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基于升清降浊理论探讨重用土茯苓治疗头痛

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升清降浊为清气、营养物质上升,浊气、糟粕下降,是人体正常的生理状态.脾胃为后天之本,即"脾为中土以溉四旁";气机升降之枢纽,主升清降浊.脾胃在头痛的发生中占据重要地位,中焦病变常致头痛,脾胃功能失调,气机升降紊乱,清浊相干,清气难升、浊气难降,壅滞于中焦,如"痰厥头痛""九窍不利皆有脾胃"皆是脾胃功能失调导致头痛的论述,在临床中很多方剂主要通过恢复脾胃的生理功能而止头痛.头痛表现为头部疼痛不适,其原因不外乎不荣则痛,不通则痛,与清气不能荣养脑窍,浊气瘀滞不通有关.中药土茯苓为阳明本草,能健运脾胃、化湿利浊,恢复脾胃正常运化功能.文章通过探究土茯苓在历史沿革中的本草功效及现代药理研究中的作用,结合头风神方和立愈汤中重用土茯苓的具体方药分析及应用,研究其发挥升清降浊、调理脾胃气机升降的作用,揭示治疗头痛的机理,最后结合相关案例和临床验案进一步分析基于升清降浊理论重用土茯苓治疗头痛有效且安全性高,为临床治疗头痛提供了很好的思路.
Discussion on treating headache with high-dosage Tufuling based on the theory of upgrading clearance and reducing turbidity
Ascending the clear and descending the turbidity is the normal physiological state of the human body,which is the rise of clear Qi(气)and nutrients,and the decline of turbid Qi and dregs.The spleen and stomach are the acquired foundation,that is,the spleen is the middle soil to irrigate the four sides,the hub of lifting cleamess and lowering turbidity.The spleen and stomach plays an important role in the occurrence of headache.The middle Jiao(中焦)lesions often cause headache.The dysfunction of spleen and stomach leads to the disorder of Qi movement,the coherence of clearing and turbidity,the difficulty of clearing Qi to rise,the difficulty of turbidity to fall,and the stagnation in the middle Jiao.For example,phlegm headache and nine orifices obstruction are all discussions of headache caused by dysfunction of spleen and stomach.In clinical practice,many prescriptions mainly are used to restore the physiological function of spleen and stomach and stop headache.Headache is manifested as pain and discomfort in the head.The reason is nothing more than pain if it is not proud,and pain if it is impassable.It is related to the inability of Qing qi(气)to nourish the brain orifices and the stagnation of turbid Qi and stasis.Tufuling(Rhizoma Smilacis Glabrae),a traditional Chinese medicine,is a Rind of herb for Yangming(阳明),which can strengthen the spleen and stomach,remove dampness and turbidity,and restore the normal function of spleen and stomach.By exploring the herb efficacy of Tufuling in the historical evolution and the role of modern pharmacological research,combined with the analysis and application of the specific prescriptions of the Toufengshen decoction(头风神方)and the Liyu decoction(立愈汤),this paper studies the role of Tufuling in ascending clearness and descending turbidity and regulating the ascending and descending of spleen and stomach Qi,and reveals the mechanism of treating headache.Finally,combined with relevant cases and clinical cases for further analysis,it is concluded that high-dosage the reuse of Tufuling is effective and safe in the treatment of headache based on the theory of ascending clear and descending turbidity,which provides a good idea for clinical treatment of headache.

High doseTufulingRegulating the spleen and stomachAscending and lowering turbidityHeadache

孙娟娟、唐赛雪、刘春梅

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山东中医药大学,山东 济南,250014

山东中医药大学附属医院,山东 济南,250014

大剂量 土茯苓 调脾胃 升清降浊 头痛

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(11)