孙一凡　李国铭　翁銮坤　刘文琛　赵敏　招远祺

〔摘要〕 中风病是难治性脑病，历代医家对中风病病因病机观点各异。立足于湿邪和中风病的古今文献研究，结合湿邪致病的特点和中风病的证候特点，探讨湿邪与中风病之间的关系，剖析“湿邪致中风”的源流、辨證要点及临证思路，强调湿邪为中风病的重要病理因素，以期加深临床上对中风病的研究，进一步拓宽治疗思路。

〔关键词〕 中风;湿邪;病因病机

〔中图分类号〕R255.2        〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.01.021

〔Abstract〕 Stroke is a refractory disease of encephalopathy. The understanding of the etiology and pathogenesis of stroke has been different in generations of physicians. Based on the ancient and modern literature researches of dampness and stroke， combined with the pathogenic characteristics of dampness and the syndrome characteristics of stroke， this article discussed the relationship between dampness and stroke. We analyze the origin and development， dialectical points and clinical thinkings of "stroke caused by pathogenic dampness" and emphasized that pathogenic dampness is an important pathological factor of stroke. This paper aims to deepen the clinical research on stroke and further broaden the treatment ideas.

〔Keywords〕 stroke; pathogenic dampness; etiology and pathogenesis

中风又名卒中，是临床常见疾病，与“痨、鼓、膈”共为古代中医的4大顽症[1]，并居首位，历来受到医家的重视，中医对中风病机的认识经历了一个逐步完善的过程。唐宋以前多以“内虚邪中”立论，自金元以来，内风学说逐渐占据上风，近代以内风学说成为主流，并与现代医学紧密结合，在继承传统的基础上开始深入探讨脉络闭阻、痰瘀阻络、脑神失养等微观病机，此外，外风学说也引发了新的思考[2]。

当前，中风的病理因素仍以风、火、痰、瘀、气、虚6端论述较多[3]，本研究团队在总结临床经验和研究中发现，湿邪也是中风的重要病因。本文拟通过分析湿邪和中风病的古今文献，结合临床经验，提出“湿邪致中风”假说，认为湿邪入络，湿聚为痰，痰滞为瘀，痰瘀互结，损伤血络，从而引起或加重中风病。

1 “湿邪致中风”的理论源流

“湿邪致中风”理论滥觞于《黄帝内经》，《素问·通评虚实论》提到“凡治消瘅、仆击、偏枯、痿厥、气满发逆，肥贵人，则高梁之疾也”，张山雷评述“肥贵人则高梁之疾，则痰湿壅塞皆在不言之中”[4]，指出痰湿内盛的肥贵人易患中风等疾病。……