刘海亮 王中琳

    〔摘要〕 紧张性头痛(tension-type headache， TTH)是临床最为常见的慢性头痛，属于中医学“头痛病”“头风”范畴。脑为髓海所在，脑窍受脏腑经络之气血涵养，相关脏腑经络之病变皆可影响气血调畅，而致脑络拘急，发为头痛。西医对TTH发病机制目前尚不完全明确，以药物对症治疗为主，王中琳教授在长期的临证与理论探究中总结TTH的病机在于阳郁神颓、脑络绌急，强调情志因素在TTH辨病辨证中的影响，突出阳气在病机演变的枢纽作用，治疗上应用大补肝汤、柴胡加龙牡汤、柴胡桂枝干姜汤等经方，常选北沙参、龙骨、牡蛎、白薇等疗恚除烦等药物，通过振奋阳气、清化血浊、补益肝肾、消导积滞等诸法来标本兼治、调畅气血。

    〔关键词〕 紧张性头痛;头风;名医经验;王中琳

    〔中图分类号〕R249;R277.7? ? ? ?〔文献标志码〕B? ? ? ?〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.03.018

    〔Abstract〕 Tension-type headache (TTH) is the most common clinical chronic headache. It belongs to the category of "headache" and "head wind" in Chinese medicine. The brain is the sea of marrow， the brain orifice is nourished by the qi and blood of the viscera and meridian. The pathological changes of related viscera and meridian can affect the smooth flow of qi and blood， resulting in anxious brain and collaterals and headache. The pathogenesis of TTH in western medicine is still not completely clear， and the main focus is on symptomatic treatment with drugs. Professor Wang Zhonglin concluded that the pathogenesis of TTH lies in Yang depression ......