王涛从督脉论治前庭性偏头痛理论探微  

Exploration of Wang Tao′s Theory of Treating Vestibular Migraine from the Perspective of GV

作　　者：孙鹤天 王涛[2] 贾世震 李莹莹 SUN Hetian;WANG Tao;JIA Shizhen;LI Yingying(Anhui University of Chinese Medicine,Hefei,Anhui,China,230000;The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230000)

机构地区：[1]安徽中医药大学,安徽合肥230000 [2]安徽中医药大学第二附属医院,安徽合肥230000

出　　处：《河南中医》2024年第12期1851-1855,共5页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82274656);安徽省高校科学研究项目:自然科学类(2023AHO50844);安徽中医药大学第二附属医院人才支持计划(杏林计划)项目(0500-48-19)。

摘　　要：王涛主任医师认为,前庭性偏头痛的病机、病位与督脉、肝肾及脑之间的经络联系密切相关,辨证与治疗要点应重在脑、肝、肾三者,结合张道宗教授“病变在脑,首取督脉”的学术思想,以通督脉、调神志、和阴阳、补不足为总体治疗原则,该病发病及转归与督脉密不可分,故临证多从督脉论治。王主任认为,针多伤气,选穴之要贵在精,穴少而中病为上,以免伤正气,亦可扶正祛邪。根据其多年临床经验,总结出一套以循经取穴为主,同时注重上下配穴及兼顾经验效穴,以“通督调神,兼补肝肾”为治疗原则的针灸治疗方案,取穴:百会、神庭、风府、列缺、后溪、太阳。病虚者为肾精亏虚,脑髓失养,头痛多为隐痛,或拘挛、绵痛不休,可取命门、肾俞。病实者为肝阳亢盛,患者平素多有精神紧张,急躁易怒等阳亢之象,临证可取太冲、太溪。王主任认为,前庭性偏头痛患者依其疼痛性质有虚实之分,故在针刺手法上应分而治之。针对实证患者,应在吸气时进针,此时正值穴内机能充实,进针和吸气互相配合下,抑制病势的减退,待患者呼气,肌肉松弛时出针,使机体倚退针之势托邪外出,是为“迎而夺之”。故虚证患者应在呼气时进针,因此时人体肌肉处于放松状态,穴内的机能如穴虚状,待吸气时肌肉收缩,穴内机能充实时出针,是“随而济之”的体现,针对虚证患者,选择温针灸法较普通针刺疗效更佳。此外,王涛主任还强调“治未病”的理念,积极预防疾病的发生、发展、传变及改善预后,联合认知行为疗法对前庭性偏头痛患者进行心理干预,调整及纠正患者情绪和行为。Chief physician Wang Tao believes that the pathogenesis and lesion site of vestibular migraine(VM)are closely linked to the govern vessel(GV),liver,kidney,and brain.Diagnosis and treatment should emphasize the interconnection of these three systems.Drawing from Professor Zhang Daozong′s academic concept of"lesion in the brain,primarily treating the GV,"Professor Wang adopts the treatment principle of unblocking the GV,regulating the mind,harmonizing yin and yang,and replenishing deficiencies.Given the strong association between this disease′s occurrence,progression,and the GV,clinical treatment often starts from the GV.Wang emphasizes precision in acupuncture,advocating for fewer but more effective points to avoid depleting healthy qi and to balance expelling pathogenic factors while strengthening the body.Based on his extensive clinical experience,he has developed an acupuncture treatment principle that prioritizes meridian-based point selection,complemented by balancing upper and lower body points and leveraging effective empirical points.His core treatment concept is"unblocking the GV and regulating the mind,as well as supplementing the liver and kidney."Point selection:Baihui(GV20),Shenting(GV24),Fengfu(GV16),Lieque(LU7),Houxi(SI3),and Taiyang(EX-HN5).For deficiency syndrome characterized by kidney essence depletion and insufficient nourishment of the brain marrow,presenting as persistent dull or spasmodic pain,Mingmen(GV4)and Shenshu(BL23)are selected.For excess syndrome with liver yang hyperactivity,seen in patients prone to irritability and anger,Taichong(LR3)and Taixi(KI3)are selected.Wang advocates differentiated acupuncture techniques based on syndrome nature.For excess syndrome,needles are inserted during inhalation to suppress pathological energy and withdrawn during exhalation to expel pathogens,embodying the principle of"gaining and eliminating."For deficiency syndrome,needles should be inserted during exhalation and withdrawn during inhalation to replenish deficiencies,reflecting the principle

关 键 词：前庭性偏头痛 从督脉论治 针灸 通督调神 王涛 

分 类 号：R277.747.2[医药卫生—中医学]