董婷 鲍远程 匡春俊

【摘 要】 鲍远程教授为国家级名老中医，从事中医脑病工作五十余年，中医理论基础深厚，临床经验丰富，博采诸家之成，对中医脑病有独到的见解。鲍远程教授认为阿尔茨海默病的根本病机在于髓减脑消，神机失用，常见证型为肾精亏虚、气血两虚、痰瘀阻窍、肝郁气滞，予以填精益髓、补益气血、消痰化瘀、疏肝理气等治疗，临床疗效显著。

【关键词】 鲍远程;阿尔茨海默病;痴呆病

【中图分类号】R249.2/.7   【文献标志码】 A    【文章编号】1007-8517（2021）12-0095-03

Abstract：Professor Bao is a state-level and well-known Chinese medicine doctor who has been engaged in encephalopathy in traditional Chinese medicine for more than 50 years. He has a solid theoretical foundation and rich clinical experience. He has a wealth of expertise and has unique insights into encephalopathy in traditional Chinese medicine.Professor Bao believes that the basic pathogenesis of Alzheimer's disease lies in the reduction of brain marrow and the loss of neurological functions. The common syndromes are deficiency of kidney essence，deficiency of both energy and blood，phlegm and blood stasis，liver depression and stagnation. The treatment should be filled with essence and marrow，supplementing energy and blood，eliminating phlegm and removing blood stasis，relieving liver and regulating energy，etc. The clinical effect is remarkable，and it is worth learning and promoting.

Keywords：Bao Yuancheng;Alzheimer's Disease;Dementia

阿尔茨海默病（Alzheimer's disease，AD）是老年期最常见的痴呆类型，与基因突变、Aβ沉积、tau蛋白过度磷酸化、胆碱能缺陷等有关[1]。根据AD临床表现可归于祖国医学的“痴呆”“善忘”“文痴”等范畴。《医林改错》首次将本病归为脑病，认为是老年人髓海空闲，脑失所养所致，对临床有重要指导意义。随全球老龄化加剧，AD发病率逐年上升，65岁以上患病率为5%～10%，85岁20%～50%[2]，预估2030年我国AD患者将达到2330万[3]，对国家及家庭是一个严重的负担考验[4]。鲍远程教授为国家级名老中医，从事中医脑病工作五十余年，中医理论基础深厚，临床经验丰富，博采诸家之成，对中医脑病有独到的见解，现将鲍远程教授对AD中医治疗的经验总结如下。

1 病因病机

《左传》中“不慧，盖世人所谓白痴”是对本病最早的描述。“痴呆”一词最早见于《华佗神医秘传》，指脑衰髓减引起的记忆下降，智力衰退等表现的疾病。《医林改错》“小儿无记性者，髓海未满，高年无记性者，髓海渐空。”明确痴呆病病在脑髓。鲍远程教授认为本病以肾虚为主，痰瘀为要。……