气郁体质相关病证及方药探析  

Exploration of Syndromes and Prescriptions Related to Qi-Depression Constitution

作　　者：王雪可[1,2] 李天星 方旖旎 李玲孺 王琦[2] WANG Xueke;LI Tianxing;FANG Yini;LI Lingru;WANG Qi(Henan University of Chinese Medicine,Zhengzhou,450018;National Institute of Traditional Chinese Medicine Constitution and Preventive Medicine,Beijing University of Chinese Medicine;Institute of Basic Theory of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences;Zhejiang Chinese Medical University)

机构地区：[1]河南中医药大学,河南省450018 [2]北京中医药大学国家中医体质与治未病研究院 [3]中国中医科学院中医基础理论研究所 [4]浙江中医药大学

出　　处：《中医杂志》2023年第20期2057-2062,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81874413);国家重点研发计划(2022YFC2010104);国家中医药管理局第七批全国老中医药专家学术继承项目(国中医药办人教函[2021]272号)。

摘　　要：以气郁体质为切入点,系统梳理总结气郁体质具体病证证候表现及治疗用药。认为气郁体质人群平衡状态失调时可继发一系列病证,归纳总结出了临床最常见的四种病证,即肝郁、虚郁、痰热郁、郁结。“肝郁”为肝失疏泄,气机郁结,治疗主张肝气郁结、脾虚血少用逍遥散;肝郁脾虚、郁而化火用丹栀逍遥散;肝郁化火、气逆上冲用奔豚汤。“虚郁”为长期情志不畅,久则暗耗气血,气血衰少,治疗主张心脾两虚、心神失养用甘麦大枣汤;心肺阴虚、神魄失守用百合地黄汤。“痰热郁”为气机不舒,影响精血津液运行,聚湿成痰化热,治疗主张肝郁不舒、痰凝气结用半夏厚朴汤;肝郁痰热内扰、胆胃不和用柴胡(芩)温胆汤;肝气郁结、痰火内扰用自拟舒肝解郁汤。“郁结”为气滞血瘀痰浊集聚,日久成瘀,治疗主张肝郁不舒、痰火湿食血郁用越鞠丸;肝郁气滞血瘀用自拟乳癖散结汤。Based on qi-depression constitution,we systematically sorted out and summarized the manifestations of specific symptoms and prescriptions of qi-depression constitution.It is believed that a series of syndromes can be developed due to the imbalance in patients with qi-depression constitution.The four most common syndromes inclinic were summarized as liver depression,deficient depression,phlegm-heat depression,and stagnation.“Liver depres⁃sion”resulted from liver failing to free flow of qi,then qi stagnated,so Xiaoyao Powder(逍遥散)was recommended as treatment for liver qi depression,spleen deficiency and blood insufficiency;Danzhi Xiaoyao Powder(丹栀逍遥散)for liver depression and spleen deficiency,depression transforming into fire;Bentun Decoction(奔豚汤)for liver depres⁃sion transforming into fire,upward rushing of qi counterflow.“Deficient depression”resulted from long-term mental disorder and will consume qi and blood potentially to qi and blood deficiency,so Ganmai Dazao Decoction(甘麦大枣汤)was recommended as treatment for deficiency of both heart and spleen,and heart and spleen failing to tonify;Baihe Dihuang Decocotion(百合地黄汤)for heart and lung with yin deficiency,spirit and soul failing to guard.“Phlegm-heat depression”resulted from disturbance of qi movement,affecting the transportation of essence,blood and body fluids,gathering dampness and forming phlegm into heat.Banxia Houpo Decoction(半夏厚朴汤)was recommended as treatment for liver depression and failing to transportation,phlegm coagulation and qi stagnation;Chaihu(or Chaiqin)Wendan Decoction(柴胡(芩)温胆汤)for liver depression and phlegm-heat harassing internally,and disharmony of gallbladder and stomach;self-made Shugan Jieyu Decoction(舒肝解郁汤)for liver-qi stagnation and phlegm-fire harassing internally.“Stagnation”resulted from stagnation of Qi and blood,accumulation of turbid phlegm,and form⁃ing stasis over time,so Yueju Pill(越鞠丸)was recommended as treatment for liver depre

关 键 词：体质 气郁 病证分型 方药应用 

分 类 号：R259[医药卫生—中西医结合]