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222.15 以内经之头痛病理观点诊治慢性紧张性头痛之案例

TJ TCM.22(2) : 147-156, 2019

DOI : 10.6516/TJTCM.201909_22(2).0015

以内经之头痛病理观点诊治慢性紧张性头痛之案例

Chronic Tension Type Headache Alleviated by the Treatment Principle According to Huangdi Neijing: A Case Report

锺郁蓉1　叶家舟1,2*

1 佛教慈济医疗财团法人大林慈济医院中医部，嘉义，台湾

2 慈济大学学士後中医学系，花莲，台湾

【摘要】

慢性紧张型头痛(CTTH) 为最常见的原发性头痛类型，其大大降低患者的生活品质，发作时会有双侧、压迫或紧缩性、轻到中度、不因日常活动如走路或爬楼梯而加剧的疼痛。本病例为54 岁女性，患者因反覆头痛五年时间深受症状困扰，依照内经系统分析，诊断为营卫不和合并膀胱经风寒湿表实证，使用葛根汤治疗，又患者并有内湿体质，方中另加甘露消毒丹合并治疗，经服用第一剂中药一小时後，疼痛指数(VAS) 由3 分下降为1 分，服用第二剂中药後，腰痛问题缓解。显示中医治疗头痛可达到快速缓解慢性紧张型头痛效果，并且有效增进患者日常生活品质。

【关键词】葛根汤、慢性紧张型头痛、营卫不和、黄帝内经

Yu-Jung Chung1　Chia-Chou Yeh1*

1Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical

Foundation, Chia-Yi, Taiwan

2School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan

【Summary】

Chronic tension type headache (CTTH) is the most common type of primary headache, and it significantly influenced the quality of life of the patients. CTTH has episodes at least 15 days per month, typically bilateral pressing or tightening in quality and mild to moderate pain intensity, which would not worsened with daily physical activity such as walking or climbing stairs. Herein, we represented a case of 54-year-old female was suffered from recurrent headache for 5 years.

According to pathological point of view of Huangdi Neijing, this case was diagnosis as construction-defense disharmony combines with exterior repletion pattern due to wind-cold dampness excess invading bladder channel. After taking first dose of Ge Gen Tang and Gan-Lu-Xiao-Du-Dan, the pain intensity of visual analog scale (VAS) score decreased from 3 to 1 in one hour. The back pain was resolved after patient took second dose of prescription. We showed that rapid resolved CTTH with Chinese medicine was shown in this case report; moreover, pain relief can also enhance the quality of life of the patients.

【Keywords】

Ge Gen Tang, Chronic tension type headache, disharmony between nutrient and defense phases, Huangdi Neijing

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