吴绣莲治疗良性阵发性位置性眩晕经验

Wu Xiu-lian′s Experience of Treating Benign Paroxysmal Positionalvertigo

吴绣莲教授认为,良性阵发性位置性眩晕(benign paroxysmal positionalvertigo,BPPV)是由于气血阴阳升的不足、升的太过或降的不足所致,其病位在脑,病性多虚实夹杂。气血阴阳、脏腑功能的失衡是BPPV发病的重要病机。吴教授认为,眩晕的治疗原则为补虚泻实,调整阴阳。针对升的不足,以八珍汤为基础方,采用升降平衡的方法,使不足的上升以达充养脑髓之功;针对升的太过,多采取平抑肝阳,清火熄风之法,以天麻钩藤饮加减,采用升降平衡的方法,使亢逆有余者,回归至本位;针对降的不足,多采用泽泻汤联合通窍活血汤为基本方,使邪有出路,该降的下降,平衡气血阴阳。吴教授还擅长使用引经药物,如升的不足时,常常使用蔓荆子、升麻、藁本等药物,引药上行,充养脑髓;升的太过或降的不足时,常联用怀牛膝引药下行、泽泻引痰湿之邪从小便而出;若因气机壅塞不通之时,常用柴胡、白芍疏肝柔肝,畅达肝气。

Professor Wu Xiu-lian believes that benign paroxysmal positional vertigo(BPPV)is caused by insufficient,excessive ascending,or insufficient descending of qi and blood,yin and yang.The location of the disease is in the brain,and the disease is mixed with deficiency and excess.The imbalance of qi,blood,yin and yang,viscera function is an important pathogenesis of BPPV.Professor Wu.Professor Wu believes that the treatment principle of vertigo is tonifying deficiency and reducing excess,and adjusting yin and yang.In terms of insufficient ascending,Eight-Gem Decoction is regarded as the basic formula,and the method of keeping the balance between ascending and descending is used to make the deficiency ascend to nourish the brain.In terms of excessive ascending,the method of suppressing liver yang,clearing fire and extinguishing wind can be used.Modified Gastrodia and Uncaria Decoction is often selected to keep the balance between ascending and descending.In terms of insufficient descending,Rhizoma Alismatis Decoction combined with Decoction for Activating Blood Circulation is usually regarded as the basic formula to make pathogen have a way out,to balance qi and blood,yin and yang.Professor Wu is also good at using drugs for guiding meridians,such as Manjingzi(Fructus Viticis),Shengma(Rhizoma Cimicifugae),Gaoben(Rhizoma Ligustici),etc.,in order to guide drugs up,and nourish brain marrow.For excessive ascending or insufficient descending,Huainiuxi(Radix Achyranthis Bidentatae)is often used to guide phlegm dampness out of urination.For stagnated qi movement,Chaihu(Radix Bupleuri)and Baishao(Radix Paeoniae Alba)are commonly used to soothe and soften liver and smooth liver qi.