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222.15 以內經之頭痛病理觀點診治慢性緊張性頭痛之案例

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

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

以內經之頭痛病理觀點診治慢性緊張性頭痛之案例

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

鍾郁蓉1　葉家舟1,2*

1 佛教慈濟醫療財團法人大林慈濟醫院中醫部，嘉義，台灣

2 慈濟大學學士後中醫學系，花蓮，台灣

【摘要】

慢性緊張型頭痛(CTTH) 為最常見的原發性頭痛類型，其大大降低患者的生活品質，發作時會有雙側、壓迫或緊縮性、輕到中度、不因日常活動如走路或爬樓梯而加劇的疼痛。本病例為54 歲女性，患者因反覆頭痛五年時間深受症狀困擾，依照內經系統分析，診斷為營衛不和合併膀胱經風寒濕表實證，使用葛根湯治療，又患者併有內濕體質，方中另加甘露消毒丹合併治療，經服用第一劑中藥一小時後，疼痛指數(VAS) 由3 分下降為1 分，服用第二劑中藥後，腰痛問題緩解。顯示中醫治療頭痛可達到快速緩解慢性緊張型頭痛效果，並且有效增進患者日常生活品質。

【關鍵詞】葛根湯、慢性緊張型頭痛、營衛不和、黃帝內經

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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