基于证候和体质研究偏头痛中医病机和分期治疗思路探索

Based on Syndrome and Constitution to Explore TCM Pathogenesis and Staging Treatment of Migraine

目的:探索偏头痛的中医病机和分期治疗思路。方法:在300例偏头痛患者规范化、标准化研究的基础上,运用现代统计学的方法探索偏头痛中医病机,并根据病机提出分期治疗思路。结果:偏头痛的中医病机以肝肾阴虚为本,风、瘀、痰、热伏邪为标,外界的不良刺激或机体的机能失调可引动伏邪而发病。根据病机所提出的治疗思路为急性期应以祛风活血、化痰清热为主;缓解期以柔肝补肾为主,辅以祛风活血、化痰清热以清除伏邪。另外运用中医体质理论,特别是对阴虚质、气郁质和血瘀质患者进行体质干预,可作为偏头痛缓解期治疗的补充。讨论:运用规范化、标准化的研究方法,以统计数据为依据而总结的偏头痛中医病机和分期治疗的思路更具有科学价值和临床实用价值。

Objective：To explore the TCM pathogenesis and staging treatment ideas of migraine. Methods~ Based on the re- search of normalization and standardization of three hundred cases of patients with migraine,employ the modem statistical methods to explore migraine TCM pathogenesis and propose staging treatment ideas. Resu/ts ：The TCM pathogenesis of migraine is Yin defi- ciency of liver and kidney as the root, incubative pathogen of wind, stasis, phlegm, heat and latent evils as the standard. The exter- nal stimuli adverse or the bodyg dysfunction can motivate incubative pathogen and disease. The acute phase should be expelling blood and phlegm- heat mainly according to the pathogenesis of the proposed treatment ideas. In the remission phase,it should re^ainly be softening liver and tonifying kidney ,supplemented by expelling blood and phlegm -heat to remove incubative pathogen. In addition, the use of physical theories of Chinese medicine, especially the patients with Yin deficiency, Qi depression and blood stasis which were given to physical intervention, can he as the supplement therapy in remission. Conclusion： Based on the research of normalization and standardization and the statistical data as the basis,this conclusion of migraine TGM pathogenesis and staging treatment ideas has more scientific and clinical value.