通讯作者: 刘强, lq_925@163.com

DOI：10.12201/bmr.202505.00052

Exploring the Pathogenesis and Management Strategies of Presyncope from the Perspective of the ascending the Qing and descending the Zhuo Theory

• 摘要：晕厥前状态是晕厥发生的早期预警阶段,其本质为脑血流动力学代偿失衡,涉及气血逆乱与清浊升降失调。该文基于《内经》“升清降浊”理论,系统剖析其病因病机,提出“阳气失运”与“阴化异常”为核心病机,强调阳虚致清阳不升、阴精亏耗致虚阳上亢的双重病理机制。以“斡旋中焦、燮理升降”为治则,结合通阳益气、滋阴潜阳、疏肝调气、化痰活血等法,构建标本同治的中医诊疗模式。明确指出中医“升清降浊”理论与西医病因分层诊疗相结合,可发挥“未病先防”优势,减少晕厥事件及其并发症的发生。该辨证体系为防治晕厥前状态提供了理法方药完备的中西医结合诊疗路径,具有重要的临床实践价值。

  关键词： 晕厥前状态; 升清降浊; 阳气失运; 阴化异常; 理论探讨

   

  Abstract: Presyncope, an early warning stage preceding syncope, is fundamentally characterized by an imbalance in cerebral hemodynamic compensation, involving chaotic qi-blood dynamics and dysregulation of the ascending-descending movement of Qing and Zhuo . Guided by the theory of ascending the Qing and descending the Zhuo from theHuangdi Neijing, this article systematically analyzes the etiology and pathogenesis of presyncope. It proposes that yang qi dysfunction and abnormal yin transformation constitute the core pathological mechanisms, emphasizing the dual pathogenesis of yang deficiency leading to failure of clear yang to ascend, and yin essence depletion causing hyperactivity of deficient yang. The treatment principles focus on regulating the middle and harmonizing ascending-descending movements, integrating methods such as activating yang and replenishing qi, nourishing yin to suppress yang hyperactivity, soothing the liver and regulating qi, resolving phlegm, and promoting blood circulation. This establishes a holistic Chinese medicine (CM) therapeutic mode targeting both symptoms and root causes. The study highlights the synergy between the CM theory of ascending the Qing and descending the Zhuo and Western medicine’s stratified etiological management, which leverages the preventive advantage of treating pre-disease to reduce syncope episodes and complications. This integrated diagnostic and therapeutic framework provides a comprehensive CM-Western medicine pathway with well-defined principles, methods, and prescriptions for presyncope prevention and treatment, demonstrating significant clinical value.

  Key words: presyncope; ascending the Qing and descending the Zhuo; yang qi dysfunction; yin jing dysfunction; theoretical exploration

  提交时间：2025-05-31

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2025-04-05	10.12201/bmr.202505.00052V1	下载

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