陈建强主任运用调肝健脾法治疗偏头痛临证经验  

Director CHEN Jianqiang’s clinical experience in treating migraine by regulating liver and invigorating spleen

作　　者：潘信宏 李金菊 陈建强 PAN Xinhong;LI Jinju;CHEN Jianqiang

机构地区：[1]山东中医药大学,山东济南250355 [2]济南市中西医结合医院,山东济南271100

出　　处：《中医临床研究》2022年第33期76-78,共3页Clinical Journal Of Chinese Medicine

摘　　要：总结陈建强主任运用调肝健脾法治疗偏头痛的临证经验。陈建强主任认为,偏头痛在中医学中称为“偏头风”,其不属于感受风邪引起的普通“头痛”,是头痛的特殊类型。《素问·至真要大论篇》:“诸风掉眩,皆属于肝。”肝主疏泄,调达气机,促进全身气血的正常流通。如果情志抑郁,多思多虑,紧张恐惧,不良的心理状态及精神心理疾病最先伤及肝脏,肝失疏泄,气机不畅,气血失和,脉络瘀阻,上扰脑络,脑络不通,不通则痛,故发为偏头痛。且其认为,偏头痛反复发生,必有宿疾。宿疾必有夙根,夙根则责之于痰、瘀。首先“久病、怪病皆属于痰”,偏头痛呈反复发作性,且一般来势迅速,病因较为复杂,符合痰邪的致病特点,说明痰在偏头痛中起到的重要作用。其次,瘀血是偏头痛的主要病理因素。外伤血瘀内停,或女性经血不畅,病久或痛久不愈,皆使气血运行不畅,成痰成瘀,阻滞脉道。偏头痛疼痛位置固定,符合瘀血疼痛的性质;该病反复发作,缠绵难愈,而“久病多瘀”。总之,痰瘀是偏头痛的夙根,是其发病的病理因素。而痰、瘀的产生与脾关系密切。因此,陈主任认为,肝脾与偏头痛关系密切,治疗应以调肝健脾为法。经过其长期的临床实践观察,该法治疗偏头痛具有较为满意的疗效,目前已成为各类偏头痛的主要治法之一,值得今后广泛推广。Professor CHEN Jianqiang’s clinical experience in treating migraine by regulating the liver and strengthening the spleen is summarized.Director CHEN Jianqiang believes that migraine is called“migraine wind”in TCM,which does not belong to the common“headache”caused by the attack of wind,is a special type of headache.Suwen(《素问》)holds that“All the wind leads to vertigo,which belongs to the liver”.The liver is in charge of dispersing Qi(气),regulating Qi,promoting the normal circulation of Qi and blood throughout the body.If the emotion is depressed,one will be overthinking,nervous and fearful,the unhealthy psychological state and mental and psychological disease first injure the liver,the liver loses its Qi,Qi and blood lose harmony,the collaterals become blocked,the brain collaterals are disturbed and are blocked,which finally leads to migraine.And the director holds that if migraine occurs repeatedly,there must be chronic disease.Long-standing disease must have long-standing roots,and phlegm and blood stasis are responsible for long-standing roots.First of all,“Long term disease and strange disease are caused by phlegm”,migraine is recurrent,and the general trend is rapid,the cause of disease is more complex,which is in line with the pathogenic characteristics of phlegm,indicating that phlegm plays an important role in migraine.Secondly,blood stasis is the main pathological factor of migraine.Traumatic blood stasis inside accumulation,the failure in smooth flow of menstrual blood,lingering disease or pain all make Qi and blood flow fail to be smooth,forming phlegm or blood stasis,which blocks the channel.In short,phlegm and blood stasis are the root of migraine and the pathological factor of its pathogenesis.The accumulation of phlegm and blood stasis is closely related to spleen.Therefore,Director CHEN believes that there is a close relationship between the liver and the spleen and migraine,and the treatment should be based on regulating the liver and strengthening the spleen.After a lo

关 键 词：偏头痛 中医药疗法 调肝健脾法 

分 类 号：R747.2[医药卫生—神经病学与精神病学]