川芎最早見于《神農本(ben)草經(jing)》，又名芎(xiong)(xiong)(xiong)勞，金元(yuan)以后始(shi)稱川(chuan)芎(xiong)(xiong)(xiong)，至于(yu)其(qi)治療(liao)頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)早在《神農本(ben)草經(jing)》就記載“主中風(feng)入腦(nao)頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)”，李東垣更(geng)言明頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)必用(yong)川(chuan)芎(xiong)(xiong)(xiong)，其(qi)曰：“頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)必用(yong)川(chuan)芎(xiong)(xiong)(xiong)，如不愈，加各引經(jing)藥：太(tai)(tai)陽(yang)羌活，陽(yang)明白(bai)芷(zhi)，少(shao)陽(yang)柴胡，太(tai)(tai)陰(yin)(yin)蒼術，厥陰(yin)(yin)吳(wu)茱(zhu)萸(yu)，少(shao)陰(yin)(yin)細辛(xin)(xin)，是也。”沈老也認為，治頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)當(dang)(dang)用(yong)川(chuan)芎(xiong)(xiong)(xiong)，烈舉治頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)常用(yong)方都取(qu)用(yong)川(chuan)芎(xiong)(xiong)(xiong)。例如，風(feng)寒(han)頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)應用(yong)川(chuan)芎(xiong)(xiong)(xiong)茶調散，風(feng)熱(re)頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)取(qu)芎(xiong)(xiong)(xiong)芷(zhi)石膏湯(tang)，治風(feng)濕(shi)頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)羌活勝濕(shi)湯(tang)（川(chuan)芎(xiong)(xiong)(xiong)、羌活、藁(gao)本(ben)、防風(feng)等），血瘀頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)取(qu)通竅活血湯(tang)（川(chuan)芎(xiong)(xiong)(xiong)、赤(chi)芍、紅(hong)花(hua)、桃(tao)仁、生姜、蔥白(bai)、紅(hong)棗、麝香(xiang)），氣(qi)虛頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)可取(qu)《證(zheng)治準繩》的順氣(qi)和中湯(tang)（川(chuan)芎(xiong)(xiong)(xiong)、黃芪、黨參、當(dang)(dang)歸、陳皮、細辛(xin)(xin)、升麻(ma)(ma)）。關于(yu)濕(shi)濁頭(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)(tong)，一般醫籍中首推(tui)半夏白(bai)術天麻(ma)(ma)湯(tang)，沈老認為，必須加用(yong)川(chuan)芎(xiong)(xiong)(xiong)才有效。
沈(shen)(shen)老指(zhi)出，川(chuan)(chuan)芎(xiong)(xiong)(xiong)為(wei)(wei)血(xue)(xue)(xue)(xue)(xue)中(zhong)氣(qi)藥(yao)，取其辛竄走上通(tong)血(xue)(xue)(xue)(xue)(xue)脈，為(wei)(wei)除(chu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)良藥(yao)。正如張(zhang)(zhang)元素論川(chuan)(chuan)芎(xiong)(xiong)(xiong)所說“川(chuan)(chuan)芎(xiong)(xiong)(xiong)上行(xing)頭(tou)(tou)(tou)(tou)(tou)目(mu)，下(xia)行(xing)血(xue)(xue)(xue)(xue)(xue)海”，又說“其用(yong)(yong)(yong)有(you)四為(wei)(wei)少(shao)陽(yang)(yang)引經一也，諸經頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)二也，助清陽(yang)(yang)之(zhi)(zhi)氣(qi)三(san)也，祛濕氣(qi)在頭(tou)(tou)(tou)(tou)(tou)四也”。而(er)血(xue)(xue)(xue)(xue)(xue)虛(xu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)張(zhang)(zhang)元素贊川(chuan)(chuan)芎(xiong)(xiong)(xiong)是(shi)“血(xue)(xue)(xue)(xue)(xue)虛(xu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)之(zhi)(zhi)圣(sheng)藥(yao)也”。《李杲(gao)十書(shu)》也主(zhu)張(zhang)(zhang)可取用(yong)(yong)(yong)治(zhi)之(zhi)(zhi)，“血(xue)(xue)(xue)(xue)(xue)虛(xu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)當歸川(chuan)(chuan)芎(xiong)(xiong)(xiong)為(wei)(wei)主(zhu)”。可是(shi)近(jin)代(dai)名(ming)醫張(zhang)(zhang)山(shan)雷反對用(yong)(yong)(yong)川(chuan)(chuan)芎(xiong)(xiong)(xiong)謂：“血(xue)(xue)(xue)(xue)(xue)虛(xu)之(zhi)(zhi)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)，也是(shi)陰虛(xu)于下(xia)而(er)陽(yang)(yang)越(yue)于上，此豈可與風寒外束清陽(yang)(yang)不升混作(zuo)一例論治(zhi)。”沈(shen)(shen)老認(ren)為(wei)(wei)，血(xue)(xue)(xue)(xue)(xue)虛(xu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)該用(yong)(yong)(yong)川(chuan)(chuan)芎(xiong)(xiong)(xiong)，因為(wei)(wei)血(xue)(xue)(xue)(xue)(xue)虛(xu)可用(yong)(yong)(yong)四物(wu)湯(tang)而(er)該方(fang)中(zhong)也用(yong)(yong)(yong)川(chuan)(chuan)芎(xiong)(xiong)(xiong)。治(zhi)療(liao)(liao)血(xue)(xue)(xue)(xue)(xue)虛(xu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)為(wei)(wei)何不可大(da)劑(ji)補血(xue)(xue)(xue)(xue)(xue)養榮之(zhi)(zhi)藥(yao)中(zhong)加入少(shao)許(xu)川(chuan)(chuan)芎(xiong)(xiong)(xiong)，既能養血(xue)(xue)(xue)(xue)(xue)和(he)營(ying)、補而(er)不滯(zhi)，又能鼓營(ying)血(xue)(xue)(xue)(xue)(xue)直上巔頂以榮腦絡(luo)治(zhi)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)。《金(jin)匱翼》就載(zai)有(you)治(zhi)血(xue)(xue)(xue)(xue)(xue)虛(xu)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)之(zhi)(zhi)加味(wei)四物(wu)湯(tang)（川(chuan)(chuan)芎(xiong)(xiong)(xiong)、當歸、熟地、白(bai)芍、蔓荊、菊花）。同理(li)，沈(shen)(shen)老認(ren)為(wei)(wei)，治(zhi)療(liao)(liao)肝陽(yang)(yang)頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)，在天麻鉤藤飲(yin)方(fang)中(zhong)重用(yong)(yong)(yong)養肝陰息風和(he)引血(xue)(xue)(xue)(xue)(xue)下(xia)行(xing)之(zhi)(zhi)牛(niu)膝(xi)的(de)量，加入少(shao)許(xu)川(chuan)(chuan)芎(xiong)(xiong)(xiong)上下(xia)貫通(tong)營(ying)血(xue)(xue)(xue)(xue)(xue)。川(chuan)(chuan)芎(xiong)(xiong)(xiong)用(yong)(yong)(yong)于頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)是(shi)有(you)利無弊的(de)。而(er)肝火頭(tou)(tou)(tou)(tou)(tou)痛(tong)(tong)(tong)(tong)(tong)古人應用(yong)(yong)(yong)《證治(zhi)準繩》的(de)清肝散（川(chuan)(chuan)芎(xiong)(xiong)(xiong)、山(shan)梔、丹皮、白(bai)芍、龍(long)膽草）、宋代(dai)錢乙(yi)的(de)瀉青丸(wan)（川(chuan)(chuan)芎(xiong)(xiong)(xiong)、龍(long)膽草、大(da)黃、山(shan)梔等(deng)）歷來也有(you)所爭議，沈(shen)(shen)老主(zhu)張(zhang)(zhang)遣方(fang)用(yong)(yong)(yong)藥(yao)應巧用(yong)(yong)(yong)配(pei)伍、掌握適度，可變弊為(wei)(wei)利。
近年來對川芎進行了深(shen)人廣泛(fan)的藥理藥效研究，上海長海醫院報道其有以下作用：
①改(gai)善軟腦膜和外周微循環；
②抗血小板(ban)凝集，抑制血栓素(su)A和增加前列環素(su)的濃度；
③增加腦血流量；
④保護實(shi)驗性腦缺血；
⑤減輕腦水腫和微血管內纖維(wei)蛋白元沉淀；
⑥修復變性的神經細(xi)胞樹突和(he)保護動脈內皮(pi)細(xi)胞；
⑦增(zeng)加(jia)顱內中心動脈的順(shun)應性和降低腦(nao)血管的特(te)性阻抗；
⑧對實(shi)驗性(xing)內臟器官(guan)(心、腦、肝、脾）實(shi)質損害有(you)(you)明顯保(bao)護作(zuo)用。臨床上(shang)常選用速(su)效救心丸(wan)緩解心絞痛，川芎嗪靜脈滴注治療(liao)急慢(man)性(xing)缺血性(xing)腦血管(guan)疾(ji)病(bing)有(you)(you)顯著(zhu)療(liao)效。
沈老在老年心(xin)腦(nao)血(xue)管疾(ji)病治(zhi)療中(zhong)，尤(you)其在腦(nao)中(zhong)風恢復期、冠心(xin)病心(xin)絞痛、心(xin)律不齊等，都在處方(fang)中(zhong)辨證配伍應用川芎，以增強療效。
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川芎茶調散方歌，組成，功效與作用
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