陈相明治疗椎动脉型颈椎病的经验.docVIP

陈相明治疗椎动脉型颈椎病的经验 　　【摘要】 陈相明教授认为， 椎动脉型颈椎病病因为肝藏血主筋， 脾统血主运化、升清， 肾主骨藏精生髓， 其发生多与肝脾肾关系最为密切。同时认为椎动脉型颈椎病属于本虚标实之证， 本虚是肝、脾、肾功能衰弱， 标实为督脉、足太阳膀胱经经脉阻滞。中医多辨证为肾精亏虚型、痰凝血瘀型， 陈教授主张采用补肾活血法和通阳化痰祛瘀法治疗， 疗效显著。 　　【关键词】 椎动脉型颈椎病;临床经验;陈相明 　　DOI：10.14163/j.cnki.11-5547/r.2015.04.166 　　Chen Xiangming’s experience in treating vertebral artery type cervical spondylopathy DENG Yong-zhi. 2012 Grade Shi Chengzhi Doctor Class， Heilongjiang University of Chinese Medicine， Harbin 150040， China 　　【Abstract】 In the viewpoint of Professor Chen Xiangming， the main pathogenesis of vertebral artery type cervical spondylopathy are liver storing blood advocate muscle， spleen controlling blood advocate transportation and ascending lucidity， and kidney governing bones storing essence generating marrow. The disease has close relationship with liver， spleen and kidney. Vertebral artery type cervical spondylopathy is also considered as a syndrome with deficiency in origin and enrichment in symptom. Deficiency in origin reveals function decline of liver， spleen and kidney; Enrichment in symptom shows retardation in the Governor Meridian and the Bladder Meridian of Foot-Taiyang. The syndrome differentiation in tradition Chinese medicine includes kidney essence deficiency type and phlegm and blood stasis type. Professor Chen holds a proposition in applying tonifying kidney activating blood method and activating yang reducing phlegm removing stasis method in treating the disease with remarkably curative effect. 　　【Key words】 Vertebral artery type cervical spondylopathy; Clinical experience; Chen Xiangming 　　椎动脉型颈椎病是由于椎动脉在颈椎横突孔中， 因椎间隙的狭窄、钩椎关节骨赘的增生， 或颈椎失稳、受刺激或压迫， 使动脉血流的暂时阻断， 导致脑部椎动脉-基底动脉供血不足， 产生了一系列的临床症状[1]， 如头痛、颈性眩晕、视觉障碍、猝倒、感觉障碍或者运动障碍等， 通过X线平片可显示患者椎体出现病理性移位或椎间孔形态改变以及钩椎关节骨赘增生， 椎动脉造影可帮助提供明确的病变部位， 主要表现为椎动脉因受压呈现出扭曲上行的阴影[2]。 　　1 临床表现 　　中医学中目前没有椎动脉型颈椎病这一病名， 根据其临床表现分析， 应该属于中医学的“眩晕”、“痹证”、“头痛”、“项强”、“颈肩痛”等范畴， 对它的论述可见于部分古籍文献中[3]。如《素问?至真要大论》中有“诸风掉眩， 皆属于肝”， 以肝立论， 这是在《内经》中关于眩晕等病因病机的论述[4]。《灵枢?海论》云：“髓海不足， 则脑转耳鸣， 胫疫眩冒， 目无所见， 懈