| 宋磊,王文婷.史大卓教授从“风、痰、瘀、虚”辨治头痛经验撷要[J].浙江中西医结合杂志,2025,35(6): |
| 史大卓教授从“风、痰、瘀、虚”辨治头痛经验撷要 |
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| 投稿时间：2025-02-09 修订日期：2025-04-16 |
| DOI： |
| 中文关键词: 头痛 临床经验 辨证论治 |
| 英文关键词:headache, clinical experience, syndrome differentiation |
| 基金项目:杭州市生物医药和健康产业发展扶持科技专项(2022WJC202),浙江省医坛新秀培养项目,浙江省中医药科技计划项目(2024ZR024) |
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| 中文摘要: |
| 头痛是临床常见病症,严重头痛可显著影响患者生活质量。西医针对原发性头痛往往予以对症治疗,但后续仍反复发作。史大卓教授在近40年的临床实践中对头痛的中西医结合诊疗具有独到的心得体会,擅从“风、痰、虚、瘀”几大方面进行论治。外风根据风寒、风热、风湿病邪选用不同的药物,内风则以疏肝郁、平肝阳、养肝肾为治；针对痰邪,基于“脾胃阴火升降论”益气升清健脾化痰；从瘀论治常结合活血化瘀药物的现代药理学研究进展,擅以丹参、红花、川芎赤芍药对共奏活血化瘀止痛之功,血瘀较重者以小剂量虫类药为辅；从虚论治则注重补宜脾肾先后天。本文对史教授的临床经验进行疏理总结,以期更好地传承并提供临床借鉴。 |
| 英文摘要: |
| Headache is a common clinical condition. Severe headache significantly affects the quality of life of patients. Western medicine provides symptomatic treatment for primary headache, but the subsequent recurrent attacks still occur. In the clinical practice for nearly 40 years, Prof Shi has unique experience in the combination treatment of Chinese and Western medicine for headache, specializing in the treatment from the aspect of “wind, phlegm, deficiency and stasis” theory. Different herbs are selected to clear the wind-cold, wind-heat and win-damp in terms of exogenous wind. As for endogenous wind, the main treatment methods are “dispersing stagnated liver qi for relieving qi stagnation”, “suppressing hyperactive liver and subsiding yang” and “tonifying and replenishing liver and kidney”. Prof Shi often use the treatment method of “benefiting qi and ascending clear, strengthening spleen and dissipating phlegm “according to the theory of “ascending, descending and yin fire of spleen and stomach”. The determination of drugs for removing blood stasis is according to the modern pharmacological research progress of herbs. Prof Shi is good at promoting blood circulation for removing blood stasis with the herb-pair of Salviae miltiorrhizae- Flos Carthami and Radix paeoniae rubra-Lovage rhizome. Small doses of insect herbs are used for severe blood stasis. Patients with obvious deficiency syndrome are treated with tonifying and replenishing liver and kidney, invigorating spleen and replenishing qi. Collectively, this article summarizes Professor Shi’s clinical experience in the treatment of headache for better inheritance and clinical reference. |
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