摘要
赵永烈提出“体-病-脉”三位一体辨治体系,整合偏头痛病因、病机与诊疗。融合“玄府学说”与体质理论,提出“玄府郁闭”是偏头痛核心病理基础,患者多有先天“玄府易郁体质”,诱致气郁、痰瘀等壅塞玄府引发头痛。病因上重视风邪,风邪是外感先导,其特性对应偏头痛症状,内风与外风相引是发病关键。同时强调偏头痛病理要素的动态演变与复杂,治疗要重视多种病理因素兼夹、急缓期侧重及体质对病理要素的影响等。诊疗以脉为纲,脉诊是洞察病机金标准,通过脉象判断体质和病理状态,指导治则与方药选择。
Professor Zhao Yonglie proposes an integrative"body-disease-pulse"triadic paradigm,which systematizes the etiology,pathogenesis,and management of migraine.By integrating the classical"Xuanfu"(sweatpore gateways)doctrine with the constitution theory,he identifies"Xuanfu stagnation"as the core pathological basis of migraine,in which migraineurs are believed to possess an inborn"Xuanfu-prone-to-stagnation"constitution,inducing qi stagnation,phlegm-stasis,and depressed heat,obstructing Xuanfu,disrupting the ascent of clear yang,thereby igniting headaches.Among its external causes,wind is the primary factor,whose rapid and mutable nature mirrors the sudden onset and cessation of migraine,along with shifting pain and protean symptoms,and endogenous wind acts in synergy with exogenous wind to trigger its attacks.Pathological elements are viewed as dynamically evolving and intermingled,therefore its treatment must address their overlap,differentiating acute versus remission phases,and weighing constitutional influence on its pathogenesis.Pulse diagnosis,as a cornerstone in traditional Chinese medicine,is instrumental in discerning constitutions and dynamic pathological status,thereby directly influencing therapeutic principles and the selection of prescriptions in the treatment of migraine.
作者
李诺
赵永烈
章春平
周晓卿
LI Nuo;ZHAO Yonglie;ZHANG Chunping;ZHOU Xiaoqing(Shenzhen Hospital<Longgang>,Beijing University of Chinese Medicine,Shenzhen 518100,China;The Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100020,China)
出处
《吉林中医药》
2025年第12期1365-1368,共4页
Jilin Journal of Chinese Medicine
基金
国家重点研发计划项目(2019YFC1709702)
国家自然科学基金面上项目(81873256)
首都卫生发展科研专项课题(2024-2-7033)。
关键词
偏头痛
临证经验
辨证论治
“体-病-脉”体系
migraine
clinical experience
treatment based on syndrome differentiation
"body-disease-pulse"paradigm
