抑郁症病机与经方证治  

Pathogenesis and Classical Prescriptions for Treatment of Syndromes of Depression

作　　者：丁元庆[1] DING Yuanqing(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014

出　　处：《山东中医杂志》2020年第4期323-326,394,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省名老中医药专家传承工作室建设项目(编号:鲁卫中发展字[2018]1号);全国中医学术流派传承工作室第二轮建设项目(编号:国中医药人教函[2019]62号)。

摘　　要：基于六经阴阳气有多少、功能各异的论述,结合临床阐述抑郁症证候特征与发病机制,提出其证治原则。抑郁症病机主要责之阳气郁遏或阳气损伤,从而形成抑郁症"情绪低落、思维缓慢、意志行为降低"即所谓的"三低"症状。由于阳气抑遏,或阳气不足,气化失常,造成神机不振。其临床证治要在通阳开郁,怡神强志,扶阳振颓。从病有虚有实之分出发,针对邪实治宜祛邪开郁,宣通阳气;针对正虚治宜振奋阳气。然无论正虚或邪实,皆需要兼顾怡悦心神。Based on the description of quantity and function of yangqi and yinqi of six meridians and clinical experiences,the syndrome characteristics,pathogenesis,medicines and prescriptions for treatment of depression were analyzed. The main pathogenesis of depression is stagnation or impairment of yangqi which causes symptoms of low spirit,slow thought and decreased activity("three-low" symptoms). The main pathogenesis of "three-low" symptoms in the disease is stagnation of yangqi,deficiency of yangqi,dysfunction of qi transformation and dysfunction of mental activity. The key treatment is activating yang to relieve the stagnation,cheering the mental state and lighting up the feelings,strengthening yang and reinforcing the mind. The disease can be divided into excess syndrome and deficiency syndrome. The excess syndrome should be treated with eliminating pathogenic factor for activating yang,while the deficiency syndrome should be treated with strengthening yang. The method of cheering the mental state and lighting up the feelings must be applied in the two syndromes.

关 键 词：抑郁症 三阴三阳 阳气郁遏 阳气损伤 气化失常 通阳开郁 怡神悦志 

分 类 号：R277.7[医药卫生—中医学]