針藥併施治療偏頭痛經驗－病例報告

本病例報告為一名38歲男性，自十年前起有左顳側頭痛，約每兩年發作一次，好發季節為五、六月或工作繁忙，發作病程約持續一個月。每次發作症狀為左顳側頭脹痛，多夜間發作而影響睡眠或工作，一天發作一次，脹痛持續一至二小時，需服用止痛藥（1-2次／天）方能緩解，伴隨症狀為左眼窩疼痛、流淚、流鼻水、時嘔吐。無頭暈、閃光、耳鳴或疼痛放射至他處。98/06/29曾至本院西醫就診，確診為典型性偏頭痛（classical migraine），頸部ｘ光檢查顯示輕微退化，腦波檢查結果無異狀。本次於100/10/22發作，發作型態同前，因服止痛藥（2-3次/天）疼痛仍無法緩解，故至本院中醫門診就診。經中醫診治辨證為肝鬱脾虛，氣滯血瘀，風襲少陽膽經。初診處方給予科學中藥散偏湯合逍遙散加味，並配合頭針及體針治療一次。一週後頭痛發作頻率減為兩至三天發作一次，週間僅服用一次止痛藥。二診時改用飲片煎劑使用並配合針刺治療一次，服藥一帖後症狀即消，中藥治療療程共三週，期間配合兩次針刺治療，一個月後追蹤症狀未發作，分別於治療後五個月（101/03/22）、十個月（101/08/04）、一年八個月（102/06）、兩年十一個月（103/09/23）、三年三個月（104/01/23）我們再次追蹤訪談，患者表示工作繁忙時及五、六月頭痛並未發作，仍需再持續追蹤。本患者治療成效令人振奮，以中醫藥治療偏頭痛可獲得良好的緩解效果，傳統中醫藥可為治療偏頭痛的輔助方法，或許可做為治療偏頭痛的另類選擇。

關鍵字

偏頭痛；中醫藥；輔助療法

並列摘要

A 38-year-old male had suffered from left temporal area headache since ten years ago. The headache occurred about every two years and usually happened in May to July or when he was busy. Every time when the headache attacked him, it was located at left temporal area and was swollen pain in character. The frequency was once per day and the duration was one to two hours. It also happened at night that affected his sleep and day-time work. The headache was subsided with an analgesic but relapsed after the drug duration passing. The accompany symptoms were left eye pain, tearing, sneezing, and sometimes vomiting. There were no dizziness, vertigo, lighting, tinnitus or radiating pain. He had visited our Neurology out-patient department for headache in 2009 and was diagnosed as classical migraine difiately. The X-ray of cervical spine lateral view disclosed mild degeneration and the EEG showed normal data. This time, the left temporal headache relapsed on 10/22/2011. He then visited our Chinese Medicine department for the headache. Based on Chinese medical differential diagnosis, we prescribed Xiao-yao-san combined with Suan-pian-tang. The left temporal headache and associated symptoms improved after one week TCM treatment. During the third week of treatment, the headache was remissed. The TCM treatment persisted one month. After ten months, the headache did not relapse. In conclusion, Chinese medicine may be the complementary therapy of migraine and even can be the first choice of this intractable disease.