张景岳辨治头痛特色探析

Analysis on the Features of Treating Headache by ZHANG Jing-yue

从病因病机、处方用药特点等方面对《景岳全书》中有关头痛等章节及医案进行研读分析,归纳总结张景岳辨治头痛的特色,分析其治病的基本理念及对后世的指导意义。其辨治头痛首辨病程久暂,次辨表里虚实,后别外感内伤,从外感、火邪、阴虚、阳虚、痰厥等进行论治,体现了其治外感多投疏散、治火邪多投清补、治内伤多益精血、滋阴液多固其本、辨虚寒注重温补、治痰涎多重脾肾等学术经验。辨治时尤其重视病机的动态演变,探微蒇谋,遣方简效,针砭并用,善用风药及引经药,"有感时弊"而力倡温补,善补精血,攻补兼施,内涵丰富,经验独到,对当今辨治头痛具有重要意义。

The chapters and medical records related to headaches in Jing Yue Quanshu were studied and analyzed from the etiology, pathogenesis, characteristics of prescription drugs, etc. The characteristics of the diagnosis and treatment of headache were summarized. ZHANG Jing-yue’s basic concept of treatment and guiding significance of future generations were analyzed. He differentiates and treats headaches for a long period of time, then distinguishes external and internal deficiency and excess, and then distinguishes exogenous disease and internal injuries. The treatment is divided into exogenous disease, fire evil, Yin deficiency, Yang deficiency,phlegm, etc. It reflects his academic experience, including treating exogenous disease often by evacuation, treating fire-evil by clearing and replenishing, treating internal injuries by benefiting essence and blood, nourishing Yin and to replenish roots, distinguishing deficiency and excess syndrome, focusing on warming tonic, and treating phlegm and salivation according to spleen and kidney, etc. He attaches importance to the dynamic evolution of pathogenesis and his formula is simple in composition with good effect. He uses acupuncture and stone needle together in clinical and makes good use of wind herbs and meridian drugs. According to the disadvantages of the current situation, he advocates warm supplementation, and he is good at supplementing essence and blood,with combination of tonification and purgation. His academic thought is rich in connotation with unique experience,and it is of great significance in the differentiation and treatment of headache.