河南中医2025，Vol.45Issue(5)：712-717,6.DOI:10.16367/j.issn.1003-5028.2025.05.0116
叶海敏运用自拟柴附四物汤治疗偏头痛肝郁血虚、气滞血瘀证经验
Ye Haimin's Experience in Treating Migraine with Liver Depression and Blood Deficiency and Qi Stagnation and Blood Stasis Syndrome Using Self-Formulated Bupleurum and Aconite Four Substances Decoction
摘要
Abstract
Associate Professor Ye Haimin thinks that migraine originates in the brain,but involves dysfunction of the five zang organs,with liver depression,blood deficiency,qi stagnation,and blood stasis syndrome being the most common pattern.The core pathogenesis lies in liver depression and qi stagnation,which leads to blood stasis causing pain,compounded by liver blood deficiency that deprives the brain of nourishment causing deficiency resulting in pain.Depression,anxiety,and sleep disorders are significant triggers for mi-graine attacks and key factors contributing to its increasing prevalence among young people.Based on the complex interplay of deficien-cy and excess in this syndrome of liver depression with blood deficiency,qi stagnation and blood stasis.Professor Ye advocates a treat-ment strategy focusing on soothing the liver,nourishing blood,unblocking collaterals,and relieving pain,supplemented with regulating qi and dispelling wind.Her self-formulated Bupleurum and Aconite Four Substances Decoction has shown notable clinical efficacy.For in-somnia,dreaminess,and difficulty in sleep due to liver blood deficiency failing to anchor the ethereal soul,Fushen(Sclerotium Poriae Pararadicis),Yuanzhi(Radix Polygalae)or Sour Jujube Decoction can be added to nourish blood and calm the mind.For poor appe-tite,abdominal distension,loose stools,and white greasy tongue coating due to spleen deficiency and dampness,Fuling(Poria)and Yiy-iren(Semen Coicis)can be added to induce diuresis and drain dampness,fortify the spleen and stop diarrhea.For dizziness,chest tight-ness,and nausea due to wind-phlegm ascending,Pinellia and White Atractylodes and Gastrodia Decoction is combined to resolve phlegm and extinguish wind.For timidity,irritability,dry mouth,and yellow greasy tongue coating from gallbladder-stomach disharmony and phlegm-heat,Gallbladder-Warming Decoction is combined to regulate qi,resolve phlegm,and clear heat.If accompanied by restlessness and insomnia,Ten-Ingredient Gallbladder-Warming Decoction can be used to boost qi,nourish blood,and calm the mind.For neck stiff-ness and pain triggered by wind-cold-dampness,Gegen(Radix Puerariae Lobatae)and Weilingxian(Radix et Rhizoma Clematidis)can be added to unblock meridians.For hand numbness,Jixueteng(Caulis Spatholobi)can be added to relax sinews.For aversion to cold,spontaneous sweating,or night sweats due to qi deficiency,Huangqi(Radix Scutellariae)and Baizhu(Rhizoma Atractylodis Macroceph-alae)can be added to tonify qi and secure the exterior.For bitter taste,acid reflux,or vomiting due to liver fire attacking the stomach,Huanglian(Rhizoma Coptidis)and Wuzhuyu(Fructus Evodiae)can be added to soothe the liver,purge fire,and harmonize the stom-ach.For chest tightness,vomiting and nausea,severe unilateral headache with recurrent attacks,Huangqin(Radix Scutellariae)can be added to guide medicinals to the lesser yang meridian.关键词
偏头痛/肝郁血虚、气滞血瘀证/柴附四物汤/叶海敏Key words
migraine/liver depression with blood deficiency,qi stagnation and blood stasis syndrome/Bupleurum and Aconite Four Sub-stances Decoction/Ye Haimin分类
中医学引用本文复制引用
李卓燕,赵梦圆,刘叶辉,叶海敏..叶海敏运用自拟柴附四物汤治疗偏头痛肝郁血虚、气滞血瘀证经验[J].河南中医,2025,45(5):712-717,6.基金项目
湖南中医药大学2021年度校级科研基金与联合基金项目(2021XJJJ057) （2021XJJJ057）
