从痉证论治阵发性交感神经过度兴奋综合征

Treatment of paroxysmal sympathetic hyperactivity from convulsive syndrome

关键词:  痉证  阵发性交感神经过度兴奋综合征  辨治

Key words:  convulsive syndrome  paroxysmal sympathetic hyperactivity  diagnosis and treatment based on syndrome differentiation

摘要:

阵发性交感神经过度兴奋综合征（PSH）是一种与中重度脑损伤相关的临床综合征，以同时发生的肌张力障碍及交感神经功能亢进为临床表现。目前针对PSH的临床治疗侧重于西医对症处理，中医整体观念与辨证论治思维可以兼顾多证，能够对西医治疗进行有效补充。通过临床观察发现，在西药对症治疗基础上联合中药及针灸等中医疗法有助于提高疗效，减少不良反应，同时缩短病程。但由于从发现到逐步认识PSH的时间较短，因此对其病位、病因、病机、分型及中医治疗尚无系统认识。PSH发作时的肌张力障碍表现为四肢肌张力高、角弓反张等，发作表现符合中医痉证范畴，故文章试从痉证论述PSH的中医辨治，以期为PSH的中医治疗提供理论基础。

Abstract:

Paroxysmal sympathetic hyperactivity（PSH） is a clinical syndrome associated with moderate to severe brain injury，characterized by concurrent muscle tone disorders and sympathetic hyper-function. At present，the clinical treatment of PSH focuses on symptomatic treatment in Western medicine，while the overall concept and dialectical thinking of traditional Chinese medicine（TCM） can balance multiple syndromes，which is an effective supplement to Western medicine treatment. Through clinical observation，found that the combination of TCM，acupuncture and moxibustion and other TCM treatments on the basis of symptomatic treatment of western medicine can help improve the efficacy，reduce adverse reactions and shorten the course of disease. However，due to the short time from discovery to gradually understanding this group of syndromes，there is no systematic understanding of the location，etiology，pathogenesis，classification and TCM treatment of this group of syndromes. During the onset of PSH，muscle tone disorders are characterized by high muscle tone in the limbs and reflexes，which are consistent with the category of spasms in TCM. Therefore，the author attempts to discuss the TCM diagnosis and treatment of PSH from the perspective of spasms，in order to provide a theoretical basis for the TCM treatment of PSH.