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全生讲中医 (20)—头痛的中医防治(9/7/2011)

凡整个头部以及头的前、后、单侧部位的疼痛总称头痛。头痛是临床上常见的自觉症状, 可单独出现亦可见于多种急慢性疾患。因颅内外组织结构中的痛觉神经末梢,即痛觉感受器受到物理性的(如炎症、损伤或肿物的压迫)或化学性的(如去甲肾上腺素、 5-羟色胺、缓激肽等)致病因子的刺激,产生异常神经冲动,经痛觉传导通路传达到中枢神经系统最终至大脑皮层, 从而产生头痛。
 
偏头痛是反复发作的一种搏动性头疼,是头痛的常见类型。 它发作前常有闪光、视物模糊、肢体麻木等先兆,约数分钟至1小时左右出现一侧头部一跳一跳的疼痛,并逐渐加剧,直到出现恶心、呕吐后,感觉才会有所好转在安静、黑暗环境内或睡眠后头疼缓解。在头痛发生前或发作时可伴有神经、精神功能障碍。同时,它是一种可逐步恶化的疾病,发病频率通常越来越高。 据研究显示,偏头痛患者比平常人更容易发生大脑局部损伤,进而引发中风。其偏头疼的次数越多,大脑受损伤的区域会越大。
 
偏头痛是一组常见的头痛类型,病因目前尚不清楚,但可能与下列因素有关:(1)遗传因素,由于约60%的患者可问出家族史,部分病人家庭中有癫痫病人; (2)内分泌因素; (3)饮食因素,经常食用奶酪、巧克力、刺激性食物或抽烟、喝酒的人均易患血管性偏头痛;(4)其它因素,如情绪紧张、精神创伤、忧虑、焦虑、饥饿、失眠、外界环境差以及气候变化也可诱发偏头痛
 
头痛之因多端,但中医认为不外乎外感和内伤两大类。外感头痛多因起居不慎,感受风、寒、湿、热等外邪或外伤。内伤头痛与肝、脾、肾三脏关系密切。
 
因头痛的原因不一,故临床表现各异,外感风寒头痛,痛连项背,遇风尤剧,且有寒象;风热头痛,头痛如裂,发热恶风,面红目赤;风湿头痛,头痛如裹,肢体困重,胸闷纳呆;内伤肝阳头痛,头痛而眩,心烦易怒;肾虚头痛,头痛且空,腰膝酸软;气血亏虚头痛,头痛头晕,遇劳加剧;痰浊头痛,头痛昏蒙,脘闷泛恶;淤血头痛,经久不愈,痛如锥刺。
 
 临床上治疗头痛的原则,大致上外感引起者,当以祛风为主,佐以散寒,清热,祛湿等;内伤引起者较复杂,有虚有实,或虚实夹杂,当根据头痛之短暂、性质、特点及部位之不同,辨别虚实,进行辨证施治。
 
北京中医药大学名老中医程士德教授,全国百名名老中医之一,积70余年临床经验,对关节痹痛、咳嗽、胃脘痛、闭经、、不孕不育、失眠、抑郁等精神情志失调性疾病和过敏性疾病等疑难杂证有丰富的理论和经验。下面抄录当时作者跟随程老坐诊时病例一则.
 
 Cristina, 女, 33岁, 加拿大人, 1997年10月12日就诊. 患者头胀痛数年,有额窦炎病史. 程老根据辨证, 施药如下: 天麻, 白芷, 川芎, 羌活, 防风, 半夏, 苍耳子,辛夷, 薄荷, 菊花, 苍术, 生甘草, 各10g, 公英30g, 板蓝根30g, 细辛3g.
 
针灸对于头痛的防治,疗效很好。但首需辨别内感、外伤;然后根据兼症,采用不同组穴,方可取得满意效果。
 
 另外,一些自我保健知识,对缓解头痛有帮助。揉太阳穴: 每天清晨醒来后和晚上临睡以前,用双手中指按太阳穴转圈揉动,先顺揉7~8圈,再倒揉7~8圈,这样反复几次,连续数日,偏头痛可以大为减轻。白芷、川芎各10克,葱白7根。每日1剂,水煎分两次服,主治偏头痛。取白萝卜一根,洗净切丝,以洁净纱布包后榨取汁约20毫升。如左侧偏头痛,就将萝卜汁分数次滴入右侧鼻孔中;右侧偏头痛则滴入左侧鼻孔中。一日两次,连用4~5天即可见效。
 
     更多全生讲中医, 敬请访问卢全生中西医结合博士的网站www.wholelifeherb.com,或直接拨打中文热线电话301-919-9898, 301-340-7682约诊. 全生中医针灸医疗中心地址:  416 Hungerford Dr, Suite 215, Rockville, MD 20850. 或 9801 Georgia Ave, Suite 337, Silver Spring, MD 20902.
 

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