[Objective]To summarize the clinical experience of a Master of traditional Chinese medicine(TCM),Professor XIONG Jibai,in treating severe cerebrovascular diseases(CVD)with modified Ditan Decoction combined with Tianma Zhijing Powder based on syndrome differentiation.[Methods]By tracing the historical understanding of severe CVD in both Chinese and western medicine,and summarizing Professor XIONG Jibai's diagnostic and therapeutic system for treating apoplexia from the phlegm-wind perspective by using insect drugs,this study analyzes the formulation principles and synergistic effects of Tianma Zhijing Powder and Ditan Decoction.Using a clinical case of severe CVD as example,it extracted the syndrome differentiation and treatment experience of applying modified Ditan Decoction combined with Tianma Zhijing Powder in managing severe CVD.[Results]Severe CVD falls under the category of apoplexia involving the Zang-Fu organs in TCM.Professor XIONG Jibai attributes this condition to the simultaneous pathogenic effects of phlegm and wind.The treatment requires the use of insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.The combination of Ditan Decoction and Tianma Zhijing Powder works to dispel wind-phlegm and dredge the meridians and collaterals.These two formulas mutually reinforce each other's effects,enhancing their therapeutic potency.In the clinical case,adding heat-clearing and orifice-opening ingredients helped restore consciousness in comatose patient,demonstrating the favorable clinical efficacy of this approach in treating severe CVD.[Conclusion]Professor XIONG Jibai postulates the theory of internal wind complicated by phlegm and successfully treated patients with severe CVD.Using Ditan Decoction combined with Tianma Zhijing Powder as the core formula,he applies insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.This case provided a novel approach to overcome therapeutic bottlenecks in severe CVD management,highlight the potential for further exploration of TCM in treating this critical condition.

[Objective]To summarize the clinical experience of a Master of traditional Chinese medicine(TCM),Professor XIONG Jibai,in treating severe cerebrovascular diseases(CVD)with modified Ditan Decoction combined with Tianma Zhijing Powder based on syndrome differentiation.[Methods]By tracing the historical understanding of severe CVD in both Chinese and western medicine,and summarizing Professor XIONG Jibai's diagnostic and therapeutic system for treating apoplexia from the phlegm-wind perspective by using insect drugs,this study analyzes the formulation principles and synergistic effects of Tianma Zhijing Powder and Ditan Decoction.Using a clinical case of severe CVD as example,it extracted the syndrome differentiation and treatment experience of applying modified Ditan Decoction combined with Tianma Zhijing Powder in managing severe CVD.[Results]Severe CVD falls under the category of apoplexia involving the Zang-Fu organs in TCM.Professor XIONG Jibai attributes this condition to the simultaneous pathogenic effects of phlegm and wind.The treatment requires the use of insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.The combination of Ditan Decoction and Tianma Zhijing Powder works to dispel wind-phlegm and dredge the meridians and collaterals.These two formulas mutually reinforce each other's effects,enhancing their therapeutic potency.In the clinical case,adding heat-clearing and orifice-opening ingredients helped restore consciousness in comatose patient,demonstrating the favorable clinical efficacy of this approach in treating severe CVD.[Conclusion]Professor XIONG Jibai postulates the theory of internal wind complicated by phlegm and successfully treated patients with severe CVD.Using Ditan Decoction combined with Tianma Zhijing Powder as the core formula,he applies insect drugs to eliminate phlegm,unblock collaterals and reinforce healthy Qi.This case provided a novel approach to overcome therapeutic bottlenecks in severe CVD management,highlight the potential for further exploration of TCM in treating this critical condition.