张建英教授从“不荣则痛”角度治疗脑震荡后遗头痛经验  

Professor ZHANG Jianying’s experience in treating headache after concussion is based on the theory of“Pain Because of Malnutrition”

作　　者：王巧凤 张建英[2] 韩煦 贾琪 WANG Qiaofeng;ZHANG Jianying;HANG Xu;JIA Qi

机构地区：[1]山东中医药大学,山东济南250013 [2]山东中医药大学附属医院,山东济南250000

出　　处：《中医临床研究》2024年第18期29-32,共4页Clinical Journal Of Chinese Medicine

基　　金：山东省自然科学基金重大基础研究项目(ZR2020ZD17);齐鲁医派中医学术流派传承项目(鲁卫函[2020]132号);山东中医药大学科研创新基金资助(220315)。

摘　　要：脑震荡后遗症为神经外科常见疾病,由于头部遭受外界暴力,导致脑血管或神经组织损伤,进而引起脑肿胀、缺血等病理改变。临床多表现为遭受头部创伤2周后仍有头痛、头晕、乏力、失眠、食欲不振、健忘等症状,多数患者因头痛缠绵难愈,严重影响工作。西医对于本病尚缺乏有效的治疗方法,目前主要是对症处理,包括输液扩充血管、服用止痛药、营养神经及高压氧治疗等,虽然能在一定程度上减轻患者的症状,但效果不甚理想,容易复发,严重影响患者的工作生活。中医认为本病与气血瘀滞、髓海失养、经络不通有关,治疗上强调以“通”为顺,兼顾阳气。头为诸阳之会,阳气通达,气血调顺则髓海安和。张建英教授认为在此基础上,该病病久头痛缠绵难愈,属于临床难治杂病,在通调阳气基础上应抓住病久脾胃虚弱、气血亏虚的病机,脾胃为气血生化之源,脾主升清,清阳上升则利于湿瘀之邪的祛除。针灸可以改善血液循环及脑组织氧代谢,张教授在此基础上结合中医经典论述“凡刺有十二节……傍针刺者,直刺傍刺各一,以治留痹久居者也”的启发进行创新,采用双针温针灸,对于久病患者既提高了临床效果,又增加了治疗的安全性,并配合中药,温补气血,健脾养心,使脑髓充养,头痛自愈。Concussion sequelae is a common disease in neurosurgery.Due to external violence on the head,cerebral vascular or nerve tissue damage is caused,resulting in brain swelling,ischemia and other pathological changes.The clinical manifestations are mainly headache,dizziness,lacking in strength,insomnia,loss of appetite,poor memory and other symptoms after 2 weeks of head trauma.Most patients are difficult to recover from headache and lingering,which seriously affects work and live.Western medicine still lacks effective treatment for this disease.At present,the main symptomatic treatment,including rest,pain relief,nutritional nerve and hyperbaric oxygen therapy,can alleviate some symptoms of patients to a certain extent,but the effect is not satisfactory,seriously affecting the work and life of patients.The traditional Chinese medicine thinks that this disease is related to Qi(气)and blood stasis,brain has no nutrients,meridians and collaterals impassability.The treatment emphasizes to“pass”as purpose and give consideration to Yang(阳)Qi.The head is the place where Yang Qi gathers.Only Yang Qi access and Qi and blood regulation the brain can be work normally.Professor ZHANG Jianying believed that on this basis,the disease was long headache lingering and difficult to cure,which belonged to the clinical complicated diseases.On this basis,we should grasp the chronic disease and stomach weakness,spleen and stomach are the source of Qi and blood,the spleen carries nutrients,and the rise of Qingyang is conducive to the elimination of the evil of wet blood stasis.Needel warming moxibustion can improve blood circulation and brain tissue oxygen metabolism,Professor ZHANG on this basis combined with the traditional Chinese medicine classic“Where there are twelve acupuncture sections…BandZhenCi means near the direct acupuncture side to acupuncture again,in order to cure the patients who suffer arthralgia syndrome for long time”innovation the use of double needle warm acupuncture,for patients with chronic disease that

关 键 词：脑震荡后遗症 头痛 双针温针 温补气血 健脾养心 

分 类 号：R747.2[医药卫生—神经病学与精神病学]