《千金要方》中有关“头眩”的证治用药探讨及其对前庭外周性眩晕辨治的启示  

Discussion on Syndrome Differentiation and Medication for Dizziness in Qian Jin Yao Fang and Its Implications for Syndrome Differentiation and Treatment of Peripheral Vestibular Vertigo

作　　者：刘锦光 刘蓬[2,3] 何伟平 LIU Jin-Guang;LIU Peng;HE Wei-Ping(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Dept.of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Lingnan Institute of Otolaryngology,Guangdong Clinical Research Academy of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院耳鼻咽喉头颈外科,广东广州510405 [3]广东省中医临床研究院岭南耳鼻喉病研究所,广东广州510405

出　　处：《广州中医药大学学报》2024年第12期3355-3360,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药管理局2023年中医药循证能力提升项目;广州市科技计划项目(编号:202201020308)。

摘　　要：《千金要方》有关“头眩”篇章中,对“头眩”的病机及用药记载较详细,其涉及的病症表现与前庭外周性眩晕类似。《千金要方》中有关“头眩”的病机特点可归纳为“风”(风邪)、“水”(水饮寒痰)及“虚”(气血虚弱),三者常互相兼夹而各有所重。“风眩”篇治疗“头眩”的方剂共有13首。治疗因“风”致眩的药物以辛温透散为主,通过祛邪外出、清利头目,可改善头面诸窍血脉的运行。治疗因“水”致眩的药物以温化寒饮为主,视饮之停留部位而酌用降逆化饮、利尿渗湿、峻下逐水等药物;治疗因“虚”致眩的药物可选用健脾益气、滋养阴血、补益肝肾之品。总结《千金要方》中有关“头眩”的中医理法用药,可为前庭外周性眩晕的现代中医辨治提供临床思路。In the chapters about dizziness in Qian Jin Yao Fang(Invaluable Prescriptions),detailed descriptions about pathogenesis and medication for dizziness were presented,and the symptoms of dizziness were similar to the clinical manifestations of peripheral vestibular vertigo.The pathogenesis of dizziness in Qian Jin Yao Fang can be summarized as wind(wind pathogen),water(retained fluid and cold phlegm)and deficiency(deficiency of qi and blood),which are often intertwined with each other and each has its own characteristics.There are 13 formulas for treating dizziness in the chapter about wind-dizziness.Drugs for treating dizziness caused by wind are mainly pungent and warm with the expelling and dispersing actions,which can expel the pathogens from the upper orifices and improve the blood circulation of upper orifices.For the treatment of dizziness caused by water,therapy of warming and resolving cold fluid is frequently adopted,and drugs for checking upward adverse flow of qi and removing fluid,drugs for promoting diuresis and percolating dampness,and drastic purgatives for eliminating fluid retention are selected according to the location of fluid retention.For the treatment of dizziness caused by deficiency,drugs for invigorating spleen and replenishing qi,drugs for nourishing yin and enriching blood,and drugs for nourishing liver and spleen can be chosen.The exploration of the therapeutic principles,formulas and drugs for dizziness in Qian Jin Yao Fang will provide ideas for the clinical Chinese medical treatment of peripheral vestibular vertigo nowadays.

关 键 词：《千金要方》 头眩 前庭外周性眩晕 风 水 虚 

分 类 号：R255.3[医药卫生—中医内科学]