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

Corresponding author: LiuQiang, lq_925@163.com

DOI: 10.12201/bmr.202505.00052

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  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

  Submit time: 31 May 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2025-04-05	10.12201/bmr.202505.00052V1	Download

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