李果烈从气机失常辨治眩晕与头昏经验  

LI Guolie’s Experience in Differentiating and Treating Vertigo and Lightheadedness Caused by Abnormal Qi Circulation

作　　者：李楠楠 陈永魁 严云 陆艳[2] LI Nannan;CHEN Yongkui;YAN Yun;LU Yan(Graduate School of Nanjing University of Chinese Medicine,Nanjing 210001,China;Department of Encephalopathy,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210022,China)

机构地区：[1]南京中医药大学研究生院,江苏南京210001 [2]南京中医药大学附属南京中医院脑病科,江苏南京210022

出　　处：《山东中医杂志》2024年第10期1141-1144,1149,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81804022);全国中医药创新骨干人才项目(批文号:国中医药人教函[2019]128号);2022年全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：眩晕和头昏是临床常见疾病,因二者症状相似、难以严格区分,临床医生常将头昏笼统归入眩晕进行治疗。李果烈教授着眼于气机变化,认为眩晕与头昏症状不同、病机各异,治疗应采用与病机相应的调气法。眩晕患者有自觉外界事物或自身旋转症状,病机以气机上逆为主,治疗可采用疏肝降逆法(处方以镇肝熄风汤加减)和疏肝泄浊法(处方以半夏白术天麻汤化裁);头昏患者无旋转症状,病机以气机下陷为主,治疗可采用补脾升陷法(处方以补中益气汤加减)和健脾通滞法(处方采用二陈汤)。附验案2则。Vertigo and lightheadedness are common clinical conditions,and due to the similarity of their symptoms and the difficulty in strict differentiation,clinicians often categorize lightheadedness as vertigo for treatment purposes.Professor LI Guolie focuses on the changes in qi movement and believes that vertigo and lightheadedness have different symptoms and pathogenesis.Therefore,the treatment should employ the method of regulating qi that aligns with the underlying pathogenesis.Patients with vertigo experience symptoms of perceiving external objects or self-rotation.The main pathogenesis is the upward reversal of qi,and treatment can be carried out using methods such as soothing the liver and descending adverse qi[The prescription is modified from Zhengan Xifeng Decoction(镇肝熄风汤)],as well as soothing the liver and eliminating turbidity[The prescription is modified from Banxia Baizhu Tianma Decoction(半夏白术天麻汤)].Patients with lightheadedness does not have symptoms of rotation.The pathogenesis is mainly due to the sinking of qi movement,and treatment can be carried out using methods such as tonifying the spleen and raising the sinking[The prescription is modified from Buzhong Yiqi Decoction(补中益气汤)],as well as invigorating the spleen and promoting circulation[The prescription uses Erchen Decoction(二陈汤)].Two proved cases are attached.

关 键 词：眩晕 头昏 气机 调气法 李果烈 名医经验 

分 类 号：R255.3[医药卫生—中医内科学] R249[医药卫生—中医学]