龚信《古今医鉴》论治头痛病思路探析  

Discussion on the Treatment of Headache in GONG Xin's“Ancient and Modern Medical Review”

作　　者：赵紫薇 陈永华[1] 杨文明[1] ZHAO Ziwei;CHEN Yonghua;YANG Wenming(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2023年第9期1680-1684,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(NO.U22A20366)。

摘　　要：头痛是指以头部疼痛为主要表现的病证,既可单独出现,也可发生于多种急慢性疾病过程中。中医学上常将头痛分为外感头痛和内伤头痛,认为外感头痛多由外感六淫邪气而致;内伤头痛多由痰浊、血淤、脏腑气血亏虚而致。《古今医鉴》为明代名医龚信所著,经其子廷贤整理续编而成。龚信在《古今医鉴》中对头痛进行了详细的分析,认为头痛主要为风、寒、火、湿、痰、气虚、血虚、气血虚所致头部经脉阻滞,清阳不升,精明之府失养,病理因素涉及痰湿、风火、血瘀,治疗上以祛风寒、散风热、化痰息风、活血化瘀、补益气血等为主。龚氏提出在头痛的治疗上应当先辨外感和内伤,结合脉诊,分经论治,灵活用药,选用引经之药,重视辨证与辨病论治相结合,取先辈医家治头痛之经验,以益疗效,具有很高的临床指导价值。Headache is a kind of disease characterized by headache,which can occur alone or in the course of many kinds of acute and chronic diseases.In traditional Chinese medicine,headache is usually divided into external headache and internal injury headache,which is mainly caused by six exogenous pathogenic factors,while internal injury headache is mainly caused by Phlegm,blood stasis and deficiency of Qi and blood in Zang-Fu organs.Ancient and modern medical records was written by GONG Xin,a famous doctor in Ming dynasty.GONG Xin made a detailed analysis of headache in ancient and modern medical records,and considered that headache was mainly caused by wind,cold,fire,dampness,Phlegm,Qi deficiency,blood deficiency and Qi and blood deficiency,the pathological factors involved phlegm-dampness,wind-fire and blood stasis.The treatment was mainly to dispel wind-cold,dissipate windheat,dissipate phlegm and relieve wind,activate blood circulation and remove blood stasis,replenish Qi and blood.GONG suggested that in the treatment of headache,we should first distinguish external pathogenic factors and internal injuries,combine pulse diagnosis,divide treatment into channels,use drugs flexibly,select drugs for channel leading,pay attention to the combination of syndrome differentiation and disease differentiation,and take the experience of our predecessors in treating headache,to benefit the efficacy,has a high value of clinical guidance.

关 键 词：头痛 外感内伤 分经论治 辨证论治 

分 类 号：R2-09[医药卫生—中医学]