基于“脑脾同治”理论论治紧张型头痛  

Discussion on Treating Tension-Type Headache Based on Theory of Simultaneous Treatment of Brain and Spleen

作　　者：梁欢欢 金远林[1] 黄汝成[1] 方浩涛 张芷如 黄星然 叶杰超 孔杰[1] LIANG Huanhuan;JIN Yuanlin;HUANG Rucheng;FANG Haotao;ZHANG Zhiru;HUANG Xingran;YE Jiechao;KONG Jie(The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen Bao'an Traditional Chinese Medicine Hospital Group,Shenzhen Guangdong 518000,China)

机构地区：[1]广州中医药大学第七临床医学院(深圳市宝安区中医院),广东深圳518000

出　　处：《新中医》2024年第4期173-178,共6页New Chinese Medicine

基　　金：广东省名中医传承工作室建设项目(粤中医办函[2018]150号)。

摘　　要：黄汝成教授认为,头痛病主要责之于风、火、痰、瘀、虚等病因病理,致病关键在“瘀”,总为气瘀、血瘀、痰瘀;治当以脾胃为中心,倡导“脑脾同治”。黄教授基于脾与脑经络相通;脾主升清、清阳得养、脑清神聪;脾主运化、气血津液条达、脑窍荣畅;脾主统血、脉行得道、奉养脑窍四个方面构建脑脾同治法的理论基础;治疗以醒脾开窍,行气化瘀;运脾通窍,理气化瘀;健脾益窍,补气化瘀为三大法则。临床中自拟健脾祛瘀方加减治疗头痛,若气滞血瘀者,合血府逐瘀汤加减;痰瘀阻窍者,合化痰通络汤加减;血虚血瘀者,合补阳还五汤加减,疗效显著。Professor HUANG Rucheng believes that headache is mainly due to wind,fire,phlegm,stasis and deficiency.The key pathogenesis of headache is"stasis",which mainly includes qi stasis,blood stasis and phlegm stasis.For its treatment,the spleen and stomach should be given priority and the simultaneous treatment of the brain and spleen is advocated.Professor HUANG constructs the theoretical basis of simultaneous treatment of the brain and spleen from four aspects:a)the meridians and collaterals of the spleen communicates with those of the brain;b)the spleen governs ascent of the clear;when the clear yang is nourished,the brain and the mind become clear;c)the spleen governs transportation and transformation;when qi,blood,fluids and essence transport freely,the brain is nourished to function normally;d)the spleen governs control of the blood;when qi and blood transport along the meridians and collaterals,the brain is nourished.His treatment reflects three major principles:a)to awaken the spleen and open the orifices,to move qi and dissolve stasis;b)to activate the spleen and unblock the orifices,to rectify qi and dissolve stasis;c)to fortify the spleen and boost the orifices,to supplement qi and dissolve stasis.In clinical practice,Professor HUANG self-designs Jianpi Quyu Prescription and modifies it to treat headache.For patients with syndrome of qi stagnation and blood stasis,he combines the treatment with modified Xuefu Zhuyu Decoction;for patients with syndrome of phlegm stasis obstructing the orifices,he combines the treatment with modified Huatan Tongluo Decoction;for patients with syndrome of blood deficiency and blood stasis,he combines the treatment with modified Buyang Huanwu Decoction.In this way,the curative effect is significant.

关 键 词：紧张型头痛 脑脾同治法 健脾祛瘀方 名医经验 黄汝成 

分 类 号：R747.2[医药卫生—神经病学与精神病学]