[关键词]
[摘要]
总结宁为民教授基于疏肝开郁透邪法治疗慢性偏头痛的经验。慢性偏头痛是一种常见的神经系统疾病,其发病率相对较高。目前其治疗以口服药物为主,存在治疗效果不稳定、长期服药副反应大、依从性低、药物依赖、对焦虑抑郁等情志共病兼顾不足等临床问题。广东省名中医宁为民教授认为,慢性偏头痛部位为肝胆经循行之处,与肝之疏泄功能密切相 关;肝气郁结,易致痰瘀内停,日久肝郁化热,经风、寒、暑、湿、热等外邪或情志不畅等多种因素诱发,而致肝风内动,痰火伏邪郁结于经络,发为头痛;治疗慢性偏头痛应以疏肝开郁透邪为法,可采用内服开郁透邪方 (由川芎、 白芷、细辛、柴胡、天麻、郁金、白芍、僵蚕、全蝎、白背叶根、甘草组成) 结合针刺治疗。针刺循经取穴主要取风池、率谷、头临泣、完骨、悬厘、阳白、阳陵泉、太冲、行间等肝胆经穴位,辅以外关、合谷、百会、头维等。宁为民教授基于疏肝开郁透邪法采用中药内服结合针刺治疗慢性偏头痛的经验,可为临床治疗慢性偏头痛提供借鉴。
[Key word]
[Abstract]
This article summarized Professor Ning Wei-Min’ s experience in treating chronic migraine with the method of soothing liver,relieving depression and expelling pathogens. Chronic migraine is a common neurological disease with relatively high incidence. Currently,its treatment is mainly through oral administration of drugs,but there exist the disadvantages of unstable therapeutic effect,obvious adverse reactions after long-term medication,low treatment compliance,drug dependence,and easily ignorance of emotional co-morbidities such as anxiety and depression. Professor NING Wei-Min,a famous traditional Chinese medicine(TCM)physician of Guangdong Province,believes that chronic migraine affects the region along the meridians of the liver and gallbladder,and is closely related with the liver’ s function of ensuring the free movement of qi. Once the liver-qi stagnates,internal retention of phlegm and blood stasis easily induced,and persisting illness causes stagnant liver qi turning into heat,and then the headache will attack by the trigger of a variety of factors of external pathogens such as wind,cold,summer-heat,dampness and heat,as well as the emotional disorders,which leads to the stirring of liver-wind and the stagnation of phlegm-fire insidious pathogens in the meridian. For the treatment of chronic migraine,therapies of soothing liver,relieving depression and expelling pathogens can be utilized,and oral administration of Kaiyu Touxie Prescription combined with acupuncture is recommended. Kaiyu Touxie Prescription is composed of Chuanxiong Rhizoma,Angelicae Dahuricae Radix,Asari Radix et Rhizoma,Bupleuri Radix,Gastrodiae Rhizoma,Curcumae Radix,Paeoniae Radix Alba,Bombyx Batryticatus,Scorpio,Malloti Apeltae Radix Et Rhizoma, and Glycyrrhizae Radix et Rhizoma. Acupuncture is performed mainly on the acupoints along the meridians of the liver and gallbladder,such as Fengchi(GB20),Shuaigu(GB8),Toulinqi (GB15),Wangu (GB12),Xuanli(GB6),Yangbai(GB14),Yanglingquan(GB34),Taichong(LR3) and Xingjian(LR2),alternatively on acupoints of Waiguan (TE5) ,Hegu (LI4) ,Baihui (GV20) ,Touwei (ST8) ,etc. Professor NING Wei-Min’ s experience in treating chronic migraine with oral administration of Chinese medicine combined with acupuncture based on the method of soothing liver,relieving depression and expelling pathogens will provide a reference for clinical treatment of chronic migraine.
[中图分类号]
R255.9
[基金项目]
广东省自然科学基金面上项目 (编号:2214050005808);广东省中医药局科研项目 (编号:20212250);东莞市卫生局“宁为民东莞市名中医传承工作室建设项目”(东卫办[2019]36号)