通讯作者: 海英, haiying200311@163.com

DOI：10.12201/bmr.202605.00029

Staging and Differentiated Treatment of Migraine Based on the Theory of Hidden

• 摘要：偏头痛是一种常见的慢性发作性神经系统疾病,具有病程较长、反复发作、迁延难愈的临床特点,常由特定诱因所引发,这与“伏邪”潜匿体内,伺机而发的特征高度契合。该文基于“伏邪”理论阐释偏头痛“因虚致伏、伏而后发、痰瘀互结”的动态病机演变,即因正气不足,邪气伏藏,遇诱因引动,导致邪气外发,上扰清窍,若邪气久羁,则痰瘀互结,深入血络,疾病全过程分为正虚邪伏期,邪发少阳期及邪恋痰瘀期。临证时当分期辨治:正虚邪伏期,外来之邪与内伤之邪相合,此期当以“扶正透邪”为主,注重体质调理与诱因规避;邪发少阳期,伏邪转出于少阳经脉,致少阳枢机不利,经气郁滞,此期当和解少阳、疏机通络;邪恋痰瘀期,病邪已由气分深入血络,痰浊与瘀血相互搏结,则需消补兼施,化痰祛瘀通络。冀此理论体系能够丰富偏头痛的中医辨治思路,为构建具有中医特色的偏头痛防治方案提供理论支撑。

  关键词： 伏邪理论; 正虚邪伏; 偏头痛; 分期辨治; 和解少阳

   

  Abstract: Migraine is a common chronic episodic neurological disorder characterized by a prolonged course, recurrent attacks, and difficulty in resolution, often triggered by specific factors. This closely aligns with the feature of latent pathogenic factors hiding within the body and activating opportunistically. This article explains the dynamic pathogenesis evolution of migraine as caused by deficiency leading to latent pathogenic factors, which then manifest, with phlegm and blood stasis interweaving based on the theory of latent pathogenic factors. Specifically, due to insufficient vital energy, pathogenic factors remain hidden and are triggered by inducements, leading to their outward manifestation, disturbing the sensory orifices; if the pathogenic factors linger for a long time, phlegm and blood stasis interweave and penetrate the collaterals. The entire disease process is divided into the stage of vital deficiency with latent pathogenic factors, the stage of pathogenic factors manifesting in the Shaoyang, and the stage of pathogenic factors adhering to phlegm and blood stasis. Clinical treatment should be based on stage differentiation: in the stage of vital deficiency with latent pathogenic factors, external and internally injurious pathogenic factors coexist, and the primary treatment should be supporting the vital energy and dispelling pathogenic factors, focusing on constitution adjustment and avoidance of triggers; in the stage of pathogenic factors manifesting in the Shaoyang, the latent factors emerge along the Shaoyang meridians, causing dysfunction of the Shaoyang pivot and stagnation of meridian Qi, and the treatment should focus on harmonizing Shaoyang and unblocking the meridian pathways; in the stage of pathogenic factors adhering to phlegm and blood stasis, the pathogenic factors have penetrated the blood collaterals from the Qi aspect, with phlegm turbidity and blood stasis intertwining, requiring a combined approach of eliminative and tonic therapies to resolve phlegm, remove blood stasis, and unblock the meridians. It is hoped that this theoretical framework can enrich the TCM-based differentiation and treatment approaches for migraine and provide a theoretical basis for developing migraine prevention and treatment programs with distinctive TCM characteristics.

  Key words: Fuxie theory; Righteousness and deficiency and evil are hidden; migraine; Phased treatment; Reconciliation of Shaoyang

  提交时间：2026-05-06

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-03-31	10.12201/bmr.202605.00029V1	下载

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