通讯作者: 郭永胜, 13020687669@163.com

DOI：10.12201/bmr.202609.00024

Exploration of Traditional Chinese Medicine Syndrome Differentiation and Treatment of Stroke Based on the Theory of "Turbid Pathogen Damaging the Clear"

• 摘要：“浊邪害清”理论源于《黄帝内经》清浊生理观，确立于叶天士《温热论》，本为温病湿热蒙窍而设。本文从中医经典理论出发，将其拓展应用于脑卒中的辨治。通过辨析“浊邪”与风、火、痰、瘀、虚等传统病机要素的内在关联，提出“浊邪”是对痰瘀浊毒在脑窍局部蓄积、胶结、从化状态的统一概括；从清阳、清窍、清络三个层面界定“复清态”的理论内涵；将脑卒中病机演变梳理为“浊蒙清阳—痰瘀浊毒痹窍—正虚浊恋”三期递进，据此构建先兆期芳香化浊通窍、急性期化痰逐瘀开窍、恢复期升清化浊通络的分期论治方案。本文以经典理论为依据，系统构建脑卒中“浊邪害清”辨治体系，为脑卒中中医辨治提供新的理论视角。

  关键词： 脑卒中；浊邪害清；叶天士；清阳；辨治思路; ; ; ; 

   

  Abstract: The theory of "turbid pathogen damaging the clear" originated from the physiological concept of clear and turbid in *Huangdi Neijing* (Yellow Emperor''s Inner Canon) and was established in Ye Tianshi''s *Wenre Lun* (Treatise on Warm Diseases), originally formulated for warm diseases characterized by damp-heat obstructing the orifices. Grounded in classical traditional Chinese medicine (TCM) theories, this paper extends its application to the syndrome differentiation and treatment of stroke. By analyzing the internal relationship between "turbid pathogen" and traditional pathogenesis elements including wind, fire, phlegm, blood stasis, and deficiency, it proposes that "turbid pathogen" serves as a unified generalization of the local accumulation, cohesion, and transformation of phlegm, stasis, and turbid toxin in the cerebral orifices. The theoretical connotation of "restoring the clear state" is delineated from three dimensions: clear yang, clear orifices, and clear collaterals. The pathogenesis evolution of stroke is organized into a three-stage progression—"turbid pathogen clouding clear yang — phlegm-stasis-turbid-toxin obstructing the orifices — deficiency with lingering turbid pathogen"—based on which a staged treatment regimen is constructed: aromatic turbid-resolving and orifice-opening for the prodromal stage, phlegm-resolving, stasis-dispelling, and orifice-opening for the acute stage, and clear-yang-raising, turbid-resolving, and collateral-dredging for the recovery stage. Supported by classical theories, this paper systematically establishes a "turbid pathogen damaging the clear" framework for the syndrome differentiation and treatment of stroke, offering a novel theoretical perspective for TCM-based stroke management.

  Key words: Stroke; Turbid pathogen damaging the clear; Ye Tianshi; Clear yang; Syndrome differentiation and treatment approach

  提交时间：2026-09-15

  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	2026-09-03	10.12201/bmr.202609.00024V1	下载

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