▲Ren Jixue, Master of Traditional Chinese Medicine (1926-2010)
At present, many people in the academic community recommend Zhang Zhongjing's prescription as "ancestral prescription". "Jin Kui Yao Luo Xin Dian" pointed out: "Only Zhongjing is the only ancestor of the scriptures and the collection of its culmination...... Only these two books are really the ancestors of the scriptures. "Zhongjing's prescription medicine monosodium glutamate, in line with the pathogenesis, the medicine is simple and effective, and later generations of doctors mostly add and subtract on the basis of their prescriptions to treat diseases, so it can indeed be called the "ancestor of prescriptions". Shi Pei, a physician in the late Ming and early Qing dynasties, compiled the "Ancestral Medicine", which divided the famous prescriptions of the past dynasties into "Zongfang", "Zufang", "Class Fang" and "Derivation Formula", in which the ancestral formula is the source and the derived formula is the stream.
Take Guizhi Tang in "Treatise on Typhoid Fever" as an example, this recipe is the "ancestral prescription" for the treatment of sun stroke, and if there is also sweat leakage, aconite is added to warm the meridian and support the yang; If there is also asthma, add magnolia apricot to reduce the inversion and asthma, etc., so I will not repeat it. In short, the ancestral prescription is fundamental, it can reflect the commonality and regularity of the disease treated, if we can grasp the key to the pathogenesis, flexibly use the ancestral prescription, and tailor with the evidence, it can play a role in the bypass.
In clinical practice, many modern doctors have given full play to the meaning and application of "ancestral formula", firmly grasped the key to pathogenesis, formulated drugs, and created "basic prescriptions", which are equivalent to the "ancestral prescriptions" formulated by modern doctors in combination with clinical experience, so as to guide clinical practice concisely and practically, and have achieved relatively good results.
Ren Jixue, a master of traditional Chinese medicine, also flexibly used the theory of "ancestral prescription" when identifying and treating some diseases, such as cervical spine syndrome, headache, etc., which can be seen in his flexible use of ancestral prescription. Ren Jixue especially has a deep understanding of the pathophysiology of the cerebral medullary cord, and is good at applying the theory of cerebral medullary cord to treat headache based on the ancestral formula.
Etiology and pathogenesis of headache
The head is the head of the human body, with skull, muscles, skin, hair, ears, eyes, mouth, nose and other organs; The inner protection of the brain and the marrow is in it. The six yang meridians are all connected to the head, and the six yin meridians are connected to the yin meridians, which are hidden and hidden, and the yin and yang meridians are used for each other. "Su Wen: The Subtlety of the Pulse" points out: "The head is the house of shrewdness" "The essence is the god of the body; The wise one, the treasure of the body. "The head is the dwelling of the gods, the gods are the spirits, the qi is the gods, the roots of the gods are contained in the essence, the brain is the sea of the marrow, and the house of the gods. It can be seen that the brain is the divine organ, the marrow is the divine house, and it is also a "Tai Chi" of the human body.
The ball of the left pole of the cerebrospinal meristem is moving, rigid, ascending, and opening; The ball at the right pole is static, soft, descending, and combined. The combination of Tai Chi movement and static, the combination of rigidity and softness, will make all things biochemical endlessly. The true essence is scattered, and the spirit is thousands. Therefore, the true essence of the human body is hidden in the head, and the brain and marrow are the masters. The cerebral medulla produces the muscle nucleus of God, which is the essence of God. The spermatoplasty is divided into different classes and groups, so the divine machine should be opened and closed. In this way, the cardinal can be lifted, the meridians can be unobstructed, the nerves can be transmitted, the five organs can be used interchangeably, the upper and lower levels can be called, and the life can be complete. The blood of the essence of the five internal organs and the qi of the six internal organs are all injected into the head to nourish the brain and marrow.
The three elements of the primordial spirit, the divine machine, and the nerves are the relationship between the five gods of the brain and the internal organs, forming the lifeline axis to control the whole body. As the "Nine Palaces Taiyi Purple Room Jue" said: "The spirit sect of the brain is the soul of the body, and the life of the gods." Wang Kentang's "Criteria for Governance" pointed out: "The brain likes to be quiet and evil is disturbed, quiet is clear and internal, and disturbance is scattered and scattered." "The scattered are sick. The above is a brief introduction to the pathophysiology of the cerebral spinal cord.
Headache is closely related to the pathophysiology of the cerebral spinal cord, and its causes are not external and external. Those who are sick from the outside will be due to the abnormal climate in the natural world, and the evil of the six sexual immorality and the poisonous qi of the epidemic will invade the body by the weakness of the human body, one will commit the meridians, the second will be the fur, and the third will be the guard, causing the conflict between good and evil, blocking the meridians, and the righteous qi will not be able to restrain the evil, and the upper part will be guilty of the head, and the brain will be disturbed internally, and the qi and blood in the brain will be disturbed, and the blood will be uncomfortable, and the evil qi will be reversed in the brain and cause headaches.
The disease originates from the inside, one is due to eating disorders, food and lodging in the stomach and toxin, infringing on the spleen and stomach, causing the spleen not to rise, the stomach not to fall, the central axis is not transported, the water can not be dispersed, the dampness and phlegm are gathered, and the poison is retained for a long time, which is the damp phlegm and turbidity poison, which is soaked in the brain through the small meridians of the stomach, so that the meridians in the brain are uncomfortable and cause headaches; Second, due to emotional depression, it causes imbalance in the function of the viscera, qi and organ disorders, unfavorable circulation of qi and blood in the meridians, turning into stasis, and the extravasation of water and blood into phlegm for drinking, which will produce phlegm and stasis and turbidity, disturbance and emptying, nervous disturbance and headache; The third is the dark injury of the kidney, which is damaged by the injury, and the damage causes changes, resulting in the lack of essence and qi, the lack of energy, the weakness of the spirit, and the headache caused by the uneasiness of the brain and spinal cord; Fourth, due to the deficiency of central qi, the clear yang does not rise, the brain lacks the clear yang qi, and the turbidity qi is reversed.
In addition, there are also people who can't go to the brain because of blood deficiency, and the spirit is not nourished and causes headaches; or those who have no deficiency in blood veins, but headaches due to vein blockage, poor blood transfusion, and cerebral lack of blood nourishment and operation; There are also cases caused by misingetion. This is the brief mechanism by which headaches occur.
However, regardless of external and internal injury, headache is a symptom caused by the urgency of the veins or lack of nourishment, and the unfavorable clearing of the veins, the blockage of the veins, the involvement of the nervous organs, and the unfavorable clearing of the organs is the key to the pathogenesis of the occurrence of headaches.
Create a headache ancestor
Although the onset of headache is acute and slow, the onset of headache is more painful for patients, so both symptoms and root causes should be treated, so as to achieve the purpose of rapid onset and relief of symptoms. "The general rule is not painful", so quickly dredge the head meridians, relieve pain and relieve pain is the first treatment, and other treatments can be carried out on this basis. Therefore, Ren Jixue created the ancestral prescription for headache to treat the disease.
Headache Ancestral Formula: Xinyi 15g (fried in pack), Chuanxiong 15g, Vitex 15g, Rhizome 15g, Angelica dahurica 10g.
The pungent taste in the formula is pungent and warm, which can dissipate wind and cold, clear the nasal passages, and is an important medicine for the treatment of nasal abyss headache. Chuanxiong Xinwen, invigorate blood and qi, dispel wind and relieve pain, is a medicine for blood qi, can go up to the leader, down the sea of blood, into the sun meridian, Shaoyang meridian to treat headaches, there has been a "headache does not leave Chuanxiong" said. Vitex is bitter, bitter and slightly cold, can evacuate wind and heat, clear the head, dispel wind and relieve pain, and is the menstrual medicine for headaches in the sun meridian. It can dispel wind and cold, win dampness and relieve pain, and is a menstrual medicine for the treatment of headache at the top of the syncope and yin meridians. Angelica Angelica is pungent and warm, can dispel wind, dispel cold and win dampness, relieve pain, and is good at treating pain in the head and eyebrow bones before Yangming menstruation. The combination of various medicines, targeting the main meridians of the head, can lead the medicine directly to the disease, so that the effect of the drug is concentrated and quickly revealed, dredge the meridians of the head, and it is not painful.
On the basis of the ancestral formula, the syndrome can be distinguished and treated as follows: for headache caused by Zhongqi deficiency, the symptoms are headache, dizziness, fatigue, fatigue, shortness of breath and lazy speech, pale yellow and reddish face, pale red tongue, thin white moss, and weak pulse. The treatment should replenish the middle and invigorate the qi, raise the yang and relieve pain. On the basis of the ancestral formula, 15g of lotus leaf, 5g of cimicifuga, 5g of bupleurum chinensis, 30g of astragalus, 15g of codonopsis, etc., are added to the prescription, and decoction is taken in water. Take the meaning of tonifying Zhongyi Qi soup and citrus pills.
For the headache caused by the upswing of the liver yang, the symptoms are dizziness and pain, irritability, dryness and bitterness in the mouth, dreaminess in the sleep, red face, chest tightness, yellow urine, red tongue, yellow moss and Shaojin, and smooth pulse. The treatment should calm the liver and latent yang, and relieve pain. On the basis of the ancestral formula, 5g of antelope horn (decoction first), 15g of tortoiseshell (decoction first), 15g of rehmannia root, 15g of white peony, 15g of agarwood, 15g of tribulus terrestris, etc., decoction in water. Take the antelope horns and tortoiseshell turtles that are salty and cold to calm the liver and latent yang.
For headache caused by phlegm turbidity, the symptoms are dizzy and painful head, chest tightness, vomiting, soreness and softness of the limbs, sluggishness, stickiness in the mouth, pale yellow face, faint red cheeks, fat tongue, red and faint blue tongue, white and greasy, and slow and smooth pulse. The treatment should reduce phlegm and inversion, and relieve pain. On the basis of the ancestral formula, 15g of Qingbanxia, 15g of Poria cocos, 5g of citrus aurantium, and 5g of white mustard seeds were added; If there is a hot phlegm, add 15g of indigo (fried in packs), 15g of clam powder (fried in packs), 15g of wine skullcap, etc., decoction in water. They are taken from Erchen soup and Dai clam to dissolve phlegm.
For headaches caused by blood deficiency, symptoms include hollow pain in the head, palpitations, shortness of breath, five heart irritability, headache is reduced when lying down, dry mouth, less food, yellowish face, pale lips, pale tongue, less lichen, and pulse deficiency. The treatment should replenish qi and nourish blood, and relieve pain. On the basis of the ancestral formula, 30g of astragalus, 15g of angelica, 15g of rehmannia rehmannia, 15g of sand kernels, 15g of longan meat, 15g of salvia, etc., are decocted in water. It nourishes qi and nourishes blood and relieves pain.
In addition, it can also be treated according to the characteristics of the headache, for example, if the symptoms are unbearable in the afternoon or night headache and eye beads (eyeballs), the ancestral recipe is incense with 15g, prunella vulgaris 25g, and decoction in water. It is a fragrant dry soup for the treatment of eye pain.
Symptoms include headache, neck discomfort, or numbness of the upper limbs, congestion in the ears, or chest tightness and pain, abdominal distention, red and blue complexion, red tongue, thick moss, and heavy pulse. This kind of headache is mostly seen in cervical spine syndrome, which is a condition of vein blockage, and the treatment should focus on removing stasis and channeling, giving Zufang plus 15g of Pueraria, 15g of broken bones, 10g of turtle insects, 25g of pigweed, 15g of raw puhuang (including decoction), etc., decoction in water.
Chen tea bud decoction is clinically used for the treatment of intractable migraine, and the effect is good. Its composition is as follows: 25g of aged tea buds, 20g of black beans, 5g of rush grass, 15g of honeysuckle, 10g of scutellaria, 10g of vitex, 10g of parsnip, 10g of gastrodia, 15g of Chuanxiong, 15g of Xinyi, 120g of Poria cocos (decoction, later into other medicines). Water decoction.
Ren Jixue treats headache both internally and externally, and its self-created external treatment prescription penetrates the top pain relief powder, composed of only five flavor medicines, but the effect is fast, the effect is good, and it has the characteristics of simplicity, convenience, effectiveness and inexpensive in traditional Chinese medicine, as follows: 20g of medicinal Chuanxiong, 5g of Angelica dahurica, 1g of fire nitrate, 0.03g of realgar, the medicine is a total of fine noodles, 2g of borneol, put into a porcelain bottle, take an appropriate amount when using, wrap the nose with gauze, and immediately stop the pain. This prescription can be used regardless of the type of headache.
For the various headache prescriptions introduced above, you can use pig brain marrow decoction, and then add other medicines to decoction. The use of flesh and blood products to supplement the class is indeed better.
Examples of medical cases
Zhang, male, was 36 years old at the time. He was first diagnosed on February 24, 2004 due to intermittent headache for 2 years. The patient had a headache 2 years ago with no obvious cause and had been treated with a variety of medications, which were effective at first but did not respond later. I went to the local hospital for a variety of head examinations and found no abnormalities.
Symptoms at the time of consultation: headache and drowsiness, especially on the forehead and the top of the head, chest tightness, occasional nausea and vomiting, fatigue, obesity, heavy limbs, sluggishness, sticky mouth, fat tongue, dark red tongue, white and greasy, slow and smooth pulse.
Diagnosis: phlegm-turbid headache.
Treatment: dissolve phlegm and reduce inversion, and relieve pain.
Prescription: (1) Poria cocos 150g (decoction juice, then add other medicines), Chuanxiong 10g, black bean 15g, vitex 15g, Xinyi 15g, Rehmannia 15g, Qingbanxia 15g, Gastrodia 15g, Angelica Angelica 10g, Rhizome 15g, Dilong 15g, Whole Scorpion 2g, Ginger 3 slices. Water decoction.
(2) Thorough analgesic powder, appropriate amount, external use.
Note: After the patient used the Tho Ding Pain Relief Powder, he immediately felt refreshed and the faint pain was significantly reduced. Combined with the internal administration of Chinese herbal decoction, a total of 5 doses of the medicine were taken, and the headache gradually subsided until it no longer flares up, and then 5 doses were taken to consolidate the curative effect. The intractable headache that lasted for more than 2 years was cured within 2 weeks. Although the patient's headache has no obvious cause on the surface, the patient's body is obese, and the phlegm is turbid, which must be due to the uncontrolled diet, unfavorable transportation, and the food is stagnant in the stomach and produces poison, which infringes on the spleen and stomach, resulting in the spleen does not rise, the stomach does not fall, the central axis is unfavorable, the water and jin can not be dispersed, the dampness and phlegm are generated, and the poison is retained for a long time, and the damp phlegm and turbidity are soaked in the brain through the small meridians of the stomach, so that the meridians in the brain are uncomfortable and cause headache.
When the headache attacks, it is urgent to relieve the pain to treat the symptoms, so it is urgent to use the top pain relief for external use; In the internal prescription, reuse Poria cocos to detoxify and dehumidify; Chuanxiong, Vitex, Xinyi, Angelica dahurica, and Gaoben ancestral recipes dredge the meridians of the head to relieve pain; Black beans, Qing Banxia to dispel dampness, raw land to prevent dryness and dampness to hurt yin, gastrodia for the treatment of headache medicine, with Banxia combined with the meaning of Banxia Atractylodes gastrodia soup, to dry and damp phlegm to treat headache, earth dragon, whole scorpion to insects to jump, through the channels to relieve pain, ginger to reconcile the medicines, detoxification. Based on the ancestral formula, the whole prescription is supplemented with phlegm-dissolving and channeling drugs, and the treatment of phlegm turbidity headache has a significant effect.
Xu Dachun's "Preface to Typhoid Fever Prescriptions" pointed out: "The treatment of Gai Fang is fixed, but the change of disease is uncertain. "The use of ancestral prescriptions reflects the key to the pathogenesis of diseases, and if we can firmly grasp the application methods of ancestral prescriptions, combined with clinical evidence, we can control the complexity and achieve good clinical efficacy.
Zheng reiterates:
Since each person's constitution and condition are different, the prescription and dosage in this case are only applicable to the patient's condition at that time. Without TCM syndrome differentiation diagnosis and treatment, the prescription and dosage in this case must not be copied. If necessary, readers should go to a regular hospital for diagnosis and treatment to avoid delaying their condition. ■
[Content compiled from: "China Traditional Chinese Medicine News" November 8, 2021 fifth edition, author: Liu Yanhua, Ren Baowei, Chu Hongbo, Ren Xijie, Affiliated Hospital of Changchun University of Traditional Chinese Medicine]