符为民教授从肝论治抑郁障碍相关性失眠临床经验  

Professor FU Weimin's Clinical Experience in Treating Insomnia Related to Depression from the Perspective of Liver

作　　者：闵敏[1] 柏久莲 马天牧 王永生[1] MIN Min;BAI Jiulian;MA Tianmu(Jiangsu Provincial Hospital of Chinese Medicinc,Nanjing(210029);Affiliated Hospital of Nanjing University of Traditional Chinese Medicine)

机构地区：[1]江苏省中医院,南京210029 [2]南京中医药大学附属医院

出　　处：《浙江中医药大学学报》2018年第12期1002-1005,共4页Journal of Zhejiang Chinese Medical University

基　　金：第二批江苏省名老中医药专家传承工作室建设项目(苏中医科教[2016]6号)~~

摘　　要：[目的]总结符为民教授从肝论治抑郁障碍相关性失眠的辨证诊疗思维和临证拟方用药经验。[方法]通过跟随符为民教授临证抄方及对符为民教授治疗抑郁障碍相关性失眠典型医案的收集、整理、归纳,从病因病机、拟方用药等方面论述符为民教授从肝论治抑郁障碍相关性失眠的学术观点及临证诊疗思维,并举验案一则以佐证。[结果]符为民教授常以肝为着眼点辨证论治抑郁障碍相关性失眠,认为抑郁障碍相关性失眠的发生首责于气郁。情志之郁致肝失疏泄,气机不畅,气血失和是其基本病机。临证多从肝气郁滞、肝郁化火、肝阳上亢、肝胆郁热、肝郁脾虚、肝郁痰阻、肝肾阴虚等七个证型进行论治,临床疗效确切。所举验案具体展示了该病的辨证诊疗思路。[结论]符为民教授从肝论治抑郁障碍相关性失眠,临床特色突出,疗效斐然,其经验值得我辈认真研习、借鉴和推广。[Objective]To summarize Professor FU Weimin’s experience in diagnosis and treatment of insomnia associated with depressive disorder.[Methods]By following Professor FU Weimin and collecting,arranging and summarizing the typical medical records of Professor FU Weimin’s treatment of insomnia related to depression,the etiology and pathogenesis of insomnia were summarized.This paper discusses Professor FU Weimin’s academic view on treating insomnia related to depression disorder from the view of liver and the thinking of clinical diagnosis and treatment,and gives a case to prove it.[Results]Professor FU Weimin often regards liver as the focus to treat the insomnia related to depressive disorder,and thinks that the first responsibility for the occurrence of depressive disorder related insomnia lies in Qi depression.The basic pathogenesis of this disease is the depression of emotion,the loss of the liver,the unobstructed Qi and the disharmony of Qi and blood.The clinical effect of clinical treatment is confirmed by seven syndrome types:Stagnation of liver Qi,fire of liver depression,hyperactivity of liver Yang,stagnation of heat of liver and gallbladder,deficiency of liver and spleen,stagnation of phlegm of liver and stagnation of phlegm,deficiency of liver and kidney Yin.The examination cases showed the diagnosis and treatment of the disease.[Conclusion]Professor FU Weimin treats insomnia associated with depressive disorder from liver,its clinical characteristic is outstanding,curative effect is outstanding,its experience is worthwhile for our generation to study seriously,draw lessons from and popularize.

关 键 词：失眠 抑郁症 不寐 肝郁 气郁 郁证 医案 临床经验 

分 类 号：R575[医药卫生—消化系统]