赵永烈以脉为主辨治偏头痛

Professor Zhao Yonglie’s experience in the syndrome differentiation and treatment of migraine mainly by pulse manifestations

偏头痛以反复发作的中、重度疼痛为特点,严重影响日常生活,非特异性镇痛药难以有效改善病情。中医药治疗偏头痛历史悠久,脉象为辨治关键。以脉象为主遣方用药,随症加减,临床收效甚佳。弦脉以疏,滑数以清,浮紧以散,沉涩以补,常用散偏汤、温胆汤、桂枝汤、麻黄附子细辛汤等,其中黄芪、川芎、白芍等适投重剂以益气、活血、止痛,半夏、附子等不拘常量以化痰、温经。

Migraine is characterized by recurrent attacks of moderate or severe pains,which seriously affects patients’daily life and is difficult for non-specific analgesics to effectively improve its condition.Traditional Chinese medicine has a long history in treating the disease,and pulse manifestations are the keys to administering a treatment based on syndrome differentiation.Drawing up prescriptions and deciding on medication mainly on the basis of pulse manifestations prove to be effective in the treatment of migraine,especially when they are flexibly adjusted according to specific symptoms in clinic.When a patient with migraine is manifested as a stringy pulse,disperse the stagnated liver qi;manifested as a slippery pulse or a rapid pulse,clear heat;as a floating pulse or a tight pulse,dispel pathogenic winds;as a deep pulse or a hesitant pulse,tonify qi.Clinically,several formulae are frequently used,such as Sanpian Decoction,Wendan Decoction,Guizhi Decoction,Mahuang Fuzi Xixin Decoction,etc.Among the commonly used drugs,a large dosage of milkvetch root,Sichuan lovage rhizome,debark peony root,etc.,may contribute to tonifying qi,promoting blood circulations,relieving pains,while an unusual dosage of pinellia tuber,prepared common monkshood branched root,etc.,is beneficial to resolving phlegm and warming womb and channels.