从"痛由心生"探析内伤头痛
Henan Traditional Chinese Medicine(2021)
Abstract
"痛由心生"所致内伤头痛,虽症状在头,病机关键却在心.情志刺激、饥饱失常、劳逸失度、因痛而发、外伤久病是其常见病因,可单独致病,亦能交互为害,致心主血脉、藏心神功能失调,营涩卫滞,脉道不利,心神被伤,五脏生克制化失序,气机逆乱,化火生风,风火挟痰瘀上扰清窍,引发头痛,久痛可入络,络脉瘀滞或绌急,致头痛反复发作.治宜形神兼顾,补虚泻实同用,在应用理气祛湿、化痰散瘀、益气养阴方药的同时,选择兼有清心、宁心、舒心作用的药物,以调神、通血脉、止头痛.常用方剂有热郁汤、四神散、开心散、陈荼芽煎及酸枣仁汤等.七情郁结化火、思虑过度、饮食蕴积化火者,用开心散合热郁汤加减;痰热、湿热、瘀热在体内蓄积日久者,用陈荼芽煎和除湿化瘀汤加减;过食辛辣、情志化火、久病耗伤者,选酸枣仁汤合炙甘草汤加减.
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