四逆汤治疗抑郁证  

Analysis of Sini Decoction in Treatment of Depression Syndrome

作　　者：林贵英 张源鑫 彭程[1] 叶慧婷 何凯[2] 吕小亮 LIN Guiying;ZHANG Yuanxin;PENG Cheng;YE Huiting;HE Kai;LYU Xiaoliang(Hunan University of Traditional Chinese Medicine,Changsha 410208,Hunan,China;Jinan University,Guangzhou 510000,Guangdong,China;Jiangmen Hospital of Traditional Chinese Medicine Affiliated to Jinan University,Jiangmen 529000,Guangdong,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]暨南大学,广东广州510000 [3]暨南大学附属江门中医院,广东江门529000

出　　处：《实用中医内科杂志》2021年第1期140-142,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：近年来,由于社会生活节奏的加快,社会压力的增加,抑郁症的发病率不断提升,已成为全球第四大致残疾病。抑郁症是一种多病因导致的症状综合征,西医发病机制尚不明确,抗抑郁药多从单一靶点出发,普遍存在抗抑郁谱窄、起效慢、副作用大的弊端。中药方剂以多成分、毒副作用小、多效应、协同作用强和整体调节为特点,在抑郁症治疗中具有独特优势。历代医家多从"肝"论治,治疗多从疏肝解郁为主,治以逍遥散、越鞠丸等方,也可取得一定疗效。但临床上抑郁症多以情绪低落、兴趣减退、精力下降为主,即一派晦暗、阴沉、衰落等阴郁之象,从阴阳辨证来说是属于静止的、内守的、下降的,归于阴病。总的来说是精神活动的减少,精神活动靠能量维持,阳气虚衰,精神失养则精神萎靡不振,对外界事物的反应能力低下。阳气具有温煦、升发和兴奋等功能的表达,在人体生命活动中起着重要作用,阳气旺则精力充沛,精神爽;气衰则神疲乏,精神困。在《伤寒论》中,少阴属心肾二经,心之阳气旺,故精神为之振作。肾藏精,内寄元阴元阳,是五脏六腑阴阳之根本,肾阳旺盛,神精充足,人体就会生化不息。四逆汤是《伤寒论》中治疗少阴病的主方,而少阴心肾阳气不足是抑郁症主要病机,故四逆汤治疗阳虚郁证有很好的临床疗效。In recent years,due to the acceleration of the pace of social life and the increase of social pressure,the incidence of depression is increasing.It has become the fourth largest disability disease in the world.Depression is a syndrome caused by many causes.The pathogenesis of western medicine is not clear.The antidepressants are mostly from a single target and there are generally narrow antidepressant spectrum,slow onset and side effects.Traditional Chinese medicine prescription is characterized by multi-component,few toxic side effects,multi-effect,strong synergy and overall regulation,and has unique advantages in the treatment of depression.Doctors in the past dynasties treated the disease from liver mainly with the method of soothing liver to relieve depression and used Xiaoyao Powder,Yueju Pills and other prescriptions which can also obtain certain curative effect.But in clinic,the symptoms of depression are mainly interest decline,energy decline and other gloomy images,which are static,internal and declined from Yin-Yang syndrome differentiation,attributing to Yin disease.In general,the mental activity is reduced,maintained by energy.Yang Qi deficiency and mental loss can cause depressed spirit and low respond to external things.Yang Qi has the functions of warmth,rising and exciting.It plays an important role in human life activities.Full of Yang Qi can make energy and spirit healthy.In the theory of Treatise on Febrile Diseases,Shaoyin belongs to meridians of heart and kidney,and if yang Qi of heart is flourishing,the spirit will be refreshed.Kidney stores essence and inside Yuan-Yin and Yuan-Yang,and it is the root of Yin and Yang of the five Zang-forgans and six Fu-organs.If kidney Yang is exuberant,the spirit will be healthy and the human body will be ceaseless.Sini Decoction is the main prescription for treating Shaoyin disease in the theory of Treatise on Febrile Diseases,and Yang Qi deficiency of heart and kidney is the main pathogenesis of depression,and so Sini Decoction has a good clinical effect

关 键 词：抑郁症 伤寒论 四逆汤 阳虚郁证 少阴病 心肾阳虚 温阳法 

分 类 号：R289.1[医药卫生—方剂学]