通讯作者: 龙华君, 17347131805@163.com

DOI：10.12201/bmr.202511.00049

Professor Long Huajuns Experience in Differentiating and Treating Ischemic Stroke Recovery Phase with Spleen Deficiency and Phlegm-Dampness Pattern

• 摘要：?本文基于“脾为生痰之源”理论，提出“脾虚生痰，痰阻致瘀，痰瘀互结，痹阻脑络” 的病机演变理论，阐明“脾虚痰湿”是连接代谢紊乱与中风发病、恢复迟缓及复发的核心环节。临证强调抓住肥胖舌腻、头重身困、纳呆脘痞核心症候，以健脾益气、燥湿化痰为根本治法，以六君子汤合半夏白术天麻汤为主方化裁，并灵活佐以活血通络与消膏降浊之法。其方药运用形成健脾益气、化痰祛湿、活血通络、消膏降浊四个维度的药对体系，体现标本兼治、融汇古今的用药特色。文章系统总结其辨治经验并附验案1则，为临床诊疗提供参考。

  关键词： 缺血性中风；从脾论治；病机演变；脾虚痰湿；名医经验

   

  Abstract: Based on the theory that the spleen is the source of phlegm production, this article proposes a pathomechanism evolution theory of spleen deficiency generating phlegm, phlegm obstruction leading to stasis, interaction of phlegm and stasis, and obstruction of the brain collaterals. It elucidates that spleen deficiency and phlegm-dampness is the core link connecting metabolic disorders with the onset, slow recovery, and recurrence of stroke. In clinical practice, it emphasizes identifying the core symptoms of obesity, greasy tongue coating, heavy-headedness, body fatigue, poor appetite, and epigastric fullness. The fundamental treatment methods are to fortify the spleen and boost qi, as well as to dry dampness and resolve phlegm, primarily using modified formulations of Liujunzi Tang (Six Gentlemen Decoction) combined with Banxia Baizhu Tianma Tang (Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction). These are flexibly supplemented with methods to activate blood circulation and unblock collaterals, and to disperse turbid fat and reduce turbidity. The application of medicinals forms a four-dimensional herb-pair system: fortifying the spleen and boosting qi, resolving phlegm and eliminating dampness, activating blood circulation and unblocking collaterals, and dispersing turbid fat and reducing turbidity, reflecting a medicinal characteristic that treats both the root and branch, and integrates ancient and modern knowledge. This article systematically summarizes these differentiation and treatment experiences and includes one proven case for clinical reference.

  Key words: Ischemic Stroke；Treating from the Spleen Perspective；Pathomechanism Evolution；Spleen Deficiency with Dampness-Phlegm；Expert Experience

  提交时间：2025-11-19

  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	2025-11-13	10.12201/bmr.202511.00049V1	下载

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