大柴胡汤合桂枝茯苓丸联合脱水剂治疗特发性高颅压性头痛1例并文献复习

Dachaihu decoction combined with guizhi Fuling Wan and dehydration agent for idiopathic headache with high intracranial pressure:A case report and literature review

分析1例特发性高颅压性头痛(HIIH)患者的临床、影像学资料及其他实验室等辅助检查,探讨HIIH的临床、生理、诊断及配合中医药治疗的方法。患者男性,17岁,主因"反复头痛4+年,复发加重1+月"入院。临床表现为无明显诱因的头痛,头颅CT及其他实验室等辅助检查均无明显异常,测脑压225 mmH2O,高于正常脑压80180 mmH2O,排除其他器质性疾病导致的颅内压增加而导致的头痛,但高颅压具体原因尚未明确,为特发性高颅压性头痛。本例患者经甘油果糖及甘露醇脱水降颅内压持续数天治疗后头痛症状稍改善,仍伴有头部胀痛,后配合大柴胡汤合桂枝茯苓丸继续治疗,痊愈出院并随访,诉头痛未再复发,也无其他不适,可能与大柴胡汤合桂枝茯苓丸的疗效有关。

The clinical,imaging and otherlaboratory examinations of a patient with idiopathic high cranial pressure headache(HIIH)were analyzed to explore the clinical,physiological,diagnostic and therapeutic methods of HIIH with traditional Chinese medicine.The male patient,17 years old,was admitted to the hospital mainly because of"recurrent headache for more than 4 years and recurrence aggrava-tion for more than 1 month".The clinical manifestations were headache without obvious inducement,head CT and other auxiliary examinations showed no obvious abnormality,and the cerebral pressure measured was 225 mmH2 O,which was higher than the normal cerebral pressure 80180 mmH2 O,excluding the headache caused by increased intracranial pressure caused by other organic diseases.However,the specific reason of the patient’s high intracranial pressure was not clear,so it was an essential high intracranial pressure headache.This example glycerin fructose and mannitol dehydrate decrease intracranial pressure in patients with headache symptoms slightly improved af-ter treatment for several days,still have head pain,with major dachaihu decoction and cassia Guizhi fuling wan after treatment,patients recovered discharge and follow-up,v.headache not to recur,or other discomfort,may be related to major dachaihu decoction and the curative effect of cassia Guizhi fuling wan.