吴茱萸汤治疗头痛临床体会  

Clinical experience of Wuzhuyu Decoction in treating headache

作　　者：王建东[1] 黄小波[1] WANG Jiandong;HUANG Xiaobo(Department of Traditional Chinese Medicine,Xuanwu Hospital,Capital Medical University,Beijing100053,China)

机构地区：[1]首都医科大学宣武医院中医科,北京100053

出　　处：《中国医药导报》2022年第1期150-153,共4页China Medical Herald

基　　金：北京市自然科学基金面上项目(7172094)。

摘　　要：吴茱萸汤首见于《伤寒论》,为厥阴头痛之代表方。作者认为,厥阴头痛不应局限于巅顶头痛,某些偏头痛、目睛胀痛不适者亦可归于厥阴头痛范畴,其人必伴有畏寒喜暖,尤其头部畏寒、畏风,舌质淡,苔白,脉弦,或伴有消化系统症状,如呕恶、吐涎、胃脘胀满等,其病机为肝胃虚寒、浊阴上逆,方用吴茱萸汤加减。此外,吴茱萸汤尚能治疗痰饮头痛及某些久病头痛等,拓展了吴茱萸汤在治疗头痛方面的应用。关于吴茱萸的用量,作者认为当根据病情轻重及患者体质,3 g-6 g-9 g,酌情增减,既不可照搬古方剂量,又不宜过分拘泥于药典,否则病重药轻,足以偾事。在此基础上,重视对吴茱萸饮片质量、煎煮法等的把握,是安全使用吴茱萸汤的前提。Wuzhuyu Decoction,first seen in Shanghan Lun,is a representative prescription for jueyin disease with headache.The author thinks that jueyin disease with headache should not be limited to parietal headache.Some migraines and eye distending pain can also be classified as jueyin disease with headache.The person must be accompanied by afraid of cold and fond of warm,which is especially true for the head afraid of cold and wind,pale tongue,white fur,stringy pulse,or accompanied by digestive system symptoms,such as nausea and vomiting,salivation,epigastric fullness,etc.The pathogenesis is deficiency cold of liver and stomach,upward counterflowing of turbid yin,add and subtract Wuzhuyu Decoction was used as the prescription.In addition,Wuzhuyu Decoction can also treat headache with phlegm-fluid retention and some chronic headache,which expands the application of Wuzhuyu Decoction in the treatment of headache.As for the dosage of medicinal evodia fruit,the author thinks that the dosage should be increased or decreased according to the severity of the disease and the patient’s constitution,3 g-6 g-9 g.The dosage of medicinal evodia fruit should not be copied from the ancient prescription,and it should not be too rigidly adhered to the pharmacopoeia,otherwise,the drug dose used for serious diseases is low,making the treatment effect is not good.On this basis,it is the premise of safe use of Wuzhuyu Decoction to pay attention to the quality of Wuzhuyu Decoction Pieces and decocting method.

关 键 词：吴茱萸汤 厥阴头痛 痰饮头痛 偏头痛 临床体会 

分 类 号：R277.7[医药卫生—中医学]