摘要：在医学的漫漫征途中，中风宛如一个隐藏在暗处的“神秘杀手”，悄无声息地威胁着人们的健康，尤其是中老年人的生命质量。据世界卫生组织统计，全球每年约有 1500 万人遭受中风的侵袭，其中 500 万人因此失去生命，另有 500 万人落下终身残疾。在中国，中风更是成为
在医学的漫漫征途中，中风宛如一个隐藏在暗处的“神秘杀手”，悄无声息地威胁着人们的健康，尤其是中老年人的生命质量。据世界卫生组织统计，全球每年约有 1500 万人遭受中风的侵袭，其中 500 万人因此失去生命，另有 500 万人落下终身残疾。在中国，中风更是成为了居民死亡和残疾的首要原因，其高发病率、高致残率和高死亡率，犹如三把沉重的利刃，刺痛着无数家庭的心。那么，这个可怕的“杀手”究竟有着怎样的作案手法？我们又该如何防范呢？
溯本求源：气血内虚——中风的“罪恶温床”
20 世纪 80 年代以后，中华医学会内科专业委员会从行业标准建设角度重新构架中风病的诊疗理论，为我们揭开中风神秘面纱提供了关键线索。1986 年《中风病中医诊断、疗效评定标准》发布，1996 年又进一步推出《中风病诊断与疗效评定标准》，明确指出中风病又名卒中，在 CCD（TCD）编码中中西医一致。这一系列标准的出台，如同在中风研究的黑暗中点亮了一盏明灯。
标准揭示，中风病是在气血内虚的基础上悄然滋生的。气血，乃人体生命活动的根本，如同江河之水，滋养着身体的每一个角落。当气血充足时，人体脏腑功能协调，经络通畅，生命之树茁壮成长；而一旦气血内虚，就如同江河干涸，身体的各个器官得不到充足的滋养，功能逐渐失调。此时，若再遇上劳倦内伤、忧思恼怒、嗜食厚味、烟酒等诱因，就如同在干涸的河床上点燃了一把大火，进而引起脏腑阴阳失调、气血逆乱。这股紊乱的气血如脱缰的野马，直冲犯脑，形成脑脉痹阻或血溢脑脉之外，从而引发中风。
这就好比一座坚固的大厦，气血内虚如同大厦的地基出现了裂缝，而各种诱因则像是一场突如其来的地震，让这座原本就脆弱的大厦摇摇欲坠，最终轰然倒塌。临床表现为突然昏仆，半身不遂，口舌歪斜，语言蹇涩或失语，偏身麻木等症状，并且具有起病急、变化快，如风邪善行数变的特点。按病理还可分为出血性中风和缺血性中风，如同两条不同的邪恶路径，都将患者引向痛苦的深渊。
辨证新探：七大证候——中风的“精准画像”
在辨证论治方面，如今的中风病研究也取得了重大突破。不再以中经络、中脏腑为纲，而是将中风病细致地分为风痰火亢、风火上扰、痰热腑实、风痰痹阻、痰湿蒙神、气虚血瘀、阴虚风动七个证候类型。这七个证候类型，就像是对中风这个“神秘杀手”的七张精准画像，让我们能够更清晰地认识它的真面目。
以气虚血瘀证为例，气虚就如同身体里的动力不足，无法推动血液正常运行，导致血液瘀滞。这就好比一辆汽车，发动机动力不足，就无法正常行驶，甚至会在半路上抛锚。患者常常表现为面色苍白，气短乏力，半身不遂，肢体麻木等症状。曾经有一位 60 多岁的患者，平时身体虚弱，经常感到气短乏力。一天早上起床时，突然发现右侧肢体无法动弹，口角歪斜，说话也不清楚。家人急忙将他送到医院，经过中医辨证，确诊为气虚血瘀型中风。医生根据他的病情，采用了益气活血的治疗方法，经过一段时间的治疗，患者的症状得到了明显改善，逐渐恢复了生活自理能力。
又如风痰火亢证，风、痰、火三种邪气相互交织，如同三股邪恶的势力在体内肆虐。患者往往会出现头痛眩晕，烦躁易怒，半身不遂，口眼歪斜等症状。有一位 50 多岁的患者，平时性格暴躁，喜欢吃辛辣油腻的食物。一天，他在与家人争吵后，突然出现头痛剧烈，随即昏迷不醒，被紧急送到医院。中医诊断为风痰火亢型中风，经过清热化痰、熄风通络的治疗，患者的病情逐渐稳定下来。
防患未然：养足气血——中风的“坚固盾牌”
既然气血内虚是中风的根源，那么养足气血就成为了预防中风的关键。这就好比给身体筑起一道坚固的盾牌，让中风的“利箭”无法穿透。
首先，饮食调养是养足气血的基础。中医认为，“五谷为养，五果为助，五畜为益，五菜为充”，合理的饮食结构能够为身体提供充足的营养。我们可以多吃一些具有补气养血作用的食物，如红枣、桂圆、山药、黑芝麻等。红枣被誉为“天然维生素丸”，具有补中益气、养血安神的功效；桂圆则能补益心脾、养血安神。同时，要避免食用过多辛辣、油腻、刺激性的食物，这些食物就像身体里的“垃圾”，会阻碍气血的运行。
其次，适当运动也是养足气血的重要方法。运动能够促进身体的血液循环，增强心肺功能，就像给身体的发动机进行了一次全面的保养。我们可以选择一些适合自己的运动方式，如散步、太极拳、八段锦等。散步是一种简单而又有效的运动方式，每天坚持散步 30 分钟以上，能够让身体的气血更加通畅；太极拳则以其柔和的动作和深长的呼吸，能够调节身体的阴阳平衡，增强气血的运行。
此外，保持良好的心态对于养足气血也至关重要。忧思恼怒等不良情绪就像身体里的“毒药”，会损伤气血。我们要学会调整自己的心态，保持乐观开朗的心情。就像古人所说：“笑一笑，十年少；愁一愁，白了头。”当我们以积极的心态面对生活时，身体的气血也会更加充盈。
行业规范：引领中风研究的新征程
具有行业规范性质的著作及自第五版以后高等中医药院校《中医内科学》教材，基本都以新的中风病诊断与疗效评定标准和证候分类为依据编写相关内容。这就像是在中风研究的道路上树立了一座座明亮的灯塔，为后来的研究者指明了方向。
这些规范和教材不仅总结了前人的经验，还融入了现代医学的研究成果，让中风的研究更加科学、系统。它们培养了一批又一批优秀的中医人才，为中风的治疗和预防注入了新的活力。同时，也促进了中西医的交流与合作，让两种医学体系在攻克中风这一难题上携手共进。
中风虽然可怕，但并非不可战胜。只要我们深入了解中风的发病根源，准确辨证论治，积极预防调养，就能够养足气血，筑起一道坚固的防线，让中风的“神秘杀手”无机可乘。让我们携手共进，在这场与中风的战斗中，守护好自己和家人的健康，让生命之花在气血的滋养下绽放出更加绚烂的光彩！
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
Blood and Spirit: deciphering the Stroke code and protecting the voyage of life
In the long march of medicine, stroke is like a hidden "mysterious killer" that silently threatens people's health, especially the quality of life of middle-aged and elderly people. According to the World Health Organization, approximately 15 million people worldwide suffer a stroke every year, of which 5 million lose their lives and another 5 million are permanently disabled. In China, stroke is the leading cause of death and disability. Its high incidence of a disease, high morbidity and high mortality, like three heavy knives, stabbing the hearts of countless families. So, what exactly did this horrible killer do? How can we guard against it?
Tracing the origins of the veins - the "evil hotbed" of stroke
After the 1980s, the Chinese Medical Association's Internal Medicine Professional Committee restructured the diagnosis and treatment theory of stroke from the perspective of industry standard-building, providing key clues to unraveling the mystery of stroke. In 1986, the Clinical Diagnosis and Treatment Evaluation Criteria for Stroke Disease was released, and in 1996, the Criteria for Diagnosis and Therapeutic Evaluation Criterium was further introduced, which clearly states that stroke disease, also known as stroke, is consistent with Chinese and Western medicine in the CCD (TCD) code. The introduction of this set of standards is like lighting a bright light in the darkness of stroke research.
Standards reveal that strokes develop quietly on the basis of a lack of vitality. The qi and blood are the basic life activities of the human body, and like the water of rivers, they nourish every corner of the body. When the qi and blood are sufficient, the body's inner organs function in coordination, the meridians are clear, and the tree of life thrives. Once the qi and blood are depleted, it is like rivers running dry, and the various organs of the body are not adequately nourished, and their function gradually becomes dysfunctional. At this time, if we encounter other triggers such as exhaustion and internal injury, worry and anger, heavy consumption of food, tobacco and alcohol, it is like lighting a large fire on a dry riverbed, which will cause internal disorders of yin and yang, and qi and blood disorders. This disturbed blood and oxygen rushes like a wild horse into the brain, causing a blockage or blood spilling beyond the brain's veins, which can trigger a stroke.
It was like a solid building, with cracks in its foundations, and the trigger was like an earthquake that rocked the already fragile building and collapsed. The clinical manifestation is symptoms such as sudden fainting, paralysis, a tilted tongue, slurred or unable to speak, and paralysis on the side, and it has the characteristics of rapid illness and rapid change, such as changes in evil spirits and good deeds. They can also be divided into hemorrhagic stroke and ischemic stroke, as two different evil pathways that lead the patient to the abyss of pain.
New evidence: seven signs - an "accurate picture" of stroke
In terms of dialectical treatment, major breakthroughs have been made in stroke research today. Instead of using the meridians and internal organs as the guidelines, stroke disease is broken down into seven types of symptoms: hyperthermia, hyperthermia disturbance, hyperthermemia in the internal organs, hyperthermias, paralysis of the phlegm, phlegm clouding the spirit, hypoxia, blood bruising, and conjunctivitis. These seven types of signs are like seven accurate portraits of the mysterious killer of stroke, allowing us to get a clearer picture of what it really is.
Take the syndrome of blood stasis due to qi deficiency as an example. Qi deficiency is like a lack of power in the body, unable to promote the normal operation of blood, resulting in blood stasis. It's like a car that doesn't have enough engine power, can't drive properly, and even breaks down halfway along the way. Patients often present with symptoms such as pale face, shortness of breath, attempts to function and numbness in the limbs. There was once a patient in his 60s who was usually weak and often felt shortness of breath. When I woke up one morning, I suddenly found my right limb unable to move, my mouth was tilted, and I couldn't speak clearly. The family rushed him to the hospital, and after therapeutic examination, he was diagnosed as having a stroke characterized by spleen and bruising. Based on his condition, the doctor adopted a pro-spiriting treatment. After a period of treatment, the patient's symptoms improved significantly and gradually regained his ability to care for himself.
Also, as evidenced by high levels of wind, sputum and fire, the three evils of wind, spitting and fire are intertwined, like three evil forces raging in the body. Patients often experience symptoms such as headache, dizziness, irritability, attempts at the body, and a tilted eye or mouth. There was a patient in his 50s who usually had a grumpy personality and liked to eat spicy and greasy food. One day, after an argument with his family, he suddenly suffered a severe headache and immediately fell unconscious and was rushed to hospital. TCM diagnosed a stroke characterized by fever, spleen, and hyperthermia. After the treatment of clearing the fever, healing the spleen, extinguishing the wind and healing the meridians, the patient's condition gradually stabilized.
Prevention: Hydrate your blood - a strong shield against stroke
Since ischemia is the root cause of stroke, adequate maintenance of ischemia has become the key to preventing stroke. This is like building a strong shield for the body so that the "arrows" of a stroke cannot penetrate.
First, dietary maintenance is the basis for maintaining blood and oxygen. According to traditional Chinese medicine, "five grains are for maintenance, five fruits are for help, five animals are for benefits, and five dishes are for replenishment," and a reasonable diet structure can provide adequate nutrition for the body. We can eat more foods that have the effect of reviving and nourishing blood, such as red dates, cinnamon, yams, black sesame, and so on. Jujube is known as "natural vitamine pill," which has the effect of nourishing blood for tranquillization; Longan is invigorating heart and spleen, nourishing blood for tranquillization. At the same time, we should avoid eating too much spicy, greasy, and irritating foods, which are like "junk" in the body and will hinder the operation of air and blood.
Secondly, proper exercise is also an important way to maintain your body's energy. Exercise promotes the blood circulation of the body and enhances the cardiorespiratory function, like giving the body's engine a full maintenance. We can choose some forms of exercise that are suitable for ourselves, such as walking, tai chi, gong, etc. Walking is a simple and effective form of exercise. Walking for more than 30 minutes a day can make the body's blood and blood flow more smooth. Tai chi, with its gentle movement and deep breathing, can regulate the yin and yang balance of the body and enhance the operation of qi and blood.
In addition, maintaining a good mental attitude is also essential to maintaining good health. Poor emotions such as worry and anger are like "poison" in the body and can damage the blood and blood. We should learn to adjust our mindset and maintain an optimistic and cheerful mood. As the ancients said:“A smile is a decade away; It would be a waste of time to worry.”When we face life with a positive attitude, the body's blood and blood will also be more full.
Industry norms: leading a new journey in stroke research
Since the fifth edition, books of an industry-standard nature and teaching materials on traditional Chinese medicine in higher education institutions have basically been written based on the new diagnostic and efficacy evaluation criteria and classification of symptoms of stroke. It was like erecting bright lighthouses on the road to stroke research, pointing the way for later researchers.
These norms and teaching materials not only summarize the experience of previous people, but also incorporate the research findings of modern medicine, making the study of stroke more scientific and systematic. They have cultivated a number of outstanding traditional Chinese medicine talents, injecting new vitality into the treatment and prevention of stroke. At the same time, it has also promoted exchanges and cooperation between Chinese and Western medicine, allowing the two medical systems to work together to overcome the difficult problem of stroke.
Strokes, although terrible, are not invincible. As long as we deepen our understanding of the root cause of stroke, accurately diagnose and treat stroke, and actively prevent and rejuvenate, we can build up our energy and build a strong defense line, and let the "mysterious killer" of stroke become inaccessible. Let us work together to safeguard the health of ourselves and our families during this battle against stroke, so that the flowers of life blossom even more brightly under the nourishment of vigorous blood.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
来源：首都专家梁世杰一点号
