从“脑为元神之府”辨治脑胰岛素抵抗介导的糖尿病认知功能障碍-《西部中医药》

文章信息/Info

Title:: Syndrome Differentiation of Diabetic Cognitive Dysfunction Mediated by BIR Based on the Theory of "Brain is the Seat of the Primordial Spirit"

作者:: 甘盼盼¹, 贺芹², 全毅红¹, 刘玲³; 1.华中科技大学同济医学院附属武汉中心医院，湖北武汉 430014
2.华中科技大学同济医学院附属湖北妇幼保健院，湖北武汉 430070
3.湖北省中医院，湖北武汉 430000

Author(s):: GAN Panpan¹, HE Qin², QUAN Yihong¹, LIU Ling³; 1.The Central Hospital of Wuhan Affiliated to Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430014, China
2.Maternal and Child Health Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430070, China
3.Hubei Provincial Hospital of TCM, Wuhan 430000, China

Keywords:: brain insulin resistance; diabetic cognitive dysfunction; brain; the seat of the primordial spirit

摘要:: 脑胰岛素抵抗（brain insulin resistance，BIR）介导的糖尿病认知功能障碍（diabetic cognitive dysfunction，DCD）与元神之病导致的痴呆在生理病理上高度吻合，“脑为元神之府”，其虚者多为肾精亏虚，髓海不充；其实者多因痰、瘀、热毒等邪气内扰元神，上蒙清窍。其中，上蒙清窍之痰邪与β样淀粉蛋白（amyloid β，Aβ）沉积密切相关；内扰神府之热毒与中枢神经系统炎症病机相类；壅滞脑络之瘀邪可损伤血管内皮功能；而肾虚髓空、虚火上扰所致之阴虚火旺证，则与氧化应激密切相关。因此提出以“脑为元神之府”理论辨治DCD可为其临床研究提供思路和方法。

Abstract:: Diabetic cognitive dysfunction (DCD) mediated by brain insulin resistance (BIR) is consistent with dementia caused by the disease of the primordial spirit physiologically and pathologically, "brain is the seat of the primordial spirit", the deficiency is mostly caused by depletion of kidney essence, marrow deficiency; and most of the excess is induced by the evils such as phlegm, blood stasis, toxic heat, disturbing the primordial spirit internally, and blocking the clear orifices. Phlegm that blocks the clear orifices is closely related to amyloid β (Aβ); toxic heat that disturbs the primordial spirit is identical with the pathogenesis of the inflammation of the central nervous system; blood stasis that obstructs the cerebral meridians impairs endothelial function of the blood vessels; while Yin deficiency and fire excess pattern induced by kidney deficiency and marrow depletion is closely related to oxidative stress. Hence, "brain is the seat of the primordial spirit" is applied in syndrome differentiation of DCD, which could produce the thinking and methods of clinical study of DCD.