Treatment of Minimally Conscious State with Musk Based on "Phlegm，Fire，Blood Stasis，and Deficiency"
10.13288/j.11-2166/r.2025.02.014
- VernacularTitle:运用麝香从“痰、火、瘀、虚”论治最小意识状态
- Author:
Yanbo SONG
1
;
Yongkang SUN
1
;
Mingyuan LI
2
;
Xinzhi WANG
1
Author Information
1. The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou，450099
2. The Second People's Hospital of Jiaozuo
- Publication Type:Journal Article
- Keywords:
minimally conscious state;
Shexiang （Moschus）;
disorders of consciousness;
awaken the consciousness and open the orifices;
phlegm;
fire;
blood stasis;
deficiency
- From:
Journal of Traditional Chinese Medicine
2025;66(2):188-192
- CountryChina
- Language:Chinese
-
Abstract:
Minimally conscious state （MCS） is at the edge between closed and open consciousness， but it still belongs to the category of "wind-strike block" syndrome. The basic pathogenesis of MCS is the obstruction of pathogenic qi， orifices closed and spirit hidden， with pathological factors including phlegm， fire， and blood stasis. Wind movement and water retention may also be present， and often leading to deficiency syndrome due to the exhaustion of qi， blood， yin， and yang at later stages. Treatment chooses Shexiang （Moschus） as the chief medicinal， emphasizing combination of medicinals and urgency of medication administration； the key therapeutic method is to open the orifices， with focuses on expelling pathogens and reinforcing healthy qi. For patients with severe phlegm or fire， use Xiaochengqi Decoction （小承气汤） to open the lower orifices， discharge heat and unblock the bowels， combined with Shexiang （Moschus） and Niuhuang （Bovis Calculus） to open the upper orifices， awaken the spirit and guide qi. For patients with turbid phlegm as the predominant， temporarily replace Shexiang （Moschus） with Baizhi （Angelicae dahuricae radix）， using Ditan Decoction （涤痰汤） to eliminate phlegm to open the orifices， when turbid phlegm gradually subsided， Shexiang （Moschus） could be added. For patients with blood stasis as the predominant， Tongqiao Huoxue Decoction （通窍活血汤） will be used to activate blood and open orifice， if the blood circulates， the endogenous wind will be calmed， the water will be induced， the orifices will open and the consciousness will restore. For patients with closed orifices and body deficiency， the treatment should open the orifices and reinforce healthy qi， and consider the root and branch simultaneously； qi deficiency syndrome can be addressed with Buyang Huanwu Decoction （补阳还五汤） to boost qi and reinforce healthy qi； yin deficiency syndrome can be treated with Shaoyao Gancao Decoction （芍药甘草汤） combined with Fengsui Pill （封髓丹） to nourish yin， soften sinews， and secure kidney essence； yang deficiency can be managed by using Dihuang Yinzi Decoction （地黄饮子） to enrich yin， supplement yang， and open the orifices.
