文章摘要
裘辉,张丽萍,章正祥,等.裘昌林教授从肝论治紧张型头痛经验探析[J].浙江中医药大学学报,2020,44(6):533-536.
裘昌林教授从肝论治紧张型头痛经验探析
Professor QIU Changlin's Experience in Treating Tension-type Headache from Liver
投稿时间:2019-12-21  
DOI:10.16466/j.issn1005-5509.2020.06.007
中文关键词: 紧张型头痛  从肝论治  证型  半夏白术天麻汤  名医经验  裘昌林  医案
英文关键词: tension-type headache  treatment from liver  type of syndrome  Banxia Baizhu Tianma decoction  experience of famous doctors  QIU Changlin  consilia
基金项目:浙江省中医药科技计划项目(2019ZA064、2014ZA048);浙江省医药卫生科技计划项目面上项目(2019KY116)
作者单位
裘辉 浙江中医药大学附属第三医院 杭州 310005 
张丽萍 浙江中医药大学附属第一医院 
章正祥 浙江中医药大学附属第一医院 
蒋旭宏 浙江中医药大学附属第一医院 
裘昌林 浙江中医药大学附属第一医院 
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中文摘要:
      [目的]总结裘昌林教授诊疗紧张型头痛(tension-type headache,TTH)的临床经验和学术观点。[方法]通过复习相关中医文献、跟师临证、整理医案等方式,总结TTH的病因病机、辨证分型以及裘师的治疗思路、用药特色,并举验案一则以示临床应用。[结果]裘师认为,TTH的发生虽与肝脾肾功能失调有关,但与肝的关系最为密切,肝之阴血不足,肝体失柔是导致头痛反复发作的内在病理基础;临床辨证分为肝血不足型、肝脾不调型、风痰上扰型、肝阳上亢型、肝火炽盛型5型;临证时分别以养血柔肝、调和肝脾、健脾化痰,平肝息风以及滋阴潜阳,平肝息风和清热平肝为治则,分别以四物汤、逍遥散、半夏白术天麻汤、滋水清肝饮、龙胆泻肝汤加减辨证治疗;用药上注重疏肝与柔肝并举,清肝与平肝合用,适时选用引经药,久病入络配伍虫药。所举验案属风痰上扰型头痛,方用半夏白术天麻汤加减健脾化痰、平肝息风,取得较好疗效,充分体现了裘师治疗本病的辨证诊疗思路。[结论]裘昌林教授从肝论治TTH,疏肝与柔肝并举,清肝与平肝合用,中医理论依据充分,临床效果显著,值得推广。
英文摘要:
      [Objective] To summarize Professor QIU Changlin's clinical experience and academic point of view in diagnosis and treatment of tension-type headache(TTH). [Methods] Through reviewing the relevant traditional Chinese medicine(TCM) literature, consultation with teachers and sorting out the medical records, the etiology and pathogenesis, syndrome differentiation of TTH, and treatment ideas and medication characteristics of Professor QIU in treatment of TTH were summarized, and one case was given to show the clinical application.[Results] According to Professor QIU, although the occurrence of TTH is related to the dysfunction of the liver, spleen and kidney, it is most closely related to the liver, deficiency of Yin and blood of the liver and loss of softness of the liver were the internal pathological basis of recurrent headache, and the clinical syndrome differentiation can be divided into 5 types: deficiency of the liver blood type, disharmony of liver and spleen type, disturbance of wind and phlegm type, hyperactivity of liver Yang type and hyperactivity of liver fire type. Nourishing blood and softening the liver, reconciling the liver and spleen, invigorating the spleen and resolving phlegm, calming the liver and relieving wind, nourishing Yin and suppressing Yang, calming the liver and calming the wind, and clearing heat and calming the liver are the treatment principles. Respectively with modified Siwu decoction, Xiaoyao San, Banxia Baizhu Tianma decoction, Zishui Qinggan decoction, Longdan Xiegan decoction according to syndromes.In medication, attention should be paid in soothing the liver and softening the liver, clearing the liver and calming the liver, timely selecting meridian inducing drugs, adding insect drugs for chronic disease into collaterals. The patient was disturbance of wind and phlegm type headache, and obtained good curative effect after modified Banxia Baizhu Tianma decoction was adopted to notify spleen and resolve phlegm, calm the liver and dispel wind. The case fully embodied the idea of syndrome differentiation diagnosis and treatment of Professor QIU.[Conclusion] Professor QIU Changlin treats TTH from the liver, with liver soothing and liver softening, liver clearing and liver calming. The theoretical basis of TCM is sufficient and the clinical effect is significant, which is worth popularizing.
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