment in recent years，the progress of TCM treatment in the acute stage of ischemic stroke was explained from the etiology and pathogenesis to syndrome differentiation and treatment.The treatment of syndrome differentiation in acute stage of ischemic stroke is widely used in clinic，and the combination of traditional Chinese and western medicine can improve clinical efficacy.The treatment of TCM syndrome differentiation in the acute stage of ischemic stroke has advantages of improving clinical efficacy and reducing adverse reactions，but lacks objective and unified criteria for syndrome differentiation.

Keywords Ischemic stroke; Acute stage; Syndrome differentiation

中圖分类号：R285文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.24.026

中风为古代中医“四大难证”之一，是以突然昏仆、半身不遂、口舌歪斜、言语謇涩或不语、偏身麻木为主要临床表现的病证。具有难治愈、易复发的特点。中风在西医学上称为脑卒中，现代医学将其分为缺血性脑卒中和出血性脑卒中两大类。其中，缺血性脑卒中占69.6%～70.8%[1]。随着人口老龄化，脑卒中对我国人民的危害日益加剧，据《中国脑卒中防治报告2018》显示，脑卒中是我国成人致死、致残的首位原因[2]。一般认为缺血性中风急性期是指发病2周以内[3]。西医在本病治疗方面具有一定的效果，但尚存在不足之处，例如溶栓治疗有严格的时间窗限制;抗凝药、抗血小板药物使用可能导致出血风险等。因此，我们对近年来缺血性中风急性期中医辨证治疗的研究进展进行综述，以便为临床寻找更加有效的治疗手段提供参考。

1 病因病机

《黄帝内经》中无“中风”的病名，但其中“薄厥”“偏风”“偏枯”等与中风临床表现相似[4]。……