柴胡防风汤治疗海洛因成瘾者顽固性偏头痛案例分析

Case analysis of treating intractable migraine of heroin addicts with the Chaihu Fangfeng decoction

偏头痛是以头痛剧烈、左右反复发作为特征的一种临床常见病,作为一种常见的慢性神经血管性疾病,发作时严重影响患者生活质量,而海洛因成瘾者具有个体特异性,其偏头痛病程更为顽固,而西医往往局限于症状,虽可在一定程度上缓解患者疼痛,但对于病因和个体差异缺乏探究,中医认为阿片辛香、苦、酸涩,性温,有毒,归十二经。初吸时以其辛香开泄气道,振奋精神,造成损津耗液,伐伤气血,久则成瘾,机体靠阿片提携元气,气血运行失度,导致元气耗竭,脏腑俱损。阿片成瘾为本虚标实证,毒邪雍盛为标,正气亏虚为本,脱毒后蓄积在体内的烟毒可能仍未完全排尽,而此时病情已无药力掩盖,故诸多症状顽固绵延,不易诊治。文章则是以少阳证入手运用柴胡防风汤治疗一例海洛因成瘾顽固性偏头痛患者,不仅通过“六经辨证”解释了其顽固性偏头痛病因病机,更是因人施治,根据患者辨证特点,进行加减化裁,利用附子助阳托力,兼顾吸毒患者的特殊证候,将中医学“治病求本”的宗旨体现得淋漓尽致,取得了良好的疗效,具有一定的临床参考价值。

Migraine is a common clinical disease characterized by severe headache,left and right recurrent attacks,as a common chronic neurovascular disease,the onset seriously affects the quality of life of patients,and heroin addicts have individual specificity,its migraine course is more stubborn,and Western medicine is often limited to symptoms.Although it can relieve the pain of patients to a certain extent,for the cause and individual differences lack of exploration,TCM believes that opioids are spicy,bitter,sour,warm,toxic,to the twelve meridians.When inhaled at the first time,it opens the air duct with its spicy fragrance,uplifts the spirit,causes damage to the water consumption,cuts the Qi(气)and blood,and becomes addicted for a long time,the body relies on opium to carry the vitality,and the Qi and blood run out of degree,resulting in the exhaustion of vitality and damage to the internal organs.Opioid addiction is the basis of false evidence,poison and evil are the target,righteous Qi deficiency is the foundation,the tobacco and poison accumulated in the body after detoxification may not be completely exhausted,and at this time the condition has no medicinal power to cover up,so many symptoms are stubborn and difficult to diagnose and treat.This article uses the Chaihu Fangfeng decoction(柴胡防风汤)to treat a case of heroin addicted refractory migraine based on the Shao Yang(少阳)evidence,which not only explains the etiology of his refractory migraine through six scriptures,but also treats according to people,and adds and subtracts according to the characteristics of the patient's differentiation,uses Fuzi(Aconitum carmichaeli Debx)to improve Yang,takes into account the special symptoms of drug addicts,vividly reflects the purpose of treating diseases and seeking the root of TCM,and achieves good efficacy and has certain clinical reference value.