丁元庆分型辨治偏头痛516例用药特色分析

总结丁元庆教授分型辨治偏头痛516例的证候要点及用药特色。认为偏头痛的病因病机为风、火(热)、痰、瘀、湿等邪气上壅,令清窍失和,脉络闭阻,不通则痛,风火上扰是偏头痛发作的重要因素,发病首责于肝。临床辨证分为湿热内蕴证、痰热生风证、瘀热内扰证、阴虚阳旺证四型论治,并自拟头风汤、瓜蒌牛蒡汤、二丹汤、玄参天麻汤对证加味治疗。通过中医传承辅助平台对516例偏头痛处方用药规律总结发现,丁教授治疗偏头痛的核心用药为天麻、僵蚕、蝉蜕、菊花等,除上述高频的药物外,丁教授还常用白鲜皮、苦参、瓜蒌、牛蒡子、牡丹皮、夏枯草、当归、珍珠母等特色药物,在清热、化痰、祛瘀基础上,注重对厥阴肝风、肝火、肝阳的辨治。

Medication Characteristics of DING Yuanqing in Treating 516 Cases of Migraine with Syndrome Differentiation

Syndrome factors and medicine characteristics of 516 migraine cases treated by Professor DING Yuanqing are summarized. The etiology and pathogenesis of the disease are wind,fire(heat),phlegm,blood stasis and damp accumulating in the upper location of the body,which can lead to migraine by causing metal confusion and blocking the meridian circulation. The upward disturbance of wind-fire is the key etiology of migraine and the liver is most closely related to the disease. The disease is divided into 4 types according to syndrome differentation,including the type of internal accumulation of damp-heat,the type of wind caused by phlegm and heat,the type of blood stasis and heat in the interior and the type of deficient yin and excessive yang. Self-made decoction such as Toufeng Decoction,Gualou Niubang Decoction,Erdan Decoction and Xuanshen Tianma Decoction were used to treat the disease. Total 516 cases of migraine treated by Prof. DING Yuanqing were analysized by inheritance of Traditional Chinese Medicine auxiliary platform.It showed that Tianma(Gastrodiae rhizome),Jiangcan(Bombyx batryticatus),Chantui(Cicadae periostracum),Juhua(Chrysanthemi flos) ect. were the frequently-used herbs. Baixianpi(Meanwhile Dictamni cortex),Kushen(Sophorae flavescentis radix),Gualou(Trichosanthis fructus),Niubangzi(Arctii fructus),Mudanpi(Moutan cortex),Xiakucao(Prunellae spica),Danggui(Angelicae sinensis radix),Zhenzhumu(Margaritifera concha),ect.were often used by Prof. DING Yuanqing. Based on clearing away heat,dispersing phlegm and dispelling blood stasis,Prof DING emphasizes on dignosis and treatment of liver-wind,liver-fire and liver-yang of Jueyin meridian.