@article{ZHANG2026, 
author = {Yuqi ZHANG and Bingrui ZHANG and Yawei DU and Shengxian WU},
title = {Treating persistent postural-perceptual dizziness based on the "turbid pathogen disturbing clearness" theory},
year = {2026},
journal = {Journal of Beijing University of Traditional Chinese Medicine},
volume = {49},
number = {4},
pages = {557-564},
keywords = {persistent postural-perceptual dizziness, turbid pathogen, clear orifices, clear yang},
url = {https://www.sciopen.com/article/10.3969/j.issn.1006-2157.2026.04.014},
doi = {10.3969/j.issn.1006-2157.2026.04.014},
abstract = {Persistent postural-perceptual dizziness (PPPD) is typically characterized by high prevalence, a complex etiology and pathogenesis, and a prolonged disease course. It is also frequently associated with anxiety and depression. PPPD originates in the brain, with its pathogenesis primarily characterized by a deficiency-excess complex. Its onset often involves the spleen, liver, and kidney. Western medical treatment lacks specific therapeutic approaches owing to its unclear pathogenesis. The "turbid pathogen disturbing clearness" theory, which summarizes the pathogenic pattern of dampness-heat turbid pathogen clouding the clear orifices, is derived from the Wenre Lun. From this perspective, the paper hypothesizes that the causative factors of PPPD involve dysfunction of the spleen, liver, and kidney owing to irregular diet, emotional disturbances, aging, and chronic illness, which leads to the internal generation of turbid pathogens such as dampness-turbidity, phlegm-turbidity, and blood stasis turbidity. The core pathogenesis is that turbid pathogens obscure the clear orifices and disturb the clear yang, leading to dysfunction of the clear orifices and to the failure of the original spirit to govern. Based on the pathological progression of the turbid pathogen, the disease is treated in three stages: incipient, exuberant, and latent. The principle of phased treatment centers on regulating the zang-fu, expelling turbid pathogens, unblocking orifices, and strengthening the body′s foundations. During the incipient stage, therapy focuses on strengthening the spleen, soothing the liver, and warming the kidney to prevent the generation of turbid pathogen; during the exuberant stage, therapy emphasizes resolving phlegm, dispelling dampness, and eliminating blood stasis to restore the function of the clear orifices; during the latent stage, therapy focuses on tonifying qi and clearing the mind to support vital qi and expel the latent turbid pathogen. During clinical management, adjustments can be made based on the progression of the turbid pathogen and the characteristics of the syndrome. Using the "turbid pathogen disturbing clearness" theory to guide the treatment of PPPD can provide new perspectives and practical guidance for its clinical diagnosis and treatment in traditional Chinese medicine.}
}