开玄通络法治疗脑小血管病的思路

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关键词：脑小血管病；络病；玄府；开玄通络；化瘀通络；补肾

中图分类号：R277.743 文献标志码：A 文章编号：1007-3213(2025)12-3190-05

DOI: 10.13359/j.cnki. gzxbtcm.2025.12.040

Therapeutic Strategy of Opening Sweat Pore and Unblocking Collaterals for Cerebral SmallVessel Disease

ZHENG Yingying，CHEN Lu，LIU Chengji，LIU Xingchen，LI Yuxuan, WANG Lingmin，YANG Nan (Zhongshan Traditional Chinese Medicine Hospital of Guangzhou University of Chinese Medicine, Zhongshan Guangdong，China）

Abstract：Cerebral small vessel disease （CSVD）is a common cerebrovascular disorder characterized by decreased cognitive ability，unstable gait，and other symptoms that significantly impair patients’quality of life. Traditional Chinese medicine（TCM）posits that CSVD is associated with collteral disorders and dysfunction of sweat pore，and itspathogenesis is due to blockage of collaterals by blood stasis，obstruction ofsweat pore，and malnourishment of the brain marrow.The therapeutic principle of opening sweat pore and unblocking collterals can be applied for CSVD through staging treatment.For the treatment of early CSVD，the focus is on regulating qi （204 movement of sweat pore，calming the spirit，and unblocking colaterals，which can be achieved primarily by using aromatic andacrid herbs.Forthe treatment of CSVD at intermediate stage，the emphasis shifts to resolving stasis tounblock collaterals，whichcan beachieved usually by blood-activating herbs.For the treatmentof late CSVD，treatment aims at tonifying the kidneys to open sweat pore，replenishing marrow to unblock collaterals, which can beachieved mainly by employing kidney-tonifying herbs.Theapproach of opening sweat pore and unblocking colaterals exemplifies theadvantagesofTCM'ssyndrome differentiationandtreatment，offeringvaluable insights for the clinical management of CSVD.

Keywords: cerebral small vessel disease （CSVD）；colateral disorders；sweat pore；opening sweat pore and unblocking collaterals； resolving stasis to unblock collaterals； tonifying kidney

脑小血 管 病（cerebral small vessel disease,CSVD)是一种由脑内微小血管的慢性变化导致的疾病，其主要症状涉及认知功能减退、情绪波动以及卒中等，属于脑血管疾病的范畴。（剩余7810字）