构建脑小血管病“络脉-玄府-脑髓”分期辨治体系

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[中图分类号]R277.7 [文献标志码]A [文章编号]doi：10.3969/j.issn.1674-070X.2025.12.023

Construction of a staged differentiation and treatment system for cerebral small vessel disease based on the theory of "collaterals-mysterious mansion-brain marrow"

TIAN Haoyu， HAN Yan* Yueyang Hospital of Integrated Traditional Chinese and Western Medicine，Shanghai Universityof Traditiondl Chinese Medicine，Shanghai 200437，China

[Abstract]Asthediseasespectrumevolves，agingrelateddiseases，representedbycerebralsallveseldisease（CVD）re increasinglyaffctingpublichealth，makingiturgenttoincorporatenewdiferentiationandtreamentsystemstooptimizeCM therapeuticstrategies.Tispper，byreviewingtecoreelemetsofCMmicro-paterndiferentiatioandincoporatingevidence basedmedicalfindingsandimagingindicators，constructsa"collaterals-ysteriousmansion-brainmarrow"diferentiatioand treatmentsystemcharacterizedbystagedtherapyandintegrated Chinese-Westemmedicineapproaches.Italsoproposesa multidimensionaldiseaseepistemology.Tissystemidentifies"dual-mysteriousmansiondysfunctionandcolateralinjurywith marrowdamage"asitscorepathogenesis，dividingthediseasecourseintothreestages，namely"qi-collteralimpairmentwith mysteriousmansionobstruction""dual-mysteriousmansiondysfunctionwithblood-colateralobstruction"and"mysteriousansion instabilitywithbrainmarrowdysfunction"Corespondingly，therapeuticmethodsof"reglatingmysteriousansiontorestoreproper openingclosingbalance"and"treatingqiandbloodseparatelywithacombinationoftonifyinganddispersing"areestablished， withspecifictreatmentprinciplesincluding"regulatingqitoopenmysteriousmansion，""harmonizingbloodtounblockmysterious mansion"and"replenishingmarowandreiforcingyuan-primordialqi"Thisstudyintegratesmicro-levelanalysiswithholistic TCM pattern differentiation， offering a novel perspective for TCM treatment of CSVD.

[Keywords]cerebralsmallvesseldisease;colaterals;mysteriousmansion;brainmarow;integratedChineseandWeste medicine

纵观中医学发展历史，疾病流行谱的变化促进着中医辨证体系的不断革新。（剩余9680字）