基于历代本草文献探讨头痛辨治思路  

Herbal Textural Research on Treatment of Headache Based on Syndrome Differentiation

作　　者：刘红喜 路梦颖 梁晓 迟显苏 魏竞竞 刘悦 王柳丁 张允岭 LIU Hongxi;LU Mengying;LIANG Xiao;CHI Xiansu;WEI Jingjing;LIU Yue;WANG Liuding;ZHANG Yunling(Beijing University of Chinese Medicine,Beijing 100029,China;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Foshan 528200,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院,北京100091 [3]广东省中西医结合医院,广东佛山528200

出　　处：《中国实验方剂学杂志》2023年第22期155-162,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局中医药传承与创新“百千万”人才工程(岐黄学者)—国家中医药领军人才支持计划项目(2018年);国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202007);中国中医科学院中医药防治脑病传承创新团队项目(CI2021B006);中国中医科学院科技创新工程项目(CI2021A01301)。

摘　　要：目的:基于历代本草文献,探讨头痛的辨治思路,以指导临床辨治用药。方法:检索《中华医典》数据库中本草类的全部文献数据,涉及历代本草著作76部,涵盖汉至明清各时期具有代表性的本草著作,收集整理其中治疗头痛的相关本草信息,依照《中药学》(第十一版)及2020年版《中华人民共和国药典》,对筛选纳入的本草进行性味归经统计分析,以头痛辨治病机要素进行分类统计,提取各类本草的辨治论述内容。结果:在76部历代本草专著中,筛选出114味治疗头痛的本草。在治疗头痛本草性味归经上,药性以寒性、温性为主,药味以辛味、苦味为主,归经以肺经、肝经为主。在辨治头痛病机要素本草分类中,可划分为风袭、火扰、浊阻、郁滞、寒凝、正虚六类病机要素。结论:头痛辨治用药以祛风散邪药、清热泻火药、祛痰化湿药、理气活血药、温阳散寒药、补虚扶正药为主,且相互联合运用;祛风散邪,调理气血,补虚泻实为头痛辨治主要特点,符合不通则痛,不荣则痛的生理功能紊乱状态。Objective:To summarize the thinking of treatment of headache based on syndrome differentiation by reviewing the literature of materia medica in the past dynasties,so as to guide the clinical practice.Method:All the literature of materia medica in the Chinese Medical Dictionary,involving 76 works from Han to Qing Dynasties,were searched,and the information of the herbs for treating headache was extracted.According to Chinese Materia Medica(11th Edition)and Pharmacopoeia of the People's Republic of China(2020 Edition),the nature,taste,and meridian tropism of the selected herbs were statistically analyzed,and the syndrome elements of headache were classified and counted.In addition,the contents of syndrome differentiation and treatment of headache by different herbs were extracted.Result:From the 76 monographs of materia medica in the past dynasties,114 herbs for treating headache were selected.The herbs mainly had cold or warm nature,pungent or bitter taste,and tropism to the lung and live meridians.The syndrome elements of headache treated by the herbs mainly included wind attack,fire disturbance,turbid obstruction,stagnation,cold coagulation,and healthy Qi deficiency.Conclusion:Headache is mainly treated with the herbs with the effects of dispelling pathogenic wind,clearing heat and purging fire,eliminating phlegm and resolving dampness,regulating Qi movement and activating blood,warming Yang and dispelling cold,and tonifying deficiency and reinforcing healthy Qi,and the herbs are often used in combinations.Headache is treated following the principles of dispelling wind and pathogen,regulating Qi and blood,and tonifying deficiency and purging excess,which is in line with the laws of obstruction and nutrient deficiency causing pain.

关 键 词：头痛 本草 文献 不通则痛 不荣则痛 中医药疗法 临床运用 

分 类 号：R284[医药卫生—中药学] R285[医药卫生—中医学] R289R287R22R2-031R33R24