【摘要】 痴呆是一类以进行性认知功能减退、行为障碍为主要表现的神经退行性疾病，严重影响患者生活质量，给家庭和社会带来沉重负担，中医药治疗该病具有独特优势。中医专家陈伟教授基于“形脏”与“神脏”辨证统一的学术观点，认为肾为先天之本，其形脏之体主藏精，其神脏之用体现为精生髓充脑且藏志统神。在生理状态下，肾精充盈则髓海得充，肾志安定则神明有序，二者协调统一，维持脑窍清灵、认知正常；在病理状态下，肾之精志失调，以精亏为本，瘀痰为标。肾精亏虚则髓海失养，肾志不宁则神明失用，精不化气致痰瘀内生、阻塞脑窍而发病。治疗上陈教授主张“填补肾精，益髓养脑”以固形脏之本，“安神定志，调畅神明”“化痰逐瘀，开窍醒神”以治神脏之标，且擅用经方地黄饮子加减，通过滋肾阴、补肾阳、开窍化痰，兼顾肾精亏虚与痰瘀阻窍之证，效果颇佳。文章旨在总结陈教授从“肾藏精、肾藏志”辨证论治痴呆的经验，以期为痴呆的中医药治疗开拓思路。更多还原

【Abstract】 Dementia is a neurodegenerative disease characterized by progressive cognitive decline and behavioral disorders,severely impacting patients’ quality of life and imposing a heavy burden on families and society.Traditional Chinese medicine (TCM) has unique advantages in treating this disease.Professor CHEN Wei,a TCM expert,based on the unified theory of “form and organ” and “spirit and organ,” believes that the kidney is the foundation of innate essence.Its physical function is to store essence,while its spiritual function is manifested in the generation of marrow to nourish the brain and the storage of will to govern the spirit.Under physiological conditions,abundant kidney essence leads to a full marrow sea,and stable kidney will ensures a clear and orderly spirit.The two coordinate and unify to maintain clear brain function and normal cognition.Under pathological conditions,the kidney’s essence and will are imbalanced,with essence deficiency as the root cause and phlegm stasis as the manifestation.Kidney essence deficiency leads to malnourishment of the marrow sea,and restlessness of the kidney will leads to impaired spirit function.The failure of essence to transform into Qi results in the internal generation of phlegm and blood stasis,obstructing the brain orifices and causing disease.In treatment,Professor Chen advocates “replenishing kidney essence,nourishing marrow and brain” to strengthen the body’s foundation,“calming the mind and regulating the spirit,” and “resolving phlegm and removing blood stasis,opening the orifices and awakening the mind” to address the symptoms of mental and physical dementia.He is also skilled in using modified versions of the classic formula Rehmannia Decoction,which nourishes kidney Yin,tonifies kidney yang,and opens the orifices to resolve phlegm,addressing both kidney essence deficiency and phlegm-blood stasis obstructing the orifices,achieving excellent results.This article aims to summarize Professor Chen’s experience in treating dementia based on the principles of “the kidney storing essence and the kidney storing will,” hoping to broaden the scope of traditional Chinese medicine treatment for dementia.更多还原