椎基底动脉供血不足眩晕病因及发病机理探究.docVIP

椎基底动脉供血不足眩晕病因及发病机理探究 　【关键词】 椎基 摘要：椎基底动脉供血不足性眩晕(VBI)是一种常见的神经系统病症，由于脑动脉粥样硬化，颈椎病等原因所致的基底系统供血障碍而引起疾病。该病的病因和发病机理研究在中医方面认为病因多端，以内虚为其发病基础。其病机多虚实夹杂，本虚标实，错综复杂。而现代医学对该病从解剖学和生物学方面对病因和发病机理研究进行阐述。 关键词：椎基底动脉供血不足性眩晕； 病因； 发病机理 Study of the Pathogenesis and Mechanism of Vertebrobasilar Insufficiency Vertigo Abstract:Vertebrobasilar Insufficiency(VBI)Vertigo is a kind of common nervous system symptom,since the cerebral artery gruel type hardening,the base that the reasons such as cervical vertebra illness and so on are the result of systematically feeies that the blood obstruction arouses the disease.The cause of disease of this illness and the mechanism are reserched that it is suffered from an illness at the aspest of traditional Chinese medicine that the cause of disease multiple ends and less than the void suffers from an illness on the base in the ilterest of such disease.Much the actual situations of such pathogenesis are mingled with native void sign factor is complex.But Western medicine to native illness research is through anatomy with adjusting the cause of disease the pathology physiology mechanism research is elaborated with suffering from an illness. Key words:Vertebrobasilar lnsufficiency Vertigo; Pathogenesis; Mechanism 1 中医对椎基底动脉供血不足性眩晕病因和发病机理研究 椎基底动脉供血不足性眩晕(VBI)属于祖国医学“眩晕”的范畴。《内经》的《素问#12539;至真要大论》中认为“诸风掉眩皆属于肝”指出眩晕与肝关系密切。《灵枢》有“上虚则眩”“上所不足”“髓海不足”均属因虚致眩。张仲景认为痰饮是眩晕的发病原因之一。而张景岳《景岳全书#12539;眩运》中有“眩一证虚者居八九而兼火兼痰者不过十中有一二耳”的记载。历来医家认为该病病因以虚为主，常夹风、火、痰、瘀在这方面的研究已有很多发展。中医对VBI性眩晕病因病机的研究主要分为以下几种：气虚为本、血瘀为患，痰饮瘀血为患，阴虚阳亏、痰瘀为患，瘀阻脉络为患，脾肾不足、痰瘀阻络为患［1］。在具体的认识上，许多中医学者又有不同之处。董克礼等［2］认为有些学者根据本病的发病人群和临床表现认为其病位在脑，涉及肝脾肾脏，其性质为本虚标实，以气血肾精亏虚为本，瘀血阻脉络为标，其病理机制是人到中年气血不足，肾气不旺，不能很好地推动血液运行，日久致血滞脉中气血津不能不奉清空，髓海空虚，脑窍失养，而发为眩晕，病因多端且以内虚为其发病基础。病机多为虚实夹杂，错综复杂。中医各家对椎基底动脉供血不足性眩曙病因病机也有不的认识如黄氏［3］认为VBI性眩晕主要是气虚血瘀引起，气虚为本，瘀血为标，因虚致瘀，气血不足脉络不利，清窍失养而发病。王氏则［4］认为，该病多由痰混淆内蕴，瘀血阻络所致，因痰湿粘滞难去，阻碍气机，影响血液运行，血流缓慢瘀滞，痰瘀互结，阻于脑窍脑府失养，清阳不升，浊阴不降，而发眩晕。毛氏［5］，认为该病瘀阻脉络脑窍，致气血不畅，气虚是促成血瘀的条件，气虚血瘀是主要病机。刘氏［6］，认为该病之眩晕，主要为风痰瘀痹阻脑络，气血运行不畅，脑失所养而致病。崔氏［7］，认为该病