从脾论治抑郁症  

Treatment of Depression from the Spleen

作　　者：孙素鹏 王亚军[1] SUN Su-peng;WANG Ya-jun(Gansu University of TCM,Lanzhou,Gansu,China,730000)

机构地区：[1]甘肃中医药大学

出　　处：《河南中医》2019年第12期1808-1811,共4页Henan Traditional Chinese Medicine

摘　　要：寓于五行之中的"中央之土",不仅是五脏盛衰、五脏气机调畅之源,更与抑郁症发病密切相关。脾为一身气血之本,气血运化失司致五脏"神伤",进而导致情志郁结。近年来,有医家基于"思则气结"等理论从脾论治抑郁症,认为其发病与七情中的"思"关系最为密切。一方面,脾藏意主思,思则气结,思虑过度,脾胃气机升降失调,加重思虑使情志之郁更甚。另一方面,"思则伤脾",脾之运化失职,气血生成乏源,使神失所养,二者相互为病,加重抑郁症的一系列躯体症状。另外,在五行理论中,"中土五行"模式将脾作为五脏的中心,脏腑气血皆从土而生,脾土虚则五脏气虚血亏,五神志失其所居之所而为神伤,神伤则恐惧,日久忧思过度发为抑郁;"生克五行"模式中脾与其他四脏生克相关,通过子母相及、乘侮制化而达到"牵一发而动全身"的特殊作用,进而影响复杂易变的气机,而七情内起之郁,多始于伤气。The "central earth" in the five elements is not only the source of the rise and fall of the five zang organs and the smooth regulation of the five zang organs,but also closely related to the onset of depression.Spleen is the foundation of qi and blood.Qi and blood lose their normal function and cause the five viscera to be "dejected",which leads to depression.In recent years,some doctors are based on the theory of "anxiety causing qi stagnation" to treat depression from the spleen.They think that the incidence of depression is most closely related to "anxiety" in the seven emotions.On the one hand,the spleen storing will is in charge of thinking.But Excessive contemplation will lead to qi stagnation,imbalance of spleen-stomach qi mechanism,aggravation of thinking will make the depression more serious.On the other hand, "anxiety impairing spleen" causes the spleen′s dysfunction of transportation;the generation of qi and blood lacks of source.Both mutually lead to disease,and aggravate a series of physical symptoms of depression.In addition,in the theory of five elements,the model of "the middle earth of the five elements " regards the spleen as the center of the five zang organs.Qi and blood of the zang organs are all born from the earth.If the spleen is deficient,the five zang organs will be deficient in qi and blood.If the five spirits lose their own place,they will be dejected.If they are dejected,they will be frightened.If they are over worried for a long time,they will be depressed.The spleen is related to the other four zang organs in the "generation and restraint of five elements " mode,which achieves the special function of "pulling one hair and moving the whole body" through the combination of the mother and the son organs,mutual subjugation and mutual inhibition,and then affects the complex and changeable qi movement.The depression in the seven emotions mostly starts from qi injury.

关 键 词：抑郁症 从脾论治 脾虚致郁 脾伤致郁 思伤脾 因思致病 因病致思 

分 类 号：R259.494.1[医药卫生—中西医结合]