川芎最早見于《神農本(ben)草經(jing)》，又名芎(xiong)勞，金(jin)元以后始稱川(chuan)芎(xiong)，至于其(qi)治(zhi)療頭(tou)(tou)痛(tong)(tong)(tong)早在《神農本(ben)草經(jing)》就記(ji)載(zai)“主(zhu)中(zhong)風(feng)入腦(nao)頭(tou)(tou)痛(tong)(tong)(tong)”，李東垣更言明頭(tou)(tou)痛(tong)(tong)(tong)必用(yong)川(chuan)芎(xiong)，其(qi)曰：“頭(tou)(tou)痛(tong)(tong)(tong)必用(yong)川(chuan)芎(xiong)，如不愈，加各引經(jing)藥：太陽羌(qiang)(qiang)(qiang)活(huo)(huo)，陽明白芷(zhi)，少陽柴胡，太陰(yin)蒼術，厥陰(yin)吳(wu)茱萸，少陰(yin)細辛(xin)(xin)，是也(ye)。”沈老(lao)也(ye)認(ren)為(wei)，治(zhi)頭(tou)(tou)痛(tong)(tong)(tong)當(dang)用(yong)川(chuan)芎(xiong)，烈(lie)舉(ju)治(zhi)頭(tou)(tou)痛(tong)(tong)(tong)常用(yong)方(fang)都取(qu)(qu)(qu)(qu)用(yong)川(chuan)芎(xiong)。例如，風(feng)寒(han)頭(tou)(tou)痛(tong)(tong)(tong)應用(yong)川(chuan)芎(xiong)茶調散，風(feng)熱頭(tou)(tou)痛(tong)(tong)(tong)取(qu)(qu)(qu)(qu)芎(xiong)芷(zhi)石(shi)膏湯，治(zhi)風(feng)濕頭(tou)(tou)痛(tong)(tong)(tong)羌(qiang)(qiang)(qiang)活(huo)(huo)勝濕湯（川(chuan)芎(xiong)、羌(qiang)(qiang)(qiang)活(huo)(huo)、藁本(ben)、防(fang)風(feng)等），血瘀(yu)頭(tou)(tou)痛(tong)(tong)(tong)取(qu)(qu)(qu)(qu)通竅活(huo)(huo)血湯（川(chuan)芎(xiong)、赤芍、紅(hong)花、桃(tao)仁、生姜、蔥白、紅(hong)棗(zao)、麝香），氣虛頭(tou)(tou)痛(tong)(tong)(tong)可取(qu)(qu)(qu)(qu)《證治(zhi)準繩》的順氣和(he)中(zhong)湯（川(chuan)芎(xiong)、黃芪、黨參、當(dang)歸、陳皮、細辛(xin)(xin)、升麻）。關于濕濁頭(tou)(tou)痛(tong)(tong)(tong)，一般醫籍中(zhong)首(shou)推半夏白術天麻湯，沈老(lao)認(ren)為(wei)，必須加用(yong)川(chuan)芎(xiong)才有(you)效(xiao)。
沈老(lao)指出，川(chuan)(chuan)(chuan)(chuan)芎(xiong)為(wei)血中(zhong)(zhong)氣藥，取其辛竄走上(shang)通(tong)血脈，為(wei)除頭(tou)(tou)(tou)痛(tong)(tong)(tong)良藥。正如張(zhang)元素(su)論川(chuan)(chuan)(chuan)(chuan)芎(xiong)所說(shuo)“川(chuan)(chuan)(chuan)(chuan)芎(xiong)上(shang)行(xing)頭(tou)(tou)(tou)目，下(xia)行(xing)血海”，又說(shuo)“其用(yong)(yong)(yong)有(you)四(si)為(wei)少陽(yang)引經一也(ye)，諸經頭(tou)(tou)(tou)痛(tong)(tong)(tong)二也(ye)，助清陽(yang)之(zhi)(zhi)氣三也(ye)，祛濕氣在頭(tou)(tou)(tou)四(si)也(ye)”。而(er)血虛(xu)(xu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)張(zhang)元素(su)贊川(chuan)(chuan)(chuan)(chuan)芎(xiong)是(shi)“血虛(xu)(xu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)之(zhi)(zhi)圣藥也(ye)”。《李杲十書》也(ye)主張(zhang)可(ke)取用(yong)(yong)(yong)治(zhi)(zhi)之(zhi)(zhi)，“血虛(xu)(xu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)當歸川(chuan)(chuan)(chuan)(chuan)芎(xiong)為(wei)主”。可(ke)是(shi)近代(dai)名醫張(zhang)山(shan)(shan)雷反對用(yong)(yong)(yong)川(chuan)(chuan)(chuan)(chuan)芎(xiong)謂：“血虛(xu)(xu)之(zhi)(zhi)頭(tou)(tou)(tou)痛(tong)(tong)(tong)，也(ye)是(shi)陰虛(xu)(xu)于(yu)(yu)下(xia)而(er)陽(yang)越于(yu)(yu)上(shang)，此豈可(ke)與風寒外束(shu)清陽(yang)不(bu)(bu)升混作一例(li)論治(zhi)(zhi)。”沈老(lao)認為(wei)，血虛(xu)(xu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)該用(yong)(yong)(yong)川(chuan)(chuan)(chuan)(chuan)芎(xiong)，因為(wei)血虛(xu)(xu)可(ke)用(yong)(yong)(yong)四(si)物湯而(er)該方中(zhong)(zhong)也(ye)用(yong)(yong)(yong)川(chuan)(chuan)(chuan)(chuan)芎(xiong)。治(zhi)(zhi)療血虛(xu)(xu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)為(wei)何不(bu)(bu)可(ke)大(da)劑補血養(yang)榮之(zhi)(zhi)藥中(zhong)(zhong)加(jia)入(ru)少許川(chuan)(chuan)(chuan)(chuan)芎(xiong)，既能養(yang)血和營(ying)(ying)、補而(er)不(bu)(bu)滯，又能鼓營(ying)(ying)血直上(shang)巔頂以榮腦(nao)絡治(zhi)(zhi)頭(tou)(tou)(tou)痛(tong)(tong)(tong)。《金(jin)匱(kui)翼》就載(zai)有(you)治(zhi)(zhi)血虛(xu)(xu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)之(zhi)(zhi)加(jia)味四(si)物湯（川(chuan)(chuan)(chuan)(chuan)芎(xiong)、當歸、熟地、白芍(shao)、蔓荊、菊花）。同理，沈老(lao)認為(wei)，治(zhi)(zhi)療肝(gan)陽(yang)頭(tou)(tou)(tou)痛(tong)(tong)(tong)，在天麻(ma)鉤藤飲(yin)方中(zhong)(zhong)重用(yong)(yong)(yong)養(yang)肝(gan)陰息風和引血下(xia)行(xing)之(zhi)(zhi)牛膝(xi)的(de)量，加(jia)入(ru)少許川(chuan)(chuan)(chuan)(chuan)芎(xiong)上(shang)下(xia)貫通(tong)營(ying)(ying)血。川(chuan)(chuan)(chuan)(chuan)芎(xiong)用(yong)(yong)(yong)于(yu)(yu)頭(tou)(tou)(tou)痛(tong)(tong)(tong)是(shi)有(you)利無弊(bi)的(de)。而(er)肝(gan)火頭(tou)(tou)(tou)痛(tong)(tong)(tong)古人應用(yong)(yong)(yong)《證治(zhi)(zhi)準(zhun)繩(sheng)》的(de)清肝(gan)散(san)（川(chuan)(chuan)(chuan)(chuan)芎(xiong)、山(shan)(shan)梔(zhi)、丹皮、白芍(shao)、龍(long)膽草(cao)(cao)）、宋(song)代(dai)錢乙的(de)瀉青丸（川(chuan)(chuan)(chuan)(chuan)芎(xiong)、龍(long)膽草(cao)(cao)、大(da)黃、山(shan)(shan)梔(zhi)等）歷來也(ye)有(you)所爭議(yi)，沈老(lao)主張(zhang)遣方用(yong)(yong)(yong)藥應巧用(yong)(yong)(yong)配伍、掌握適(shi)度，可(ke)變弊(bi)為(wei)利。
近(jin)年來(lai)對(dui)川芎進行(xing)了(le)深人廣泛(fan)的藥(yao)理藥(yao)效研(yan)究(jiu)，上海長海醫院報道其(qi)有以(yi)下作用：
①改善軟腦膜和外周(zhou)微(wei)循環；
②抗血(xue)(xue)小板(ban)凝(ning)集，抑制血(xue)(xue)栓素(su)A和增加前(qian)列環(huan)素(su)的(de)濃度(du)；
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蛋白元沉淀；
⑥修復(fu)變性的神經細胞樹突和保護動(dong)脈內皮細胞；
⑦增加顱(lu)內中(zhong)心動(dong)脈的(de)順應性和降(jiang)低腦血管的(de)特性阻抗；
⑧對(dui)實驗性內臟器官(心(xin)、腦、肝、脾）實質損(sun)害有明(ming)顯(xian)保(bao)護作(zuo)用(yong)。臨床上常(chang)選用(yong)速效(xiao)救(jiu)心(xin)丸緩(huan)解心(xin)絞痛，川(chuan)芎嗪靜脈滴(di)注治療急(ji)慢性缺血(xue)性腦血(xue)管疾病有顯(xian)著(zhu)療效(xiao)。
沈(shen)老在(zai)老年(nian)心腦血管疾病治療(liao)中(zhong)，尤(you)其在(zai)腦中(zhong)風恢復(fu)期(qi)、冠心病心絞(jiao)痛、心律不齊(qi)等，都(dou)在(zai)處方中(zhong)辨證配(pei)伍應用川芎，以增強療(liao)效。
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