浅谈赵德喜教授运用和解止痛方治疗偏头痛肝郁化火证的临床经验

Clinical experience of Professor Zhao Dexi for treating migraine with stagnation of liver fire syndrome with the Hejie Zhitong prescription

偏头痛是一种常见慢性疾病。偏头痛病因复杂,不能以一种发病机制解释,因此产生了多种学说。如:神经源性炎症学说、周围及中枢神经感觉敏感化、神经元异常兴奋及电压依赖通道异常、皮层扩散性抑制、神经递质学说等,每一种学说都有相对可靠的证据。本病病机复杂,目前尚难以彻底治愈。如何减少复发,减轻患者的痛苦是我们要研究的方向。本文着重探讨赵德喜教授运用和解止痛方治疗偏头痛肝郁化火证的临床经验。赵德喜教授在长期的临床过程,重新审视本病的特点,方证相应,本病符合《伤寒论》中少阳病表现,提出了偏头痛的病机关键是"少阳枢机不利"的学术观点。从六经辨证角度,以少阳病论治偏头痛,和枢机、解郁结,并以经方小柴胡汤化裁,拟定"和解止痛方"治疗偏头痛,自2005年至今积累6100余份病例中,偏头痛病人约2500例,均采用和解止痛法化裁而取得了可靠的疗效。

Migraine is a common chronic migraine disease. The etiology of it is complex and cannot be explained by a mechanism, which results in a variety of theories. Such as neurogenic inflammation theory, peripheral and central sensitization of sensory neurons theory, excited and voltage dependent channel abnormalities theory, cortical spreading depression theory, neurotransmitter theory, etc., each theory has a relatively reliable evidence. The mechanism of this disease is complicated, and it is difficult to completely cure. Therefore, how to reduce the recurrence and alleviate the pain of patients is the direction of our study. This paper explores Professor Zhao Dexi＇s clinical experience for applying the Hejie Zhitong prescription in treating migraine with stagnation of liver fire syndrome. During his long clinical practice, Professor Zhao Dexi re-examines the characteristics of this disease, which comply with Shaoyang disease in the prescription of Treatise on Febrile Diseases, he proposes the academic point of view that holds that the key pathogenesis of migraine is ＂Shaoyang cardinal is disadvantageous＂. Professor Zhao prescribes the Hejie Zhitong prescription in treating migraine with stagnation of liver fire syndrome based on syndrome-differentiation of the six meridians and modifying Xiaochaihu decoction. Since 2005, in the accumulation of more than 6100 copies of cases, about 2500 cases are of migraine patients, on which Hejie Zhitong Formula achieves reliable curative effect.