Professor Zhang Genming 's Experience In Preventing And Treating Ischemic Stroke

Stroke is the one of the most often seen diseases which characterizes by sudden lost of consciousness, paralysis of half of the body, oblique tongue and mouth, hemianesthesia, aphasia as main symptoms. Stroke has high incidence, high mortality, high morbidity, is one kind of acute cerebrovascular disease, among types of the disease ischemic stroke is most often seen, recent years there is a tendency for it becoming younger, it brings in the great burden for society, families and patient himself.TCM has a long history for the ischemic stroke disease prevention and treatment, theory of its etiology and pathogenesis experienced a development process consisted of continuous deepening and improving, mainly it can be divided into two periods:Before Tang and Song dynasties medicine specialists assumed it to be related to been influenced by pathogenic wind, After Tang and Song dynasties medics highlighted the role of internal reasons of disease in onset and transformation of pathogenesis. They have proposed theories of pathogenesis named-"Exuberance of heart fire, generation of wind by extreme heat", "Phlegm-damp as main factor, generates wind by depressed heat", "transformation of liver yang into wind" "Generation of wind by Blood stagnation". After setting the theory they paid more attention to internal reasons such as wind, fire, phlegm, qi, blood and deficiency. Modern TCM doctors following the recommendations of the ancients, according to the clinical symptoms would employ suitable according to the theory treatment after the pattern identification, but because pathogenesis of ischemic stroke is complicated, and syndrome manifestations are different, set syndrome types can not completely generalize it, and it is extremely unfavorable for treating stroke in modern clinical practice and apply scientific research. Therefore author has gathered and researched related articles which where written in recent 10 years and summarized works made by modern scientists in the field of etiology, pathogenesis and methods of treatment of ischemic stroke in addition to summarized experience of tutor.Tutor, professor Zhang Genming research clinical TCM for 20 years, he has comparatively deep thoughts about stroke disease. He proposed theory of "prevention is more important than treatment", initiated preventing disease before it appeared, which means finding stroke risk factors in time, when patient symptoms more stable, and take control of such risk factors as hypertonia, hyperlipemia, diabetes, atrial fibrillation, hyperhomocystinemia, smoking and obesity etc., to formulate relevant programs, during treating at particular situation flexibly choose methods of treatment for the patient. According to basic pathogenesis of stroke at stable period highlighted phlegm stasis as the basic of its pathology, and choose application of Banxia baizhu tianmatang with modified medicine as basic concept for removing phlegm removing stasis for promoting obstruction in collaterals, that have effect of promoting blood and collaterals circulation for removing blood stasis and combine chinese patent drugs with similar function like Xuezhitong capsules, tongsaimai tablets etc. adjuvant therapies. Professor Zhang Genming according to clinical experience summarized and think that during the period of fluctuation condition as apoplectic premonitory patients, when differentiation of syndroms mainly by wind sign, after using medicine, which have function tranquillizing liver yang and benefiting liver invigorating kidney, like modified reception Tianma Goutengyin have certain effectiveness.Ischemic stroke is a brain disease which appear in the first place because of deficiency of vital qi which causes many risk factors and they step by step produce a long-term influence on the body, and suddenly under certain circumstances would trigger the disorder of qi and blood, form a blockage in the brain vessels which in its turn causes sufficiency of brains nourishing, birth of toxic evil qi, which would poison the brain. From experience of ancient medics we can get the understanding of importance of tonifying the deficiency. Basing on that teacher Zhang further proposed the importance of supporting vital qi and protecting the brain during acute period of ischemic stroke."Supporting the vital qi" is strengthening ability of a patient to resist evil qi. Expression "protecting the brain" is pointing on the direction of treatment, though incidence of the ischemic stroke in certain measure is influencing all of the organs of the body, still the most crucial disease localization is in brain. Teacher Zhang supposes reason of the disease is that the brain gets the damage, and only after Zang and Fu organs would start changing and certain syndrome would appear. Therefore control the main pathogenesis of the disease is important, and brain needs protection as much as possible, it is key point to reducing the damage, improving clinical effect of treatment and outcome. Supporting the Vital qi and protecting the brain is a method of treating the reason of the disorder in the acute period, but along with paying attention to the syndrome differentiation the method will also consider to use other effective measures (methods of treatment), can be said that it is a combination of differentiation of the syndromes and the diseases. We have chosen Xuanmai injection as a basic medicine for supporting the vital qi and protecting the brain, it doesn’t mater if it is on the very beginning when brain would lose nourishing or the damage by the toxins already appeared, still surrounding brain matter has certain ability to recover, and that is the exact good time to use medicine for supporting the vital qi and protecting the brain, important it to be done and time to be captured well, as earlier it is as better.When comes to an actual usage, you have to connect it with TCM four Methods of diagnostics and choose medicine according to pattern identification, also you should consider from the western medicine angle if there an existence of signs of low perfusion, low blood pressure atrial fibrillation. Also you can use them together with promoting blood and collaterals circulation for removing blood stasis metod.